97th DOG Annual Meeting 1999
TREATMENT OF OCULAR BEHÇET`S DISEASE (BD) WITH RECOMBINANT HUMAN INTERFERON-a2a (IFNa2a) - A THREE CENTER PILOT STUDY
N. Stübiger1, I. Kötter2, A. K. Eckstein3, T. Ness4, M. Zierhut1
BD is a multisystem vasculitis of unknown origin. Visual outcome in BD is bad irrespective of therapy, leading to significant loss off vision in 60% of the cases. IFNa was shown to be effective in arthritis and mucocutaneous disease in several uncontrolled studies. We investigated whether IFNa2a is effective in severe ocular BD.
Patients: Thirty patients (m:f=21:9) with severe ocular BD (Uveitis posterior/Panuveitis) fulfilling the International Study Group Criteria were treated with IFN(alpha)2a. Efficacy was evaluated by the uveitis scoring system (Ben Ezra et al.), visual acuity, and BD activity score.
Results: Posterior uveitis score fell from 4.4 to 1.1, visual acuity rose from 0.2 to 0.6, and mean BD activity score fell from 7.9 to 2.4 (mean observation period 21 months). There were three non-responder. One patient was lost for follow up because of noncompliance. Two patients had to stop therapy because of intolerable side effects (hair loss in one, depression and diarrhea in the other). Other side effects were development of fibromyalgia (n=3), of thyroid antibodies (n=2), in one case with hyperthyroidism, of antinuclear antibodies (n=6) and exacerbation of psoriasis (n=2).
Conclusion: IFN(alpha)2a seems to be very effective in ocular BD and in other features of the disease. A randomized controlled study in comparison to cyclosporin A is warranted to prove this promising results.
1Universitäts-Augenklinik, Schleichstrasse 12, D-72076 Tübingen
2Medizinische Universitätsklinik, Otfried-Müller-Str. 10, D-72076Tübingen
3Universitäts-Augenklinik, Hufelandstrasse 55, D- 45122 Essen
4Universitäts-Augenklinik, Killianstrasse 5, D-79106 Freiburg