Pegylated interferon-α-2b reduces corticosteroid requirement in patients with Behçet's disease with upregulation of circulating regulatory T cells and reduction of Th17
العنوان: | Pegylated interferon-α-2b reduces corticosteroid requirement in patients with Behçet's disease with upregulation of circulating regulatory T cells and reduction of Th17 |
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المؤلفون: | Oren Tomkins-Netzer, Stephen Taylor, William Lynn, Dorian O. Haskard, Catey Bunce, R Moots, Miles Stanford, D. S. Yang, Susan Lightman, Virginia L. Calder, H Longhurst |
المساهمون: | National Institute for Health Research |
المصدر: | Annals of the rheumatic diseases. 74(6) |
سنة النشر: | 2014 |
مصطلحات موضوعية: | Male, medicine.medical_treatment, Azathioprine, DMARDs (biologic), Gastroenterology, T-Lymphocytes, Regulatory, Polyethylene Glycols, Adrenal Cortex Hormones, Surveys and Questionnaires, Immunology and Allergy, Single-Blind Method, T Cells, Behcet Syndrome, TNF-ALPHA THERAPY, Immunosuppression, TREG-CELLS, Middle Aged, Recombinant Proteins, DIFFERENTIATION, Treatment Outcome, 1107 Immunology, Rheumatoid arthritis, Cyclosporine, Corticosteroid, Drug Therapy, Combination, Female, Life Sciences & Biomedicine, Immunosuppressive Agents, medicine.drug, Adult, medicine.medical_specialty, UVEITIS, medicine.drug_class, Immunology, Alpha interferon, Interferon alpha-2, Antiviral Agents, General Biochemistry, Genetics and Molecular Biology, Mycophenolic acid, Tacrolimus, 1117 Public Health and Health Services, Rheumatology, Internal medicine, INFLIXIMAB, Post-hoc analysis, medicine, Corticosteroids, Humans, Lymphocyte Count, Adverse effect, Science & Technology, PROSPECTIVE TRIAL, business.industry, Interferon-alpha, 1103 Clinical Sciences, Mycophenolic Acid, Behcet's disease, EFFICACY, medicine.disease, RHEUMATOID-ARTHRITIS, Arthritis & Rheumatology, Methotrexate, Quality of Life, Th17 Cells, business |
الوصف: | OBJECTIVE: To determine whether the addition of 26 weeks of subcutaneous peginterferon-α-2b could reduce the requirement for systemic corticosteroids and conventional immunosuppressive medication in patients with Behcet's disease (BD). METHODS: We conducted a multicentre randomised trial in patients with BD requiring systemic therapy. Patients were randomised to 26 weeks of peginterferon-α-2b in addition to their standard care or to standard care only and followed 6-monthly for 3 years with BD activity scores and quality of life questionnaires. Patients at one centre had blood taken to measure regulatory T cells (Tregs) and Th17 cells. RESULTS: 72 patients were included. At months 10-12, while among the entire patient population there was no difference in the corticosteroid dose or immunosuppression use between the treatment groups (adjusted OR 1.04, 95% CI 0.34 to 3.19), post hoc analysis revealed that in patients who were on corticosteroids at baseline the corticosteroid requirement was significantly lower in the peginterferon-α-2b (6.5 (5-15) mg/day) compared with the non-interferon group (10 (8.25-16.5) mg/day, p=0.039). Furthermore, there was a trend towards an improved quality of life that became significant by 36 months (p=0.008). This was associated with a significant rise in Tregs and a decrease in Th17 cells which was still present at 1 year and 6 months after the interferon was stopped. The safety profile was similar with adverse events in 10% in both groups. CONCLUSIONS: The addition of peginterferon-α-2b to the drug regime of BD patients did not significantly reduce their corticosteroid dose required at 1 year. However, in those on corticosteroids at baseline post hoc analysis demonstrated that the addition of peginterferon-α-2b did result in a significant reduction in corticosteroid dose with a significantly improved quality of life and trend to reduce other required immunosuppressive agents. This effect was seen at 1 year and associated with a rise in Tregs suggesting a possible mode for interferon action. TRIAL REGISTRATION NUMBER: ISRCTN 36354474; EudraCT 2004-004301-18. |
تدمد: | 1468-2060 |
الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::79d820ea29c07cc26b9c4a43234ba1c4Test https://pubmed.ncbi.nlm.nih.gov/25269831Test |
حقوق: | OPEN |
رقم الانضمام: | edsair.doi.dedup.....79d820ea29c07cc26b9c4a43234ba1c4 |
قاعدة البيانات: | OpenAIRE |