Update on the management of colchicine resistant Familial Mediterranean Fever (FMF) | Orphanet Journal of Rare Diseases | Full Text

Update on the management of colchicine resistant Familial Mediterranean Fever (FMF) | Orphanet Journal of Rare Diseases | Full Text

Orphanet Journal of Rare Diseases

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

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

Orphanet Journal of Rare Diseases volume 14, Article number: 224 (2019) | Download Citation

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Abstract

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.