Interferon alfa-2a appears to provide some benefit as a second-line treatment for uveitis in patients who relapse after treatment with corticosteroids and immunosuppressants, according to a study published online on October 18 in the British Journal of Ophthalmology.
Among 45 patients (median age, 32 years), 19 of 23 patients with Behçet's disease (BD) and 13 of 22 patients with other conditions achieved control of their uveitis with interferon therapy during a median follow-up of 30 months, wrote Dr. Bahram Bodaghi and colleagues in their report (Br. J. Ophthalmol. DOI:10.1136/bjo.2006.101550).
In the retrospective, single-center study, patients received subcutaneous interferon alfa-2a at 3 million U three times/week, with intravenous pulses of methylprednisolone, followed by oral prednisone. Oral acetaminophen was administered to prevent interferon-associated side effects.
Patients continued on interferon until they had been in complete remission for at least 9 months, according to Dr. Bodaghi and colleagues at the University of Paris.
Overall, 10 patients with BD and 4 patients without BD discontinued interferon; of these, 4 patients with BD and 1 patient without BD had subsequent relapses.
All five of these patients responded to reintroduction of interferon with an initially increased steroid dose.
Multiple relapses occurred in four patients with BD and one patient without BD during treatment, indicating that the treatment was not effective in these patients.
The median oral prednisone threshold, which reflects the dose that leads to relapse during tapering, decreased significantly from 23.6 mg/day at baseline to 10 mg/day at the end of the period of follow-up.
The most common side effect was a flu-like syndrome at treatment initiation.
Two patients had major side effects from interferon treatment, including one case of severe depression requiring treatment discontinuation and one case of major neutropenia requiring temporary interruption.
The authors concluded that controlled studies are needed to further investigate the optimal dose and duration of interferon treatment in patients with uveitis.