Interleukin-1 targeting treatment in familial Mediterranean fever: an experience of pediatric patients.

Abstract

OBJECTIVES:

The aim of this report was to evaluate and discuss treatment of pediatric familial Mediterranean fever (FMF) patients with anti-interleukin1 (IL-1) agents.

METHODS:

Refractory or colchicine unresponsive FMF was described as severe and frequent attacks and/or having high acute phase reactance levels despite having a maximum dose of colchicine (2 mg/day). Disease course, adverse effects, duration of follow-up, treatment protocols, responses to the therapies were discussed.

RESULTS:

Eight patients (6 male, 2 female) having refractory FMF were identified. Mediterranean fever (MEFV) gene analyses revealed homozygous M694V mutations in six patients and heterozygote M694V mutations in one patient and no mutation in one patient. They were all treated with anakinra and/or canakinumab. The use of anti-IL-1 drugs was beneficial to all patients. None of them had any severe adverse effects due to the therapy.

CONCLUSIONS:

Anakinra and canakinumab were effective in patient refractory to colchicine treatment as shown both in our series and in the literature. Therefore, controlled trials are needed to evaluate the safety and long-term efficacy of IL-1 targeting agents in colchicine resistant patients.

• Authors: Özge Başaran, Nermin Uncu, Banu Acar Çelikel, Aysel Taktak, Gökçe Gür, Nilgun Cakar
• Journal: Modern rheumatology (Mod Rheumatol) Vol. 25 Issue 4 Pg. 621-4 (Jul 2015) ISSN: 1439-7609 [Electronic] England
• PMID: 25528863 (Publication Type: Journal Article)

Chemical References

• Gout Suppressants
• Interleukin-1
• Colchicine

Topics

• Adolescent
• Child
• Child, Preschool
• Clinical Protocols
• Colchicine (therapeutic use)
• Familial Mediterranean Fever (blood, drug therapy, genetics)
• Female
• Genetic Testing
• Gout Suppressants (therapeutic use)
• Humans
• Interleukin-1 (genetics, metabolism)
• Male
• Mutation