Interferon-α2a treatment for refractory Behçet's disease

We report a young male patient with Behçet's disease who suffered from sight-threatening recurrences under treatment with azathioprine, cyclosporine, and prednisolone. His uveitis responded well to antitumor necrosis factor (TNF)-alpha (adalimumab) for 5 months subsequently. Severe uveitis recurred soon after discontinuation of anti-TNF alpha therapy and could not be controlled well with reinstitution of the anti-TNF alpha therapy. Interferon-α2a (IFN-α2a) was then given along with low-dose oral prednisone (10 mg/day), and the uveitis responded well to this therapy. We continued a maintenance dose with of IFN-α2a three times/week for 2 years. Sight-threatening uveitis did not recur under IFN-α2a therapy, and the visual acuity improved from "counting fingers" to 20/100 in the right eye, while remaining stable with 20/20 vision in the left eye. The patient had flu-like symptoms, fever, and severe depression during IFN therapy, but an attempt to discontinue INF led to relapse within 1 month. This case report suggests that IFN-α2a could be an option for treatment in Behçet's uveitis. Further study is needed to clarify the efficacy and appropriate strategy for IFN-α2a therapy for Behçet's uveitis in Taiwan.