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Long‐term efficacy of interferon in severe uveitis asssociated with Behçet disease
Author(s) -
DIWO E,
GUEUDRY J,
WESCHLER B,
SAADOUN D,
LE HOANG P,
BODAGHI B
Publication year - 2014
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2014.t053.x
Subject(s) - medicine , discontinuation , uveitis , prednisone , macular edema , behcet's disease , visual acuity , retrospective cohort study , retinal vasculitis , vasculitis , fluorescein angiography , surgery , intermediate uveitis , gastroenterology , ophthalmology , anterior uveitis , disease
Purpose We aimed to evaluate long‐term efficacy of interferon alpha 2a (IFNα2a) in severe Behçet disease(BD)‐related uveitis. Methods Our retrospective study includes all patients with severe uveitis treated with IFNα2a for at least 18 consecutive months at Pitié Salpêtrière Hospital between 05/1995 and 07/2013. Before, during and after treatment, best corrected visual acuity (VA), ophthalmologic examination and fluorescein angiography were performed to evaluate the number of acute uveitis. The main evaluation criteria was the number of uveitis relapses per person per year before, during and after treatment. Results 33 patients, 12W/21M, with a mean age of 30,5 years and with mainly panuveitis (74.2%) were included. The mean observation period was 8,82 years. We followed 33, 25, 20 and 18 patients for 2, 4, 7 and 9 years respectively. The relapse rate decreased from 1,36 before treatment to 0,045 relapses/patient/year during IFNα treatment. After IFNα discontinuation (possible for 64% of all patients), it increased to 0,057 relapses/patient/year and the mean period between discontinuation and relapse was 24.2 months. Average VA improved from 0,49 to 0,27 and from 0,55 to 0,39 LogMar for the patients with a followed‐up of 4 and 9 years respectively. During 4 years following IFNα2a initiation, we observed rapid decrease of anterior inflammation, hyalitis, vasculitis, macular and papillary edema. Mean oral prednisone consumption decreased from 22,8 mg at IFN initiation to 5,5 mg per day at 9 years. Conclusion IFNα2a is efficient to treat severe BD‐related uveitis. For initial responders allowing discontinuation of IFNα2a, the long‐term remission was confirmed with our study.