Issue: June 2017
April 26, 2017
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Interferon-alpha Led to Remission in Patients With Eosinophilic Granulomatosis With Polyangiitis

Issue: June 2017
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Among 30 patients with eosinophilic granulomatosis with polyangiitis, treatment with interferon-alpha led to remission in 25 patients, according to a recently published, observational cohort study.

“The data demonstrated that [interferon-alpha] IFN-α is an effective agent for remission induction and steroid tapering in [eosinophilic granulomatosis with polyangiitis] EGPA, although serious adverse effects may occur,” Benjamin Seeliger, MD, at Jena University Hospital, and colleagues wrote. “Given its beneficial effect on [pulmonary function test] PFT and symptoms, it provides an alternative for standard therapy, especially for patients with persistent asthmatic symptoms and without poor prognostic factors.”

Relapse rates for EGPA — an antineutrophil cytoplasmic antibody (ANCA)-associated small vessel vasculitis — have reported to be as high as 85%, the researchers wrote. After first-line agents, such as azathioprine and methotrexate, IFN-α — recommended as a second-line or third-line agent by the EGPA task force — has shown it can induce remission, but data are inconsistent in patients with refractory EGPA.

Investigators assessed 30 patients with EGPA — determined by the 1990 definition — who were treated with IFN-α between 2009 and 2015 at Jena University Hospital. They found 25 patients achieved remission — defined as a Birmingham Vasculitis Activity Score (BVAS) of 0 and a prednisolone (PSL) dose no greater than 7.5 mg per day — or partial response — defined as a BVAS of 0 and a PSL dose of greater than 7.5 mg per day. The doses declined from 17.5 mg per day to 5.5 mg per day from baseline to remission. However, there was a relapse in 16 patients. Five of these were major, which were potentially life- or organ-threatening. Severe adverse events occurred in four patients, three of which were drug-induced neuropathy and the other was autoimmune hepatitis. – by Will A. Offit

Disclosure: The researchers report no relevant financial disclosures.