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EULAR/PReS endorsed recommendations for the management of familial Mediterranean fever (FMF): 2024 update
Seza Ozen1, Erdal Sağ1, Teresa Oton2
1Department of Paediatric Rheumatology, Hacettepe University, Ankara, Turkey.
Objectives:
Familial Mediterranean fever (FMF) is the most common monogenic autoinflammatory disease despite being a rare disease for many rheumatologists. These evidence-based recommendations update the ones issued in 2016 to account for the recent developments in the field and aim to guide rheumatologists and other health professionals in the treatment and follow-up of patients with FMF.
Methods:
A multidisciplinary panel was assembled, including rheumatologists, internists, paediatricians, a nephrologist, an occupational therapist, a physiotherapist, 2 methodologists, and 2 patient representatives, all from the Eastern Mediterranean area and Europe. Several systematic reviews were performed on the pharmacological treatment of FMF and its complications. The previous recommendations were revised considering the updated evidence, and the new levels of evidence were incorporated. The agreement with the recommendations was obtained through a Delphi survey.
Results:
The final set comprises 4 overarching principles and 12 recommendations, each presented with its degree of agreement (0-10), level of evidence, and rationale. The degree of agreement was greater than 9/10 in all instances, and the level of evidence improved in most updated statements. Improving adherence is emphasised as an important aspect in several statements. These new recommendations include a priority set, quality indicators, and other suggested implementation strategies.
Conclusions:
This article presents a set of widely accepted recommendations for treating and monitoring FMF, supported by the best available evidence and expert opinion. These recommendations are valuable for guiding physicians in caring for patients with FMF.
Insights
Updated guidelines offer evidence-based recommendations for managing Familial Mediterranean fever (FMF), a common autoinflammatory disease. These recommendations aim to improve treatment and follow-up for FMF patients, emphasizing adherence and incorporating new evidence.
Area of Science:
- Rheumatology
- Genetics
- Internal Medicine
Background:
- Familial Mediterranean fever (FMF) is the most prevalent monogenic autoinflammatory disease, yet often underrecognized by clinicians.
- Existing treatment guidelines require updating due to recent advancements in FMF management.
- A need exists for comprehensive, evidence-based guidance for healthcare professionals treating FMF patients.
Purpose of the Study:
- To present updated, evidence-based recommendations for the treatment and follow-up of patients with Familial Mediterranean fever (FMF).
- To guide rheumatologists and other healthcare providers in managing FMF, incorporating recent scientific developments.
- To establish a consensus on best practices for FMF care.
Main Methods:
- A multidisciplinary panel, including specialists and patient representatives from Europe and the Eastern Mediterranean, was convened.
- Systematic reviews were conducted on pharmacological treatments for FMF and its complications.
- Recommendations were revised based on updated evidence, with consensus achieved via a Delphi survey.
Main Results:
- The final set includes 4 overarching principles and 12 recommendations, with high agreement (>9/10) and improved evidence levels.
- Key findings emphasize improving patient adherence to treatment regimens.
- New recommendations incorporate a priority set, quality indicators, and implementation strategies.
Conclusions:
- This article provides widely accepted, evidence-based recommendations for FMF treatment and monitoring.
- These guidelines are crucial for physicians in optimizing the care of individuals with FMF.
- The recommendations aim to enhance clinical practice and patient outcomes in FMF management.
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