The use of interferon α in behçet disease: review of the literature

To evaluate the efficacy and safety of interferon (IFN) alpha for the treatment of Behçet’s disease (BD) and discuss its possible mechanisms of action. Reports published until July 2002 in all languages were identified by the PubMed Database and the BD conference proceedings and abstract booklets. The indexing terms used were “Behçet” and “interferon.” Thirty-two original reports and 4 selected abstracts were included in the analysis. Systemic IFN-α was administered to 338 patients. One hundred eighty-two patients with acute ocular disease were treated with IFN-α. Two hundred sixty-four patients received IFN-α2a, and 74 received IFN-α2b. Eighty-six percent of the patients with mucocutaneous symptoms, 96% with arthritis, and 94% with uveitis exhibited a partial or complete response. Higher IFN doses were more effective than low-dose regimens and led to up to 56% long-term remissions after discontinuation of IFN-α were reported. IFN-α2a apparently was superior to IFN-α2b, with more complete remissions, but this probably was the result of a bias caused by the larger number of patients treated with IFN-α2a. Side effects were dose-dependent and similar to those noted in patients with hepatitis C. Although the comparability of the studies is hampered because of different study designs, IFN-α is effective for the treatment of BD. It was beneficial even in resistant posterior uveitis, in which long-term remissions with preservation of visual acuity was achieved. In contrast, mostly partial remissions were reported for mucocutaneous symptoms.