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首页> 外文期刊>Sao Paulo Medical Journal >Anti-interleukin-1 treatment among patients with familial Mediterranean fever resistant to colchicine treatment. Retrospective analysis
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Anti-interleukin-1 treatment among patients with familial Mediterranean fever resistant to colchicine treatment. Retrospective analysis

机译：抗秋水仙碱治疗的家族性地中海热患者中的抗白介素-1治疗。回顾性分析

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BACKGROUND: Up to 5% of familial Mediterranean fever (FMF) cases are unresponsive to colchicine, through resistance, side effects and toxicity. Anakinra is an alternative treatment for FMF patients whose disease remains uncontrolled with colchicine. We aimed to evaluate anti-interleukin-1 treatment regarding clinical findings, laboratory parameters and quality of life (QoL) among FMF patients presenting resistance and toxicity towards colchicine. DESIGN AND SETTING: Descriptive observational study at the rheumatology clinic, Adnan Menderes University Medical School, Ayd?n, Turkey. METHODS: Among the patients included, age, sex, MEFV genotypes, acute-phase reactants, hepatic/renal function tests, average colchicine dose, disease duration, attack frequency, attack duration, disease severity, proteinuria, amyloidosis and QoL were evaluated. Colchicine resistance was defined as 6 typical episodes/year or 3 per 4-6 months. Kolmogorov-Smirnov, Friedman and two-way analysis of variance tests were used for statistical analyses. RESULTS: Between 2015 and 2017, 14 FMF patients receiving anakinra were enrolled. The mean colchicine dose was 1.7 ± 0.3 mg/day before use of anakinra. Ten patients were attack-free after treatment, while three showed reductions of at least 50% in attack frequency, attack duration and disease severity. Proteinuria levels in all patients with renal amyloidosis decreased after treatment. QoL among patients with renal amyloidosis differed significantly from QoL among non-amyloidosis patients. Mean visual analogue scale scores significantly improved in both groups after use of anakinra. CONCLUSIONS: Use of anakinra reduced attack frequency and proteinuria and acute-phase reactant levels, and improved QoL, with only a few uncomplicated side effects among colchicine-resistant or intolerant FMF patients. Injection-site reactions of severity insufficient to require discontinuation of treatment were seen.
机译：背景：多达5％的家族性地中海热（FMF）病例通过耐药性，副作用和毒性对秋水仙碱无反应。 Anakinra是对秋水仙碱仍无法控制疾病的FMF患者的另一种治疗方法。我们旨在评估对秋水仙碱具有耐药性和毒性的FMF患者的临床表现，实验室参数和生活质量（QoL），以评估抗白介素-1的治疗。设计与地点：土耳其艾登市阿德南·曼德斯大学医学院风湿病门诊的描述性观察研究。方法：对年龄，性别，MEFV基因型，急性期反应物，肝/肾功能检查，秋水仙碱平均剂量，疾病持续时间，发作频率，发作持续时间，疾病严重程度，蛋白尿，淀粉样变性和生活质量的患者进行评估。秋水仙碱抗性定义为每年> 6个典型发作或每4-6个月> 3个典型发作。使用Kolmogorov-Smirnov，Friedman和方差检验的双向分析进行统计分析。结果：2015年至2017年期间，招募了14名接受过无水烟的FMF患者。在使用Anakinra之前，秋水仙碱的平均剂量为1.7±0.3 mg /天。十名患者在治疗后无发作，而三名患者的发作频率，发作持续时间和疾病严重性降低了至少50％。治疗后所有肾淀粉样变性患者的蛋白尿水平降低。肾淀粉样变性患者的QoL与非淀粉样变性患者的QoL显着不同。使用anakinra后，两组的平均视觉模拟量表评分均得到明显改善。结论：anakinra的使用降低了发作频率，蛋白尿和急性期反应物水平，并改善了QoL，对秋水仙碱耐药或不耐受的FMF患者只有很少的副作用。注射部位反应的严重性不足以要求停止治疗。

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