Colchicine-resistant familial Mediterranean fever in a renal transplantation patient: successful treatment with anakinra

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

“…8 On the other hand, biological drugs such as anti-IL-1 blockers and anti-IL-6 monoclonal antibodies are promising options in the prevention of FMF attacks in colchicine-resistant patients. 9 In this study, we observed a nearly complete and fast clinical response to treatment in all but one patient. 9 Anakinra, an anti-IL-1 agent which must be used daily, has been shown to be effective in colchicine-resistant kidney transplant patients.…”

“…However, due to noncompliance or resistance to colchicine, development of amyloidosis remains to be a serious complication of FMF despite the classical treatment. 9 Anakinra, an anti-IL-1 agent which must be used daily, has been shown to be effective in colchicine-resistant kidney transplant patients. 6 In kidney transplant patients, the co-administration of immunosuppressive agents and colchicine causes an increase in the adverse effects of colchicine, which has an impact on the patient's compliance with the therapy.…”

“…6 In kidney transplant patients, the co-administration of immunosuppressive agents and colchicine causes an increase in the adverse effects of colchicine, which has an impact on the patient's compliance with the therapy. 9 Anakinra, an anti-IL-1 agent which must be used daily, has been shown to be effective in colchicine-resistant kidney transplant patients. 9 However, as immunosuppressive drugs and other medications are used to treat comorbidities, those patients are already on polypharmacy.…”

“…9 Anakinra, an anti-IL-1 agent which must be used daily, has been shown to be effective in colchicine-resistant kidney transplant patients. 9 However, as immunosuppressive drugs and other medications are used to treat comorbidities, those patients are already on polypharmacy. Daily subcutaneous administrations might cause discomfort and raise compliance concerns.…”

The Use of Interleukine-1 Inhibitors in Familial Mediterranean Fever Patients: A Narrative Review

“…Other studies give a more precise definition of colchicine resistance, but again the different definitions are highly variable. The highest agreement for colchicine resistance is the persistent elevation of acute phase reactants between the attacks ( 12 , 15 – 20 , 23 , 24 , 26 – 29 , 33 , 34 , 36 , 38 – 40 , 44 , 46 , 49 , 50 , 52 , 55 , 57 – 59 , 61 , 63 – 65 , 73 ). No consensus exists about attack frequency: some authors define colchicine resistance in patients who experience more than 1 typical inflammatory attack per 3 months ( 38 , 53 ), while others refer to colchicine resistance if there are more than 2 typical attacks per trimester ( 46 ) and still others if the patient has monthly attacks ( 35 , 40 , 48 , 51 , 52 , 55 , 59 , 62 – 65 ).…”