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Rheumatology Advance Access originally published online on August 16, 2007
Rheumatology 2007 46(10):1570-1573; doi:10.1093/rheumatology/kem199
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© The Author 2007. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Efficacy and safety of interferon-{alpha} in the treatment of corticodependent uveitis of paediatric Behçet's disease

S. Guillaume-Czitrom, C. Berger1, C. Pajot2, B. Bodaghi3, B. Wechsler4 and I. Kone-Paut

Department of Paediatrics and Paediatric Rheumatology, Bicêtre Hospital, Le Kremlin-Bicêtre, 1Department of Paediatrics, Saint-Etienne Hospital, Saint Priest en Jarez, 2Department of Paediatrics, Purpan Hospital, Toulouse, 3Department of Ophthalmology, Pitié-Salpétrière Hospital, Paris and 4Department of Internal Medicine, Pitié-Salpétrière Hospital, Paris, France.

Correspondence to: S. Guillaume-Czitrom, Department of Paediatrics and Paediatric Rheumatology, Bicêtre Hospital, 78 rue du Général Leclerc, 94270, Le Kremlin-Bicêtre, France. E-mail: severine.guillaume{at}bct.aphp.fr


  Abstract

Objective. To report both the efficacy and safety of interferon-{alpha}-2a (IFN-{alpha}) therapy in corticodependent uveitis of paediatric Behçet's disease (BD).

Methods. Data from seven children affected with corticodependent uveitis of BD and treated with IFN-{alpha} were reviewed retrospectively. IFN-{alpha} was injected sub-cutaneously thrice a week at dosages of 1.5–3 Mons IU according to the children's weight. Efficacy was judged on the ability of IFN-{alpha} to induce a corticosteroid (CS)-sparing effect while maintaining remission. All adverse events (AE) were recorded.

Results. The children included four boys and three girls. Mean age at onset of uveitis was 8.6 yrs and mean follow-up duration was 7.14 yrs. All children had a high level of corticodependence and five of them received additional DMARDs. A remarkable CS-sparing effect with remission maintenance was achieved in 5 out of 7 patients after a mean period of 14.6 months of IFN-{alpha} administration. The remission was sustained in four of the five patients (mean = 4.8 yrs), even after IFN-{alpha} was discontinued in three of them. The other patient relapsed 1.5 yrs after IFN-{alpha} discontinuation. The last two patients faced early severe adverse events attributed to IFN-{alpha}: retinal venous thrombosis and major depression.

Conclusion. IFN-{alpha} has a potent CS-sparing effect in paediatric BD patients suffering from severe uveitis. However, the possibility of major side-effects with this treatment calls for careful monitoring.

KEY WORDS: Behçet's disease in children, Uveitis, Treatment, Interferon-{alpha}

Submitted 26 March 2007; revised version accepted 3 July 2007.
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