Background/Purpose: Uveitis is one of the leading causes of morbidity in Behcet’s patients which may result in irreversible vision loss. Evidence is accumulating that interferon (IFN) α2a might be a promising treatment for Behcet’s Uveitis (BU) refractory to conventional immunosuppressive agents. The practical value of these studies, however, is limited by their heterogeneity in terms of ethnic and racial backgrounds of the patients, indication, dosage and duration of IFN treatment. In addition, while IFN was commonly given only with corticosteroids, whether and (if so) how it could be used as a combinatorial agent to conventional immunosuppressants remains to be further elucidated.In this study, we aimed to investigate the efficacy and safety of IFNα2a as an add-on treatment for refractory BU.

Methods:

Twenty-six refractory BU patients who received IFNα2a treatment in Peking Union Medical College Hospital between February 2015 and October 2017 were retrospectively reviewed. IFNα2a was used mainly as an add-on treatment for BU patients who underwent relapse under corticosteroids and conventional immunosuppressive agents. The primary outcomes were treatment success rate and changes in ocular relapse rates before and after initiation of IFNα2a. Disease activity, corticosteroid- and immunosuppressant-sparing effects, as well as side effects were secondary outcomes.

Results:

A total of 26 patients (23 males and 3 females) with a mean age of 30.5±8.6 years were included. Eighteen patients (69.2%) were treated with at least 2 immunosuppressive agents before the initiation of IFNα2a. Treatment success was achieved in 24 patients (92.3%), and the median uveitis relapse rate decreased from 8 (range 2-12) to 0 (range 0-6) per patient-year (p=0.000008) during a mean follow-up of 13.6±6.0 months, corticosteroids were lowered in 20 cases (76.9%) and completely withdrawn in 2 (7.7%). In addition, immunosuppressive agents were reduced in number and dosage in 16 (61.5%) and 23 patients (88.5%), respectively, and were completely withdrawn in 5 cases (19.2%). No severe adverse events were observed and serum autoantibodies remained negative during the treatment of IFNα2a.

Conclusion: IFNα2a is effective and relatively safe in refractory BU, with significant steroid- and immunosuppressant-sparing effects.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/efficacy-and-safety-of-interferon-%ce%b12a-as-an-add-on-treatment-for-refractory-behcets-uveitis/