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Therapeutic approach to familial Mediterranean fever: a review update

Mehmet Akif Ozturk1, Mehmet Kanbay, Benan Kasapoglu

  • 1Department of Medicine, Division of Rheumatology, Gazi University School of Medicine, Turkey. makifozturk@yahoo.com

Clinical and Experimental Rheumatology
|October 5, 2011
PubMed

Insights

Familial Mediterranean Fever (FMF) treatment primarily relies on colchicine, which effectively prevents attacks and amyloidosis. For colchicine-resistant cases, alternative therapies like biologics and steroids offer management options.

Area of Science:

  • Genetics and Immunology
  • Rheumatology
  • Internal Medicine

Background:

  • Familial Mediterranean Fever (FMF) is an inherited autoinflammatory disorder causing recurrent fever and inflammation.
  • Chronic inflammation in FMF elevates serum amyloid A (SAA), potentially leading to secondary amyloidosis in organs.
  • Effective FMF treatment is crucial for preventing acute attacks and improving long-term prognosis.

Purpose of the Study:

  • To review current medical literature on Familial Mediterranean Fever (FMF) treatment strategies.
  • To summarize therapeutic agents, including novel options and management for colchicine-resistant FMF.
  • To provide an evidence-based overview of FMF management.

Main Methods:

  • Comprehensive literature search of MEDLINE, EMBASE, and Cochrane Library databases (1960-2010).
  • Inclusion of studies on Familial Mediterranean Fever (FMF) treatment, colchicine, and alternative therapies like infliximab, anakinra, and SSRIs.
  • Analysis of therapeutic approaches for FMF manifestations and resistance.

Main Results:

  • Colchicine is the cornerstone of FMF treatment, effectively managing fever, peritonitis, pleuritis, and preventing amyloidosis.
  • Colchicine is safe for fertility, pregnancy, and nursing, with dose adjustments needed for renal/hepatic impairment.
  • Colchicine shows limited efficacy for arthritis and myalgia, often requiring additional NSAIDs and steroids.

Conclusions:

  • Colchicine remains the primary therapy for Familial Mediterranean Fever (FMF), offering significant benefits in disease control and complication prevention.
  • For colchicine-resistant FMF, alternative treatments such as corticosteroids, DMARDs (non-biological and biological), interferon alpha, and SSRIs are indicated.
  • Comprehensive management strategies are essential for optimizing outcomes in patients with FMF.

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