Treatment options in colchicine resistant familial Mediterranean fever patients: thalidomide and etanercept as adjunctive agents.
OBJECTIVE
Regular colchicine treatment cannot control the typical febrile attacks of FMF in about 5-10% of the compliant patients. Here we report the effect of thalidomide and etanercept in 5 colchicine-resistant cases.


METHODS
Five (4M/ 1F) FMF patients between April 2005 and March 2006, who were experiencing at least 2 attacks per month, despite regular colchicine were included to the study. Four male patients were given thalidomide 100 mg/d initially. Two of these patients unresponsive to thalidomide were prescribed subcutaneous injections of etanercept 25 mg, twice a week. The female patient received etanercept as the first choice due to potential side effects. She then had to be converted to thalidomide due to a severe injection site reaction.


RESULTS
The median follow up period with thalidomide and etanercept was 8 months. Both thalidomide and etanercept lowered the number of the abdominal attacks.


CONCLUSIONS
Thalidomide and etanercept might be effective as additional treatment in colchicine-resistant cases of FMF.
Seyahi
E
E
Division of Rheumatology, Department of Medicine, Cerrahpasa Medical Faculty, University of Istanbul, Istanbul, Turkey.
Ozdogan
H
H
Celik
S
S
Ugurlu
S
S
Yazici
H
H
D000328:Adult; D003078:Colchicine / Q000494:pharmacology; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D000068800:Etanercept; D010505:Familial Mediterranean Fever / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use*; D013792:Thalidomide / Q000627:therapeutic use*; D050257:Tubulin Modulators / Q000494:pharmacology
D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D018124:Receptors, Tumor Necrosis Factor; D050257:Tubulin Modulators; D013792:Thalidomide; D000068800:Etanercept; D003078:Colchicine