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 ph...

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Bibliographic Details
Published in:Modern rheumatology 2015-07, Vol.25 (4), p.621-624
Main Authors: Ba aran, Özge, Uncu, Nermin, Çelikel, Banu Acar, Taktak, Aysel, Gür, Gökçe, Cakar, Nilgun
Format: Article
Language:English
Subjects:
Adolescent
Anti IL-1 treatment
Child
Child, Preschool
Clinical Protocols
Colchicine - therapeutic use
Cytokines
Familial Mediterranean Fever - blood
Familial Mediterranean Fever - drug therapy
Familial Mediterranean Fever - genetics
Female
Fever
FMF
Genetic Testing
Gout Suppressants - therapeutic use
Humans
Interleukin-1 - genetics
Interleukin-1 - metabolism
Male
Medical treatment
Mutation
Pediatric
Pediatrics
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Summary: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.
ISSN:1439-7595
1439-7609
DOI:10.3109/14397595.2014.987437