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Efficacy and safety of treatments in Familial Mediterranean fever: a systematic review

  • Review Article - Clinical Trials
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Abstract

Familial Mediterranean fever (FMF) is an autoinflammatory disease, which can be well controlled with lifelong use of colchicine. Since studies dealing with the efficacy and safety of colchicine were conducted mainly in the sixties and seventies of the previous century, it seems that this topic needs to be updated. Recently, an international expert panel was undertaken for the establishment of recommendations on how to manage FMF. We aimed to summarize the efficacy and safety of the current treatments available to prevent FMF attacks and to avert the appearance of amyloidosis secondary to FMF. A systematic review was performed. Two reviewers and methodologist established the protocol of the review and the epidemiological questions in PICO terms. MEDLINE through PubMed, Embase, and Cochrane Central Trials Register all up to May 31, 2014, were searched, and only randomized controlled trials or quasicontrolled trials were accepted. For each study, a judgment on risk of bias was then rated as high, moderate, or low. Of 1222 initially captured publications, 153 articles were studied in detail. Finally, only seven studies met all criteria and were included. Among these seven studies, four were randomized crossover clinical trials of colchicine including a total of 57 patients, one RCT of Andrographis paniculata Herba Nees extract employed in 24 patients, one randomized crossover clinical trial of Rilonacept used in 12 patients, and one RCT of interferon treating 34 acute abdominal attacks in 22 patients. The quality of the colchicine trials was low compared with the other drugs trials. Safety was not clearly mentioned in the trials. Colchicine is an effective treatment in FMF.

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Funding

This systematic review was funded by Eular (European League Against Rheumatism) as part of an initiative to develop recommendations on the management of FMF.

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Authors and Affiliations

  1. Division of Pediatric Rheumatology, FMF Arthritis Vasculitis and Orphan Disease Research Center (FAVOR), Gülhane Military Medical Faculty, 06018, Etlik, Ankara, Turkey

    Erkan Demirkaya

  2. Division of Rheumatology, Faculty of Medicine, Istanbul University, Istanbul, Turkey

    Burak Erer

  3. Division of Pediatric Rheumatology, School of Medicine, Hacettepe University, Ankara, Turkey

    Seza Ozen

  4. Hadassah-Hebrew University Medical Center, Jerusalem, Israel

    Eldad Ben-Chetrit

Authors
  1. Erkan Demirkaya
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  2. Burak Erer
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  3. Seza Ozen
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  4. Eldad Ben-Chetrit
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Correspondence to Erkan Demirkaya.

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There is nothing to disclose for any of the authors for the purposes of this paper.

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Demirkaya, E., Erer, B., Ozen, S. et al. Efficacy and safety of treatments in Familial Mediterranean fever: a systematic review. Rheumatol Int 36, 325–331 (2016). https://doi.org/10.1007/s00296-015-3408-9

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  • DOI: https://doi.org/10.1007/s00296-015-3408-9

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