Kötter I, Eckstein A K, Stübiger N, Zierhut M
University Medical Clinic, Department Rheumatology/Clinical Immunology, Tübingen, Germany.
Br J Ophthalmol. 1998 May;82(5):488-94. doi: 10.1136/bjo.82.5.488.
To study long term effects of interferon alpha 2a (IFN alpha 2a) on panuveitis in seven patients with Behçet's disease in a prospective, open clinical trial.
Seven patients were treated with IFN alpha 2a for a mean of 23.6 months (14-37 months). They received an initial dose of IFN alpha 2a of 6 x 10(6) IU/day, followed by 3 x 10(6) IU/day after 1 month and 3 x 10(6) IU every other day after 3 months. Two patients received low dose prednisolone (between 0.2 and 0.4 mg/kg/body weight) additionally at the beginning of the therapy. Complete cessation of IFN alpha 2a was possible in three patients (observation period 22, 6, and 4 months).
Marked improvement occurred in six patients who had ocular manifestations of Behçet's disease for the first time or with minor damage during their course of chronic relapsing panuveitis. In one patient with advanced ocular Behçet's disease, new relapses were prevented. Retinal infiltrates resolved within 2 weeks; vasculitis, macular oedema, infiltration of the anterior chamber and vitreous resolved within 4 weeks. Mean posterior uveitis score before treatment (nine affected eyes) was 6.6, 4 weeks after IFN it was reduced to 0.4. The mean observation period is 27.6 months, ranging from 14 to 42 months.
Treatment of ocular symptoms of Behçet's disease with IFN alpha 2a alone or in combination with low dose steroids led to complete remission of ocular vasculitis in all patients treated in this open, uncontrolled trial. Treatment with IFN alpha 2a may prevent permanent retinal or optic nerve damage due to vascular occlusion. No severe side effects occurred. Controlled randomised studies are warranted in order to prove the efficacy of IFN alpha 2a in ocular Behçet's disease and to compare it with other, established treatments such as azathioprine or cyclosporin A.
在一项前瞻性、开放性临床试验中，研究干扰素α2a（IFNα2a）对7例白塞病全葡萄膜炎患者的长期影响。
7例患者接受IFNα2a治疗，平均治疗时间为23.6个月（14 - 37个月）。他们初始接受IFNα2a剂量为6×10⁶IU/天，1个月后减至3×10⁶IU/天，3个月后改为隔日3×10⁶IU。2例患者在治疗开始时额外接受低剂量泼尼松龙（0.2至0.4mg/kg体重）。3例患者能够完全停用IFNα2a（观察期分别为22、6和4个月）。
6例首次出现白塞病眼部表现或在慢性复发性全葡萄膜炎病程中有轻微损害的患者病情显著改善。1例患有晚期眼部白塞病的患者预防了新的复发。视网膜浸润在2周内消退；血管炎、黄斑水肿、前房和玻璃体浸润在4周内消退。治疗前平均后葡萄膜炎评分为6.6（9只患眼），IFN治疗4周后降至0.4。平均观察期为27.6个月，范围为14至42个月。
在这项开放性、非对照试验中，单独使用IFNα2a或联合低剂量类固醇治疗白塞病的眼部症状可使所有接受治疗的患者眼部血管炎完全缓解。IFNα2a治疗可预防因血管阻塞导致的永久性视网膜或视神经损伤。未发生严重副作用。有必要进行对照随机研究，以证明IFNα₂a在眼部白塞病中的疗效，并将其与其他既定治疗方法如硫唑嘌呤或环孢素A进行比较。
