Efficacy of anti-IL-1 treatment in familial Mediterranean fever: a systematic review of the literature

Abstract

Jeroen CH van der Hilst,1,2 Michel Moutschen,3 Peter E Messiaen,1,2 Bernard R Lauwerys,4,5 Steven Vanderschueren6 1Department of Infectious diseases and Immunity, Jessa Hospital, Hasselt, 2Biomedical Research Institute, University of Hasselt, Hasselt, 3Department of Immunity and Infectious Diseases, University Hospital of Liège, Liège, 4Service de Rhumatologie, Cliniques Universitaires Saint-Luc, 5Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain, Brussels, 6KU Leuven, Laboratory of Clinical Infectious and Inflammatory Disorders, University Hospitals Leuven, Leuven, Belgium Introduction: In 5%–10% of patients with familial Mediterranean fever (FMF), colchicine is not effective in preventing inflammatory attacks. Another 5%–10% of patients are intolerant to effective doses of colchicine and experience serious side effects. Treatment with anti-interleukin-1 (IL-1) drugs may be an alternative for these patients, although it is not reimbursed for this indication in many countries. Methods: We systematically searched PubMed, Web of Science, and Scopus for reports of anti-IL-1 treatment in FMF patients. Results: Out of 284 potentially relevant articles, 27 eligible reports were identified and included in the data analysis. Conclusion: A complete response to therapy without a single attack during treatment was reported in 76.5% of patients on anakinra treatment and in 67.5% of patients during canakinumab treatment. In patients with established type AA amyloidosis, anti-IL-1 treatment can reverse proteinuria. Anti-IL-1 therapy seems to be a safe and effective alternative for patients with FMF who do not respond to or cannot tolerate colchicine. Keywords: familial Mediterranean fever, interleukin-1, amyloidosis, colchicine

Keywords

• familial Mediterranean fever
• interleukin 1
• amyloidosis
• colchicine