Journal Article

Update on the management of colchicine resistant Familial Mediterranean Fever (FMF)

El Hasbani, Georges, Uthman, Imad, Jawad, Ali

2019

Overview

Background Familial Mediterranean Fever (FMF), an autoinflammatory disease, is characterized by self-limited inflammatory attacks of fever and polyserositis along with high acute phase response. Although colchicine remains the mainstay in treatment, intolerance and resistance in a certain portion of patients have been posing a problem for physicians. Main body Like many autoimmune and autoinflammatory diseases, many colchicine-resistant or intolerant FMF cases have been successfully treated with biologics. In addition, many studies have tested the efficacy of biologics in treating FMF manifestations. Conclusion Since carriers of FMF show significantly elevated levels of serum TNF alpha, IL-1, and IL-6, FMF patients who failed colchicine were successfully treated with anti IL-1, anti IL-6, or TNF inhibitors drugs. It is best to use colchicine in combination with biologics.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Abdomen / Anakinra / Analysis / Animals / Autoinflammatory diseases / Biologics / Canakinumab / Care and treatment / Colchicine / Colchicine - therapeutic use / Colchicine resistance / Drug dosages / Familial Mediterranean fever / Familial Mediterranean Fever - blood / Familial Mediterranean Fever - drug therapy / Fever / Gout suppressants / Human Genetics / Humans / Inflammation / Interleukin 1 / Interleukin 6 / Interleukin-1 - blood / Interleukin-6 - blood / Intolerance / Medical research / Medicine / Medicine & Public Health / Mutation / Pain / Periodic disease / Pharmacology/Toxicology / Phenotypes / Physicians / Polyserositis / Proteins / Rare diseases / Rare systemic diseases / Review / Rheumatoid arthritis / Rheumatology / Rilonacept / Tumor necrosis factor / Tumor Necrosis Factor-alpha - blood