Canakinumab treatment in children with familial Mediterranean fever: report from a single center

Rheumatol Int. 2018 May;38(5):879-885. doi: 10.1007/s00296-018-3993-5. Epub 2018 Feb 15.

Abstract

Familial Mediterranean fever (FMF), the most common hereditary autoinflammatory disorder is characterized by recurrent episodes of fever, serositis, arthritis. The major long-term result is amyloidosis. Colchicine remains the principle of the treatment; it not only prevents the acute attacks but also prevents the long-term complications such as amyloidosis; 5-10% of the patients are unresponsive to treatment. Recently new therapeutic options as anti-interleukin 1 agents are successfully used for the patients who do not respond to colchicine treatment. In this study, we retrospectively evaluated 11 pediatric colchicine-resistant FMF patients who were treated with canakinumab. Three of the patients had amyloidosis and two had uveitis. Based on our results, we suggest that canakinumab may be a safe and effective therapy in patients who are resistant to colchicine and even in the patients with amyloidosis. We also suggest that canakinumab might be a safe option for the patients with uveitis.

Keywords: Amyloidosis; Canakinumab; Childhood; Familial Mediterranean fever; Uveitis.

MeSH terms

  • Adolescent
  • Age Factors
  • Amyloidosis / etiology
  • Antibodies, Monoclonal / adverse effects
  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Humanized
  • Child
  • Colchicine / therapeutic use
  • Drug Resistance
  • Familial Mediterranean Fever / complications
  • Familial Mediterranean Fever / diagnosis
  • Familial Mediterranean Fever / drug therapy*
  • Humans
  • Immunologic Factors / adverse effects
  • Immunologic Factors / therapeutic use*
  • Renal Insufficiency, Chronic / etiology
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome
  • Turkey
  • Uveitis / etiology

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Immunologic Factors
  • canakinumab
  • Colchicine