Interferon-alpha as an effective treatment for noninfectious posterior uveitis and panuveitis

Jarka Plskova, Kathrin Greiner, John V. Forrester

Research output: Contribution to journalArticle

70 Citations (Scopus)

Abstract

PURPOSE: Several studies have shown the capacity of interferon-alpha UFN-alpha) to control ocular Behcet disease. The authors aimed to determine whether IFN-alpha was effective in treating patients with severe, refractory sight-threatening intraocular inflammation (uveitis) from a wider range of causes, including Behcet disease.

DESIGN: Prospective, interventional case series.

METHODS: Twelve patients with sight-threatening uve, itis that failed to respond to one or more immunosuppres, sive regimens were enrolled to this study. Recombinant human IFN-alpha-2b was administered subcutaneously daily, and the dose was adjusted according to the clinical response. Main outcome measures were visual acuity, clinical activity of uveitis (including binocular indirect ophthalmoscopy [BIO] score and presence or absence of macular edema), and adverse effects of the treatment.

RESULTS: The mean observation period was I I months (range, one to 29 months). A positive clinical response was observed in 83% of patients. Median visual acuity improved from 0.54 to 0.2 (logarithm of the minimum angle of resolution units; P < .001) and median BIO score decreased from 1.0 to 0.5 (P < .05) within one month of treatment. Macular edema, if present, resolved in all patients within days of treatment. The main adverse events were tiredness, lymphopenia, flu-like symptoms, and transient increase of liver enzymes. Weight loss occurred in four patients. Four patients experienced depression, one of them attempting suicide. Three patients experienced typical features of IFN-alpha-associated retinopathy, which resolved on reducing the dose.

CONCLUSIONS: IFN-alpha seems to have significant potential in treatment of severe, sight-threatening refractory uveitis from a variety of causes. A range of adverse events, including IFN-alpha-associated retinopathy, may occur and could limit the use of this immunomodulatory drug.

Original languageEnglish
Pages (from-to)55-61
Number of pages7
JournalAmerican Journal of Ophthalmology
Volume144
Issue number1
DOIs
Publication statusPublished - Jul 2007

Keywords

  • induced depression
  • Behcet-disease
  • TNF-alpha
  • retinopathy
  • therapy
  • management

Cite this

Interferon-alpha as an effective treatment for noninfectious posterior uveitis and panuveitis. / Plskova, Jarka; Greiner, Kathrin; Forrester, John V.

In: American Journal of Ophthalmology, Vol. 144, No. 1, 07.2007, p. 55-61.

Research output: Contribution to journalArticle

Plskova, Jarka ; Greiner, Kathrin ; Forrester, John V. / Interferon-alpha as an effective treatment for noninfectious posterior uveitis and panuveitis. In: American Journal of Ophthalmology. 2007 ; Vol. 144, No. 1. pp. 55-61.
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N2 - PURPOSE: Several studies have shown the capacity of interferon-alpha UFN-alpha) to control ocular Behcet disease. The authors aimed to determine whether IFN-alpha was effective in treating patients with severe, refractory sight-threatening intraocular inflammation (uveitis) from a wider range of causes, including Behcet disease.DESIGN: Prospective, interventional case series.METHODS: Twelve patients with sight-threatening uve, itis that failed to respond to one or more immunosuppres, sive regimens were enrolled to this study. Recombinant human IFN-alpha-2b was administered subcutaneously daily, and the dose was adjusted according to the clinical response. Main outcome measures were visual acuity, clinical activity of uveitis (including binocular indirect ophthalmoscopy [BIO] score and presence or absence of macular edema), and adverse effects of the treatment.RESULTS: The mean observation period was I I months (range, one to 29 months). A positive clinical response was observed in 83% of patients. Median visual acuity improved from 0.54 to 0.2 (logarithm of the minimum angle of resolution units; P < .001) and median BIO score decreased from 1.0 to 0.5 (P < .05) within one month of treatment. Macular edema, if present, resolved in all patients within days of treatment. The main adverse events were tiredness, lymphopenia, flu-like symptoms, and transient increase of liver enzymes. Weight loss occurred in four patients. Four patients experienced depression, one of them attempting suicide. Three patients experienced typical features of IFN-alpha-associated retinopathy, which resolved on reducing the dose.CONCLUSIONS: IFN-alpha seems to have significant potential in treatment of severe, sight-threatening refractory uveitis from a variety of causes. A range of adverse events, including IFN-alpha-associated retinopathy, may occur and could limit the use of this immunomodulatory drug.

AB - PURPOSE: Several studies have shown the capacity of interferon-alpha UFN-alpha) to control ocular Behcet disease. The authors aimed to determine whether IFN-alpha was effective in treating patients with severe, refractory sight-threatening intraocular inflammation (uveitis) from a wider range of causes, including Behcet disease.DESIGN: Prospective, interventional case series.METHODS: Twelve patients with sight-threatening uve, itis that failed to respond to one or more immunosuppres, sive regimens were enrolled to this study. Recombinant human IFN-alpha-2b was administered subcutaneously daily, and the dose was adjusted according to the clinical response. Main outcome measures were visual acuity, clinical activity of uveitis (including binocular indirect ophthalmoscopy [BIO] score and presence or absence of macular edema), and adverse effects of the treatment.RESULTS: The mean observation period was I I months (range, one to 29 months). A positive clinical response was observed in 83% of patients. Median visual acuity improved from 0.54 to 0.2 (logarithm of the minimum angle of resolution units; P < .001) and median BIO score decreased from 1.0 to 0.5 (P < .05) within one month of treatment. Macular edema, if present, resolved in all patients within days of treatment. The main adverse events were tiredness, lymphopenia, flu-like symptoms, and transient increase of liver enzymes. Weight loss occurred in four patients. Four patients experienced depression, one of them attempting suicide. Three patients experienced typical features of IFN-alpha-associated retinopathy, which resolved on reducing the dose.CONCLUSIONS: IFN-alpha seems to have significant potential in treatment of severe, sight-threatening refractory uveitis from a variety of causes. A range of adverse events, including IFN-alpha-associated retinopathy, may occur and could limit the use of this immunomodulatory drug.

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