Differential efficacy of human recombinant interferon-α2a on ocular and extraocular manifestations of behçet disease: results of an open 4-center trial
Section snippets
Study design
Fifty patients with refractory ocular BD were included in 4 participating hospitals between March 1995 and March 2000. The final evaluation was performed in March 2001. Forty-six patients fulfilled the International Study Group Criteria (16), and 4 patients had incomplete BD with typical oral aphthous ulcers and panuveitis with occlusive retinal vasculitis and/or hypopion. The study protocol (adhering to the Declaration of Helsinki) had been approved by the Ethics Committee of each hospital and
Results
Fifty patients were included (9 in Essen, 5 in Freiburg, 2 in Göttingen, 34 in Tübingen). The mean age was 32 years (SD, 7.6, range, 21–52, years) male:female ratio, 36:14, and mean duration of BD was 5.2 (SD, 4.8, range, 0–19) years. HLA-B51 was positive in 41 patients (81%). All 50 patients had typical oral aphthous ulcers (100%), 38 patients had cutaneous manifestations (76%), 26 had genital ulcers (52%), 24 had arthritis (48%), 3 patients had vascular manifestations (deep vein thrombosis)
Discussion
Severe, sight-threatening ocular disease usually is treated with AZA or CSA 23, 27, 28, 29, 30. In refractory cases, combinations of both drugs with glucocorticosteroids or cyclophophamide or chlorambucil have been used 30, 31, 32, 33, 34, sometimes with serious side effects such as renal insufficiency (when CSA at more than 5 mg/kg was required) or secondary malignancy 29, 35, 36. In the present study, rhIFN-α2a was primarily instituted to treat severe refractory ocular BD. For this
Acknowledgements
The authors thank Prof C. A. Müller, Tübingen, for the HLA-analysis; Prof R. Klein, Tübingen, for the detection of autoantibodies; U. Rückwaldt and S. Koch for their technical assistance; and Prof Graham Pawelec, Tübingen, for his critical review of the manuscript.
Ina Kötter, MD: University Hospital, Department of Internal Medicine II (Hematology, Oncology, Immunology, and Rheumatology), Tübingen, Germany
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Ina Kötter, MD: University Hospital, Department of Internal Medicine II (Hematology, Oncology, Immunology, and Rheumatology), Tübingen, Germany
Reinhard Vonthein, PhD: University Hospital, Department of Medical Biometry, Tübingen, Germany
Manfred Zierhut, MD: University Hospital, Department of Ophthalmology, Tübingen, Germany
Anja Katrin Eckstein, MD: University Hospital, Department of Ophthalmology, Essen, Germany
Thomas Ness, MD: University Hospital, Department of Ophthalmology, Freiburg, Germany
Ilhan Günaydin, MD: University Hospital, Department of Internal Medicine II (Hematology, Oncology, Immunology, and Rheumatology), Tübingen, Germany;
Bodo Grimbacher, MD: University Hospital, Department of Internal Medicine, Division of Clinical Immunology and Rheumatology, Freiburg, Germany
Sabine Blaschke, MD: University Hospital, Department of Internal Medicine, Division of Nephrology and Rheumatology, Göttingen, Germany
Hans Hartmut Peter, MD: University Hospital, Department of Internal Medicine, Division of Clinical Immunology and Rheumatology, Freiburg, Germany
Nicole Stübiger, MD: University Hospital, Department of Ophthalmology, Tübingen, Germany