The use of interferon-alfa in Behçet's disease: review of the literature

Objective

To evaluate the efficacy and safety of interferon-alfa for the treatment of Behçet's disease and discuss its possible mechanisms of action.

Methods

Reports published until July 2002 in all languages were identified by the PubMed database and the Behçet's disease conference proceedings and abstract booklets. The indexing items used were Behçet and interferon.

Results

Thirty-two original reports and four selected abstracts were included in the analysis. Systemic IFN-alfa was administered to 405 patients. Two hundred and sixteen patients with acute ocular disease were treated with IFN-alfa. Two hundred and ninety eight patients received IFN-alfa2a and 141 IFN-alfa2b. 85.6% of the patients with mucocutaneous symptoms, 95.8% with arthritis and 95.6% with uveitis exhibited a partial or complete response. Higher IFN doses were more effective than low dose regimens and led up to 56% long term remissions after discontinuation of IFN-alfa. IFN-alfa2a apparently was superior to IFN-alfa2b with more complete remissions, but this probably was due to a bias caused by the larger number of patients treated with IFN-alfa2a. Side effects were dose dependent and similar to those occurring in patients with hepatitis C.

Conclusions

Although the comparability of the studies is hampered due to different study designs, it can be concluded that IFN-alfa is effective for the treatment of BD. It was effective even in resistant posterior uveitis, where long-term remissions with preservation of visual acuity could be achieved. In contrast, for mucocutaneous symptoms, only partial remissions were reported.