Deuter Christoph M E, Zierhut Manfred, Möhle Antje, Vonthein Reinhard, Stöbiger Nicole, Kötter Ina
Centre for Ophthalmology, Tübingen University Hospital, Tübingen, Germany.
Arthritis Rheum. 2010 Sep;62(9):2796-805. doi: 10.1002/art.27581.
To retrospectively assess the development of visual acuity and the frequency and duration of relapse-free periods in patients who were treated with interferon-α (IFNα) for severe uveitis due to Behçet's disease (BD) and who completed a followup period of ≥2 years.
IFN alfa-2a was administered at an initial dosage of 6 million IU per day, then tapered to a maintenance dosage of 3 million IU twice per week, and finally discontinued, if possible. In case of a relapse, IFN treatment was repeated. Visual acuity at the end of followup was compared with visual acuity when ocular disease was in remission.
Of 53 patients (96 eyes), 52 (98.1%) responded to IFN. In 47 patients (88.7%), IFN could be discontinued when the disease was in remission. Twenty of these 47 (42.6%) needed a second treatment course during a median followup of 6.0 years (range 2.0-12.6 years). Visual acuity improved or remained unchanged in 91 eyes (94.8%). Ocular disease was still in remission in 50% of the patients 45.9 months after cessation of the first IFN course. The relapse rate tended to be lower in women than in men. The BD activity score decreased significantly during followup, but long-term remission of nonocular BD manifestations was not achieved. However, since local treatments were sufficient, no systemic treatment was administered.
Our findings indicate that IFNα induces long-lasting remission in patients with severe ocular BD, resulting in a notable improvement in visual prognosis.
回顾性评估因白塞病（BD）导致严重葡萄膜炎且接受α干扰素（IFNα）治疗并完成≥2年随访期的患者的视力发展情况以及无复发期的频率和持续时间。
IFNα-2a初始剂量为每日600万国际单位，然后逐渐减量至维持剂量每周两次，每次300万国际单位，若可能则最终停药。若复发，则重复IFN治疗。将随访结束时的视力与眼部疾病缓解时的视力进行比较。
53例患者（96只眼）中，52例（98.1%）对IFN有反应。47例患者（88.7%）在疾病缓解时可停用IFN。这47例患者中有20例（42.6%）在中位随访6.0年（范围2.0 - 12.6年）期间需要第二个疗程的治疗。91只眼（94.8%）的视力得到改善或保持不变。在首次IFN疗程停止后45.9个月，50%的患者眼部疾病仍处于缓解状态。女性的复发率往往低于男性。随访期间BD活动评分显著降低，但非眼部BD表现未实现长期缓解。然而，由于局部治疗足够，未进行全身治疗。
我们的研究结果表明，IFNα可诱导严重眼部BD患者实现长期缓解，从而显著改善视力预后。
