Anti-interleukin-1 treatment among patients with familial Mediterranean fever resistant to colchicine treatment. Retrospective analysis
São Paulo med. j
; 137(1): 39-44, Jan.-Feb. 2019. tab
Article
in English
| LILACS
| ID: biblio-1004743
Responsible library:
BR1.1
ABSTRACT
ABSTRACT BACKGROUND:
Up to 5% of familial Mediterranean fever (FMF) cases are unresponsive to colchicine, through resistance, side effects and toxicity. Anakinra is an alternative treatment for FMF patients whose disease remains uncontrolled with colchicine. We aimed to evaluate anti-interleukin-1 treatment regarding clinical findings, laboratory parameters and quality of life (QoL) among FMF patients presenting resistance and toxicity towards colchicine. DESIGN ANDSETTING:
Descriptive observational study at the rheumatology clinic, Adnan Menderes University Medical School, Aydın, Turkey.METHODS:
Among the patients included, age, sex, MEFV genotypes, acute-phase reactants, hepatic/renal function tests, average colchicine dose, disease duration, attack frequency, attack duration, disease severity, proteinuria, amyloidosis and QoL were evaluated. Colchicine resistance was defined as > 6 typical episodes/year or > 3 per 4-6 months. Kolmogorov-Smirnov, Friedman and two-way analysis of variance tests were used for statistical analyses.RESULTS:
Between 2015 and 2017, 14 FMF patients receiving anakinra were enrolled. The mean colchicine dose was 1.7 ± 0.3 mg/day before use of anakinra. Ten patients were attack-free after treatment, while three showed reductions of at least 50% in attack frequency, attack duration and disease severity. Proteinuria levels in all patients with renal amyloidosis decreased after treatment. QoL among patients with renal amyloidosis differed significantly from QoL among non-amyloidosis patients. Mean visual analogue scale scores significantly improved in both groups after use of anakinra.CONCLUSIONS:
Use of anakinra reduced attack frequency and proteinuria and acute-phase reactant levels, and improved QoL, with only a few uncomplicated side effects among colchicine-resistant or intolerant FMF patients. Injection-site reactions of severity insufficient to require discontinuation of treatment were seen.
Full text:
Available
Collection:
International databases
Database:
LILACS
Main subject:
Familial Mediterranean Fever
/
Quality of Life
/
Drug Resistance
/
Colchicine
/
Interleukin-1
/
Antirheumatic Agents
/
Interleukin 1 Receptor Antagonist Protein
Type of study:
Observational study
Aspects:
Patient-preference
Limits:
Adult
/
Female
/
Humans
/
Male
Country/Region as subject:
Asia
Language:
English
Journal:
São Paulo med. j
Journal subject:
Cirurgia Geral
/
Cincia
/
Ginecologia
/
Medicine
/
Medicina Interna
/
Obstetr¡cia
/
Pediatria
/
Sa£de Mental
/
Sa£de P£blica
Year:
2019
Document type:
Article
Affiliation country:
Turkey
Institution/Affiliation country:
Adnan Menderes Üniversitesi Tıp Fakültesi/TR