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. 2024 Mar;19(2):391-397.
doi: 10.1007/s11739-023-03486-3. Epub 2023 Dec 16.

Do we consider enough the presence of triggering factors in the evaluation of patients with FMF? Triggering factors are highly prevalent in colchicine-resistant FMF patients

Bayram Farisogullari  1 , Levent Kilic  2 , Gozde Kubra Yardimci  2 , Ali Akdogan  2
Affiliations

Do we consider enough the presence of triggering factors in the evaluation of patients with FMF? Triggering factors are highly prevalent in colchicine-resistant FMF patients

Bayram Farisogullari et al. Intern Emerg Med. 2024 Mar.

Abstract

The aim of the study is to investigate the frequency of triggering factors in colchicine-resistant and -responsive Familial Mediterranean Fever (FMF) patients as well as the effect of interleukin (IL)-1 antagonist treatment on the triggering factors. Both colchicine-resistant (patients on IL-1 antagonist treatment) and colchicine-responsive (patients on colchicine who had ≤ 3 attacks in the last year) patients were questioned for the presence of 12 different triggering factors, including exposure to cold, emotional stress, fatigue, physical activity, menstruation (for females), sleeplessness, prolonged standing, long-duration travel, high-fat diet intake, starvation, infection, and trauma. Colchicine-resistant patients were questioned for the presence of triggering factors for two time periods, before and after treatment with IL-1 antagonists. We studied 28 colchicine-resistant and 35 colchicine-responsive patients. Overall 77.8% of patients had at least one triggering factor. Triggering factors were associated with 28.5% of the total number of attacks. More than half of the patients (57.1%) declared that they had avoided these conditions. The frequency of triggering factors was higher in the colchicine-resistant group as compared to the colchicine-responsive group (89.3% vs 68.6%; p = 0.04). In colchicine-resistant FMF patients, the frequency of triggering factors (89.3% vs 32.1%) and the percentage of attacks initiated by triggering factors (27.8 vs 14.4%; p < 0.001) were decreased after treatment with IL-1 antagonists. In this study, triggering factors were more frequent in colchicine-resistant patients as compared to colchicine-responsive patients. Treatment with IL-1 antagonists seems to increase the endurance of colchicine-resistant patients in stressful conditions.

Keywords: Colchicine-resistance; FMF; IL-1 antagonist; Triggering factors.

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References

    1. Ben-Chetrıt E, Levy M (1998) Familial Mediterranean fever. Lancet 351:659–664 - DOI - PubMed
    1. Ozen S, Demirkaya E, Erer B, Livneh A, Ben-Chetrit E, Giancane G et al (2016) EULAR recommendations for the management of familial Mediterranean fever. Ann Rheum Dis 75(4):644–651 - DOI - PubMed
    1. Sari I, Birlik M, Kasifoglu T (2014) Familial Mediterranean fever: an updated review. Eur J Rheumatol 1(1):21–33 - DOI - PubMed - PMC
    1. Korkmaz C, Cansu DU, Cansu GB (2020) Familial Mediterranean fever: the molecular pathways from stress exposure to attacks. Rheumatology (Oxford) 59(12):3611–3621 - DOI - PubMed
    1. Karadag O, Tufan A, Yazisiz V, Ureten K, Yilmaz S, Cinar M et al (2013) The factors considered as trigger for the attacks in patients with familial Mediterranean fever. Rheumatol Int 33(4):893–897 - DOI - PubMed

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