Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Therapeutic Outcomes of Interferon-Alpha-2a Treatment in Behçet Uveitis
Behçet Üveitinde İnterferon-Alfa-2a Tedavisi Sonuçları
Burcu KEMER ATİKa, Çiğdem ALTANb, Berna BAŞARIRb
aDepartment of Ophthalmology, Health Sciences University Gaziosmanpaşa Training and Research Hospital, İstanbul, TURKEY
bDepartment of Ophthalmology, Health Sciences University Beyoğlu Eye Training and Research Hospital, İstanbul, TURKEY
Turkiye Klinikleri J Ophthalmol. 2020;29(4):294-9
doi: 10.5336/ophthal.2020-74706
Article Language: EN
Full Text
ABSTRACT
 Objective: To evaluate the efficacy and safety of interferon-alpha-2a (IFNα-2a) therapy in patients with Behçet uveitis. Material and Methods: The patients who were treated with IFNα-2a therapy due to Behçet uveitis refractory to conventional immunosuppressive therapies were evaluated retrospectively. The visual acuities, activity of ocular inflammation were recorded at each visit during the follow-up and ocular and systemic side effects were also monitored. The paired sample t-test was used in comparison of pre- and postIFNα-2a visual acuity values. Results: Twenty-five patients (23 males and 2 females) with refractory Behçet uveitis were included in this study. The average patient age at the time of diagnosis was 28.96±7.56 years. The mean follow-up period after the initiation of IFNα-2a therapy was 18.16±12.12 months. The mean best corrected visual acuity (BCVA) at the last visit before IFNα-2a therapy was 0.48±0.32 in the right eye and 0.44±0.38 in the left eye. At the end of follow-up, the mean BCVA was 0,61 ± 0.36 in the right and 0.60 ± 0.38 in the left, which improved with IFNα-2a therapy in both eyes (p=0.010, p=0.003; respectively). The mean number of uveitis attacks per year was 2.74±0.96 before the IFNα-2a therapy. During the IFNα-2a therapy period, mean 1.17 uveitis attacks per year were observed in 6 patients. The complete or partial remission was achieved in 22 (88%) patients with IFNα-2a treatment. The IFNα-2a therapy was discontinued due to complete remission in 5 (20%) patients during follow-up. In 3 patients (treatment failure in 2 and progressive weight loss in 1), switch to anti-tumor necrosis factor was recommended. Conclusion: Interferon alpha-2a treatment is an effective and safe treatment option in Turkish population with Behçet uveitis refractory to conventional immunosuppressive therapies.

Keywords: Behçet disease; Behçet uveitis; interferon-alfa 2a; refractory uveitis
ÖZET
 Amaç: Behçet üveiti olgularında interferon-alfa-2a (IFNα2a) tedavisinin etkinliği ve güvenirliliğini değerlendirmek. Gereç ve Yöntemler: Konvansiyonel immünsüpresif tedavilere dirençli Behçet üveiti nedeniyle IFNα-2a tedavisi alan olgular retrospektif olarak değerlendirildi. Görme keskinlikleri, oküler inflamasyon aktivitesi takip süresi boyunca her vizitte kaydedildi ve aynı zamanda oküler ve sistemik yan etkiler de takip edildi. İnterferon-alfa-2a öncesi ve sonrası görme keskinliği değerlerinin karşılaştırılmasında eşleştirilmiş örnek t-testi kullanıldı. Bulgular: Refrakter Behçet üveiti olan 25 olgu (23 erkek- 2 kadın) çalışmaya dahil edildi. Olguların ortalama tanı yaşı 28,96±7,56 yıl idi. Olguların IFNα-2a tedavisi başlangıcı sonrası ortalama takip süreleri 18,16±12,12 ay idi. İnterferon-alfa-2a tedavisi öncesi son vizitteki ortalama en iyi düzeltilmiş görme keskinliği (EİDGK) sağ gözde 0,48±0,32 ve sol gözde 0.44±0.38 idi. Takip süresi sonunda olguların EİDGK değerleri, IFNα-2a tedavisi ile her iki gözde de artış göstererek, sağ gözde 0,61±0,36, sol gözde 0,60±0,38'e ulaştı (sırasıyla; p=0,010, p=0,003). İnterferon-alfa-2a tedavisi öncesi olgularda ortalama 2,74±0,96 /yıl üveit atağı izlendi. İnterferon-alfa-2a tedavisi boyunca, 6 hastada ortalama 1,17/yıl üveit atağı izlendi. İnterferon-alfa2a tedavisi ile 22 olguda (%88) tam veya kısmi remisyon sağlandı. Beş olguda (%20) IFNα-2a tedavisi tam remisyona ulaşıldığı için kesilerek takiplere devam edildi. Üç olguya (2 olgu tedavi yetersizliği, 1 olgu ilerleyici kilo kaybı nedeniyle) anti-tümör nekrozis faktör tedavisine geçiş önerildi. Sonuç: Konvansiyonel immünsüpresif tedavilere dirençli Behçet üveiti olan Türk popülasyonunda, IFNα2a tedavisi etkili ve güvenilir bir tedavi seçeneğidir.

Anahtar Kelimeler: Behçet hastalığı; Behçet üveiti; interferon-alfa 2a; refrakter üveit
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