Long-term remission after cessation of interferon-α treatment in patients with severe uveitis due to Behçet's disease

Abstract

Objective. 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. Methods. 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. Results. 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. Conclusion. Our findings indicate that IFNα induces long-lasting remission in patients with severe ocular BD, resulting in a notable improvement in visual prognosis. © 2010, American College of Rheumatology.