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On demand use of anakinra for attacks of familial Mediterranean fever (FMF)

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Abstract

To evaluate the efficacy of on-demand use of anakinra in patients with crFMF. The Gazi FMF cohort was established in the year 2010, and from that date, 689 patients with FMF diagnosed according to the Tel Hashomer criteria were registered. Attack type, duration, severity, and their impact on life were collected either by disease diaries or a mobile phone application (FMF AIDD, AppStore, and Playstore). A retrospective cohort analysis was made from records of patients who have ever been treated with IL-1 inhibitors. A total of 78 patients were treated with IL-1 inhibitors in our cohort. Among these, 15 patients were identified who received on-demand anakinra. Rationale for on-demand use was prominent prodrome or trigger for attacks and patient’s personal claim. Six patients were switched from regular use and nine were directly started as on-demand use. All were using background colchicine in maximum tolerated doses. None of the patients had evidence of persistently elevated acute phase reactants or proteinuria. The median duration of on-demand anakinra use was 6 (3–36) months. Pre- and post- on-demand anakinra periods were compared. Patient reported attack severity (p = 0.002), duration (p = 0.001), frequency (p = 0.001), absenteeism (p = 0.002), and presenteeism (p = 0.002) were significantly improved. On-demand anakinra prevented progression of prodromes to full-blown attacks which was demonstrated by decrease in the rate of attack/prodrome ratio (p = 0.02). On-demand anakinra can be continued in ten subjects on long-term. On-demand anakinra significantly improved FMF attacks in certain patients which suggest this approach would be of benefit in daily practice in selected patients.

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Authors and Affiliations

  1. Department of Internal Medicine, Division of Rheumatology, Gazi University Faculty of Medicine, 06100, Ankara, Yenimahalle, Turkey

    Hakan Babaoglu, Ozkan Varan, Nuh Atas, Hasan Satis, Reyhan Salman, Mehmet Akif Ozturk, Seminur Haznedaroglu, Berna Goker & Abdurrahman Tufan

  2. Department of Internal Medicine, Division of Rheumatology, Erzurum Regional Research and Training Hospital, Health Science University, Erzurum, Turkey

    Hamit Kucuk

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  1. Hakan Babaoglu
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  2. Ozkan Varan
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  3. Hamit Kucuk
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  4. Nuh Atas
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  5. Hasan Satis
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  6. Reyhan Salman
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  7. Mehmet Akif Ozturk
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  8. Seminur Haznedaroglu
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  9. Berna Goker
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  10. Abdurrahman Tufan
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Correspondence to Hakan Babaoglu.

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Babaoglu, H., Varan, O., Kucuk, H. et al. On demand use of anakinra for attacks of familial Mediterranean fever (FMF). Clin Rheumatol 38, 577–581 (2019). https://doi.org/10.1007/s10067-018-4230-z

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  • DOI: https://doi.org/10.1007/s10067-018-4230-z

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