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Effect of anti‐interleukin‐1 treatment on quality of life in children with colchicine‐resistant familial Mediterranean fever: A single‐center experience
Author(s) -
Kurt Tuba,
Aydın Fatma,
Nilüfer Tekgöz P.,
Sezer Müge,
Uncu Nermin,
Çelikel Acar Banu
Publication year - 2020
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/1756-185x.13891
Subject(s) - familial mediterranean fever , medicine , colchicine , anakinra , canakinumab , erythrocyte sedimentation rate , quality of life (healthcare) , rash , interleukin , pediatrics , gastroenterology , disease , cytokine , nursing
Aim The aim of this study is to evaluate the clinical parameters, acute‐phase reactants, side effects, genetic mutations among colchicine‐resistant Familial Mediterranean fever (FMF) patients who received anti‐interleukin‐1 (anti‐IL‐1) treatment. We also evaluate the quality of life and school attendance among colchicine‐resistant FMF patients, in relation to treatment with anti‐IL‐1. Introductıon Familial Mediterranean fever is the most common inherited autoinflammatory disorder. Although the main treatment of FMF is colchicine, a small group of patients are resistant to colchicine treatment. Anti‐IL‐1 treatment is promising in colchicine‐resistant patients due to excessive IL‐1β production in pathogenesis. The aim of this study is to evaluate the quality of life and school attendance rates among colchicine‐resistant FMF patients after anti‐IL‐1 treatment. Methods This is a single center retrospective study of 25 pediatric colchicine‐resistant FMF patients treated with anti‐IL‐1 treatment. Autoinflammatory Disease Activity Index (AIDAI) was used for disease activity assessment. School attendance rates were evaluated before and after treatment. Results There were 25 patients with FMF (11 M/14 F) who were treated with anakinra or canakinumab for various indications (colchicine‐resistant recurrent febrile attacks in 20, colchicine‐related side effects in 2, subclinical inflammation in 3 patients). Only 3 patients developed side effects with anakinra (2 headache, 1 urticarial rash). There was a significant decrease in the frequency of attacks, acute‐phase reactants (erythrocyte sedimentation rate and C‐reactive protein), AIDAI and physician's and patient's global assessment scores and improvement in school attendance rates. At the last follow‐up, all patients were in remission, and only 3 had subclinical inflammation. Conclusıon Anti‐IL‐1 treatment is quite effective in children with colchicine‐resistant FMF patients, proven with improved AIDAI scores and school attendance rates. In the long term by lowering disease activation even development of amyloidosis may be prevented.