Canakinumab treatment in kidney transplant recipients with AA amyloidosis due to familial Mediterranean fever

Abstract

Canakinumab can be considered as a safe and efficient drug in preventing the FMF attacks in kidney transplant recipients.

Assessment of effectiveness of anakinra and canakinumab in patients with colchicine-resistant/unresponsive familial Mediterranean fever

“…While seven renal transplant patients were offered anakinra and the other immunosuppressive, no severe infections or drug interactions were seen. The previous studies that were carried out with renal transplant patients showed no severe adverse effect or drug interactions [19]. Multiple sclerosis is a possible adverse effect of any biological medication, and it was observed in one patient in this study.…”

<p>The Efficacy, Safety and Tolerability of Canakinumab in the Treatment of Familial Mediterranean Fever: A Systematic Review of the Literature</p>

“…The two patients who did not fulfil Tel-Hashomer criteria were both heterozygote for a disease-causing mutation. 25,28 Complete response to Canakinumab could not be achieved in either case.…”

“…The most common dose of Canakinumab was 2mg/kg in patients <40kg, or 150mg in those above. 13,17,18,[20][21][22][23][24][25][26][27][28] In case of inadequate disease control, an increase in dose to 3-4mg/kg in those below 40kg or 300mg in those over was used in 8 studies. 10,14,15,19,23,[29][30][31] In 8 studies, 10,19,22,[25][26][27][28]31 Canakinumab was given at 4-weekly intervals, in 3 studies 18,21,24 it was given at 8-weekly intervals, whereas the remaining studies had dosing frequencies tailored to clinical needs and/or protocols, with the medication being given every 4, 6 or 8 weeks.…”

“…Information about the presence of renal or systemic amyloidosis could be obtained from 121 patients in 11 of the assessed studies. 14,17,24,[26][27][28] Twenty-four patients had type AA amyloidosis at the start of treatment. Of those, six had Notes: Data are provided as mean ± standard deviation or median and range.…”

“…17 A further 14 patients were renal allograft recipients following amyloid-induced end-stage renal failure. 17,26,28 Of these, 7 had evidence of amyloid deposition in the allograft, leading to the introduction of Canakinumab, 28 whilst poorly controlled inflammatory attacks were the indication for implementation of Canakinumab in the remaining patients. Renal function remained stable in all cases, with no improvement or exacerbation of proteinuria or significant changes to serum creatinine levels reported.…”