Familial Mediterranean fever (FMF)-response to TNF-blockers used for treatment of FMF patients with concurrent inflammatory diseases - 26/09/21
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Highlights |
• | TNF-blockers may be beneficial for a proportion of colchicine-resistant FMF patients. |
• | A favorable response to TNF-blockers in FMF patients cannot be predicted by specific clinical, genetic or demographic FMF traits, nor by the type of the TNF-blocker used. |
• | A beneficial response to at least one TNF- blocker in up to 38% of patients suggests that TNF may have a role in the pathogenesis of FMF. |
Abstract |
Objective |
Familial Mediterranean fever (FMF) is the most common interleukin 1 (IL-1)-driven monogenic autoinflammatory disease. Yet published data also suggest that tumor necrosis factor (TNF) may have a role in the pathogenesis of FMF and may serve as a target for treatment. In the present study we evaluate this hypothesis.
Methods |
To this goal, we studied the incidental effect on FMF of TNF-directed treatment, administered to colchicine-refractory FMF patients for the management of a concurrent inflammatory disease. The rates of FMF patients and of treatments with complete or nearly complete FMF response were determined, based on the number of FMF attacks during TNF-blocker exposures. The possible effect of various FMF and non-FMF features on the outcome was determined using comparative analysis. Patients were identified and data were retrieved using electronic files from the FMF clinic.
Results |
Twenty-six patients were identified, each receiving ≥1 of four TNF-blockers for a mean duration of 27.6±16.4months. The TNF-blockers were found to induce complete or nearly complete FMF response in 10 (38.5%) of the patients, and in 13 of 50 (26%) exposures. No clinical, genetic, demographic, or therapeutic feature could predict which FMF patient would respond favorably to TNF-blocker therapy.
Conclusion |
This study suggests that TNF-blockers may be beneficial for a small proportion of colchicine-resistant FMF patients.
Le texte complet de cet article est disponible en PDF.Keywords : FMF, TNF-blockers, Inflammatory comorbidities, Colchicine-resistant FMF
Plan
Vol 88 - N° 5
Article 105201- octobre 2021 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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