Assessment of effectiveness of anakinra and canakinumab in patients with colchicine-resistant/unresponsive familial Mediterranean fever.

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.

• Authors: Ali Şahin, Mehmet Emin Derin, Fatih Albayrak, Burak Karakaş, Yalçın Karagöz
• Journal: Advances in rheumatology (London, England) (Adv Rheumatol) Vol. 60 Issue 1 Pg. 12 (01 30 2020) ISSN: 2523-3106 [Electronic] England
• PMID: 32000860 (Publication Type: Journal Article)

Chemical References

• Antibodies, Monoclonal, Humanized
• Antirheumatic Agents
• Interleukin 1 Receptor Antagonist Protein
• canakinumab
• Colchicine

Topics

• Adolescent
• Adult
• Amyloidosis (complications)
• Antibodies, Monoclonal, Humanized (administration & dosage, adverse effects, therapeutic use)
• Antirheumatic Agents (administration & dosage, adverse effects, therapeutic use)
• Colchicine (therapeutic use)
• Drug Resistance
• Familial Mediterranean Fever (drug therapy)
• Female
• Glomerular Filtration Rate
• Humans
• Interleukin 1 Receptor Antagonist Protein (administration & dosage, adverse effects, therapeutic use)
• Kidney Transplantation (statistics & numerical data)
• Male
• Middle Aged
• Proteinuria (drug therapy)
• Young Adult