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Interventions for reducing inflammation in familial Mediterranean fever
Xi Yin1, Fangyuan Tian1, Bin Wu1
1Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, China.
The Cochrane Database of Systematic Reviews
|March 29, 2022
Summary
Familial Mediterranean fever (FMF) treatments show limited evidence. Colchicine may reduce attacks, while canakinumab likely reduces them in resistant cases. More research is needed for other interventions.
Area of Science:
- Rheumatology
- Genetics
- Immunology
Background:
- Familial Mediterranean fever (FMF) is an inherited auto-inflammatory disorder.
- Colchicine is a primary treatment, but resistance and intolerance necessitate alternatives.
- This review updates evidence on FMF interventions last published in 2018.
Purpose of the Study:
- To evaluate the efficacy and safety of interventions for reducing inflammation in FMF patients.
- To assess treatments including colchicine, anakinra, rilonacept, canakinumab, and others.
Main Methods:
- Searched multiple databases (CENTRAL, MEDLINE, Embase, Chinese databases) and clinical trial registries up to August 2021.
- Included 10 randomized controlled trials (RCTs) with 312 participants.
- Assessed evidence certainty using GRADE methodology.
Main Results:
- Colchicine (0.6 mg three times daily) may reduce FMF attacks (low-certainty evidence).
- Canakinumab likely reduces attacks in colchicine-resistant FMF (moderate-certainty evidence).
- Anakinra and canakinumab may reduce C-reactive protein (CRP) in resistant cases (moderate-certainty evidence).
Conclusions:
- Limited RCTs exist for FMF interventions.
- Colchicine and canakinumab show potential benefits, but evidence quality varies.
- Further RCTs are crucial to establish efficacy and safety of various FMF treatments.
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