Biologic therapy in familial Mediterranean fever

Area of Science:

• Rheumatology and Immunology
• Genetics and Hereditary Diseases
• Clinical Pharmacology

Background:

• Familial Mediterranean fever (FMF) is a prevalent autoinflammatory disorder marked by recurrent fever and serositis.
• Colchicine is the primary treatment, but approximately 10% of FMF patients exhibit resistance or intolerance.
• Alternative therapies are crucial for managing colchicine-resistant or intolerant FMF cases.

Purpose of the Study:

• To review the literature on the efficacy of biologic therapies in patients with FMF.
• To focus on individuals who are resistant or intolerant to colchicine treatment.
• To evaluate biologics targeting specific proinflammatory cytokines for FMF management.

Main Methods:

• Literature review of case reports and clinical trials.
• Analysis of studies involving biologic agents targeting cytokines like IL-1, TNF, and IL-6.
• Assessment of treatment outcomes in colchicine-resistant or intolerant FMF patients.

Main Results:

• Anti-interleukin-1 (IL-1) therapies demonstrate significant benefits in clinical and laboratory findings.
• Anti-tumor necrosis factor (TNF) treatments show efficacy and safety in colchicine-resistant FMF.
• Tocilizumab (TCZ), an IL-6 inhibitor, has shown successful treatment outcomes and potential for preventing amyloidosis.

Conclusions:

• Biologic therapies offer effective alternatives for FMF patients unresponsive to colchicine.
• Targeting specific cytokines like IL-1, TNF, and IL-6 is a viable strategy for FMF management.
• Tocilizumab presents a promising option for both FMF treatment and secondary amyloidosis prevention.