Interferon alfa-2a in the treatment of Behcet disease - A randomized placebo-controlled and double-blind study

Objective: To determine the therapeutic efficacy of interferon alfa-2a in the treatment of Behcet disease. Design: A randomized placebo-controlled and double-blind study. Setting: University referral center. Patients: Fifty patients with Behcet disease were involved in the study. Intervention: The patients were given interferon alfa-2a, 6 X 10(6) IU, subcutaneously 3 times per week or placebo for 3 months, and examined clinically at weekly intervals. Main Outcome Measures: For each mucocutaneous lesion and articular symptom, the mean frequency and duration were evaluated during the 3-month pretreatment, treatment, and follow-up periods. Pain for oral and genital ulcers was scored on a scale of 0 to 3. The ocular inflammatory score, the frequency of attacks, and changes in visual acuities for patients with ocular involvement were assessed before the study, at the end of treatment, and during the follow-up periods. In addition, overall responses at the end of the treatment period were graded as follows: complete remission, disappearance of all clinical signs and symptoms during treatment; partial remission, greater than a 50% decrease in the frequency, duration, and severity of pain for oral and genital ulcers and/or a decrease in the severity and frequency of ocular attacks; stable disease, less than a 50% change in the clinical signs and symptoms; and no effect or deterioration, ineffectiveness or worsening of clinical signs and symptoms. Results: Twenty-three interferon alfa-2a- and 21 placebo-treated patients, ranging in age from 16 to 55 years (mean+/-SD age, 32.38+/-7.94 years), were evaluable for efficacy. Interferon alfa-2a treatment significantly decreased the duration (P=.02) and pain (P=.01) of oral ulcers and the frequency of genital ulcers (P=.03) and papulopustular lesions (P=.01). The mean frequency and duration of erythema nodosum-like lesions (P=.77 and .27, respectively), thrombophlebitis (P=.29 and .61, respectively), and articular symptoms (P=.92 and .74, respectively) also decreased. But there were no statistically significant differences, An improvement in the severity and the frequency of ocular attacks occurred in 5 of 6 patients in the interferon alfa-2a-treated group and in 1 of 3 patients in the placebo-treated group. Of the 23 patients in the interferon alfa-2a-treated group, 15 responded to treatment (2 complete and 13 partial responses); and of the 21 patients in the placebo group, 3 responded to treatment (3 partial responses) (P<.005). Conclusion: Interferon alfa-2a is an effective alternative treatment for Behcet disease, particularly for the management of the mucocutaneous lesions of the disease.