Yang Peizeng, Deng Yang, Zhang Yinan, Zhu YunYun, Huang Ziqian, Dai Lingyu, Wu Qiuying, Su Guannan, Cao Qingfeng, Lai Yujie
The First Affiliated Hospital of Chongqing Medical University, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, No. 1 Youyi Road, Yuzhong District, Chongqing 400016, China.
Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Henan Province Eye Hospital, Henan International Joint Research Laboratory for Ocular Immunology and Retinal Injury Repair, Zhengzhou, China.
Ther Adv Chronic Dis. 2024 Dec 11;15:20406223241304889. doi: 10.1177/20406223241304889. eCollection 2024.
The application of biologic agents has benefited patients with Behcet's uveitis (BU) who do not respond to conventional treatment regimens. However, there is currently no consensus on the optimal treatment regimen of interferon alpha-2a (IFN-α2a) for refractory BU.
To evaluate treatment outcomes and safety of IFN-α2a in a large series of refractory BU patients and to explore whether nonbiologic immunomodulatory agents (cyclosporin A) other than corticosteroids should be concomitantly used.
We conducted a retrospective cohort study, which included 153 BU patients who received IFN-α2a treatment between December 2012 and September 2023 with a minimum duration of 6 months.
Best-corrected visual acuity (BCVA), the frequency of uveitis relapse, corticosteroid-sparing effect, and side effects were evaluated.
Of the 153 patients enrolled, 87 patients were treated with IFN-α2a plus corticosteroids (IC), and 66 patients were treated with IFN-α2a plus corticosteroids and cyclosporin A (ICC). Both IFN-α2a treatment regimens significantly improved BCVA as early as 2 months following treatment, and the improvement was maintained over at least a 2-year follow-up. At the final visit, 86.8% and 73.1% of the affected eyes in the ICC and IC groups achieved improved or stable vision, respectively. The ICC regimen was more effective at improving vision ( = 0.01). Overall, the frequency of uveitis relapse and the dose of oral prednisolone were significantly reduced in both groups after treatment (all < 0.0001). However, there were no statistically significant differences in these parameters between the two groups. None of the included patients experienced serious side effects that led to the discontinuation of IFN-α2a therapy.
IFN-α2a treatment is a promising option for patients with refractory BU. Our results showed that cyclosporin A as an adjunct could enhance the therapeutic effect of IFN-α2a.
生物制剂的应用使对传统治疗方案无反应的白塞氏葡萄膜炎（BU）患者受益。然而，目前对于难治性BU的干扰素α-2a（IFN-α2a）最佳治疗方案尚无共识。
评估IFN-α2a在大量难治性BU患者中的治疗效果和安全性，并探讨除皮质类固醇外是否应同时使用非生物免疫调节剂（环孢素A）。
我们进行了一项回顾性队列研究，纳入了2012年12月至2023年9月期间接受IFN-α2a治疗且最短疗程为6个月的153例BU患者。
评估最佳矫正视力（BCVA）、葡萄膜炎复发频率、皮质类固醇节省效应和副作用。
在纳入的153例患者中，87例患者接受IFN-α2a联合皮质类固醇（IC）治疗，66例患者接受IFN-α2a联合皮质类固醇和环孢素A（ICC）治疗。两种IFN-α2a治疗方案在治疗后2个月时均显著改善了BCVA，且在至少2年的随访中这种改善得以维持。在末次随访时，ICC组和IC组分别有86.8%和73.1%的患眼视力得到改善或稳定。ICC方案在改善视力方面更有效（P = 0.01）。总体而言，治疗后两组葡萄膜炎复发频率和口服泼尼松龙剂量均显著降低（均P < 0.0001）。然而，两组在这些参数上无统计学显著差异。纳入的患者均未出现导致IFN-α2a治疗中断的严重副作用。
IFN-α2a治疗是难治性BU患者的一个有前景的选择。我们的结果表明，环孢素A作为辅助药物可增强IFN-α2a的治疗效果。
