Department of Ophthalmology, Faculty of Medicine, Ankara University, Mamak Cad. Dikimevi, Ankara, Turkey.
J Ocul Pharmacol Ther. 2012 Aug;28(4):439-43. doi: 10.1089/jop.2011.0238. Epub 2012 Mar 28.
Corticosteroids, the main treatment option in acute attacks of ocular Behcet's disease (BD), are ineffective in preventing recurrent inflammation. Even combined therapy with systemic corticosteroids and azathioprine, cyclosporine, chlorambucil, or cyclophosphamide may be ineffective in controlling the disease in severe cases. We report our clinical experience with the efficacy and tolerability of interferon alpha-2a (IFN-α-2a) monotherapy in patients with Behcet uveitis refractory to conventional immunosuppressive agents.
We retrospectively analyzed the medical records of 12 Turkish Behcet patients who had been treated with IFN-α-2a between February 2009 and October 2011 because of severe uveitis refractory to traditional immunosuppressants. IFN-α-2a was initially administered at 4.5×10(6) IU/day subcutaneously; then, the dosage was tapered gradually depending on the clinical response. Previous immunosuppressive drugs such as systemic corticosteroids, azathioprine, and cyclosporine were stopped 1 day before the initiation of IFN-α-2a treatment.
The mean duration of IFN-α-2a use was 13.3 months (range: 3-28 months). Eighty-three percent of patients with ocular BD achieved partial or complete response. Best-corrected visual acuity improved or remained stable in all of patients. All patients experienced flu like symptoms responding to oral acetaminophen, hair loss was also developed in 7 of them (58%), and psoriatic skin rash was seen in 3 patients (25%) during treatment with IFN-α-2a. No other side effects were observed.
IFN-α-2a treatment is effective in Behcet uveitis refractory to traditional treatment regimens and provides significant improvement in visual prognosis.
皮质类固醇是治疗眼部贝赫切特病（BD）急性发作的主要选择，但在预防复发炎症方面无效。即使联合使用全身皮质类固醇和巯嘌呤、环孢素、苯丁酸氮芥或环磷酰胺治疗，在严重病例中也可能无法控制疾病。我们报告了干扰素α-2a（IFN-α-2a）单药治疗对常规免疫抑制剂治疗抵抗的贝赫切特葡萄膜炎患者的疗效和耐受性的临床经验。
我们回顾性分析了 2009 年 2 月至 2011 年 10 月期间因严重葡萄膜炎对传统免疫抑制剂治疗抵抗而接受 IFN-α-2a 治疗的 12 例土耳其贝赫切特患者的病历。IFN-α-2a 最初以 4.5×10(6)IU/天皮下给药；然后，根据临床反应逐渐减少剂量。在开始 IFN-α-2a 治疗前一天停止使用以前的免疫抑制剂，如全身皮质类固醇、巯嘌呤和环孢素。
IFN-α-2a 使用的平均时间为 13.3 个月（范围：3-28 个月）。83%的眼部 BD 患者获得部分或完全缓解。所有患者的最佳矫正视力均有所改善或保持稳定。所有患者均出现流感样症状，口服对乙酰氨基酚即可缓解，其中 7 例（58%）出现脱发，3 例（25%）出现银屑病皮疹。在 IFN-α-2a 治疗期间未观察到其他不良反应。
IFN-α-2a 治疗对传统治疗方案抵抗的贝赫切特葡萄膜炎有效，可显著改善视力预后。
