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Assessment of effectiveness of anakinra and canakinumab in patients with colchicine-resistant/unresponsive familial Mediterranean fever
Şahin, Ali; Derin, Mehmet Emin; Albayrak, Fatih; Karakaş, Burak; Karagöz, Yalçın.
  • Şahin, Ali; Cumhuriyet University. Faculty of Medicine. Department of Internal Medicine - Rheumatology. Sivas. TR
  • Derin, Mehmet Emin; Cumhuriyet University. Faculty of Medicine. Department of Internal Medicine - Rheumatology. Sivas. TR
  • Albayrak, Fatih; Cumhuriyet University. Faculty of Medicine. Department of Internal Medicine - Rheumatology. Sivas. TR
  • Karakaş, Burak; Cumhuriyet University. Faculty of Medicine. Department of Internal Medicine - Rheumatology. Sivas. TR
  • Karagöz, Yalçın; Sivas Cumhuriyet University. Medical Faculty. Department of Biostatistic. Sivas. TR
Adv Rheumatol ; 60: 12, 2020. tab
Article in English | LILACS | ID: biblio-1088649
ABSTRACT
Abstract İntroduction Familial Mediterranean fever (FMF) is a hereditary auto-inflammatory disease characterized by recurrent fever and serosal inflammation. Anti-interleukin-1 (Anti-IL-1) treatments are recommended in colchicine resistant and/or intolerant FMF patients. This study aims to evaluate the efficacy of anakinra and canakinumab in FMF patients that are resistant/intolareted to colchicine or complicated with amyloidosis.

Methods:

Between January 2014 and March 2019, 65 patients following-up at Sivas Cumhuriyet University (Medical Faculty Rheumatology-Internal Medicine Department) who were diagnosed with FMF according to the criteria of Tel-Hashomer were included in the study. The laboratory values and clinical features of patients and disease activities were recorded at least every 3 months, and these data were analyzed.

Results:

Forty-one (63.1%) patients used anakinra (100 mg/day) and 24 (36.9%) patients used canakinumab (150 mg/8 week). The median duration of anti-IL-1 agents use was 7 months (range, 3-30). Fifteen (23.1%) cases were complicated with amyloidosis. Seven (10.8%) patients had renal transplantation. Overall, the FMF 50 score response was 96.9%. In the group that had a glomerular filtration rate (GFR) ≥ 60 ml/min/m2, the median proteinuria decreased from 2390 mg/day (range, 1400-7200) to 890 mg/day (range, 120-2750) (p = 0.008). No serious infections were detected, except in one patient.

Conclusions:

Anti-IL-1 agents are effective and safe in the treatment of FMF patients. These agents are particularly effective at reducing proteinuria in patients with GFR ≥ 60 ml/min/m2, but less effective in cases with FMF associated with arthritis and sacroiliitis. Large and long follow-up studies are now needed to establish the long-term effects of these treatments.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Familial Mediterranean Fever / Colchicine / Interleukin 1 Receptor Antagonist Protein / Amyloidosis Type of study: Observational study / Prognostic study / Risk factors Limits: Humans Language: English Journal: Adv Rheumatol Journal subject: Artrite / Reumatologia Year: 2020 Type: Article Affiliation country: Turkey Institution/Affiliation country: Cumhuriyet University/TR / Sivas Cumhuriyet University/TR

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Full text: Available Index: LILACS (Americas) Main subject: Familial Mediterranean Fever / Colchicine / Interleukin 1 Receptor Antagonist Protein / Amyloidosis Type of study: Observational study / Prognostic study / Risk factors Limits: Humans Language: English Journal: Adv Rheumatol Journal subject: Artrite / Reumatologia Year: 2020 Type: Article Affiliation country: Turkey Institution/Affiliation country: Cumhuriyet University/TR / Sivas Cumhuriyet University/TR