Interferon-alpha as a treatment modality for colchicine- resistant familial Mediterranean fever.
OBJECTIVE
Previous reports on interferon-alpha (IFN-alpha) were conflicting with respect to its efficacy in familial Mediterranean fever (FMF) refractory to colchicine treatment. We investigated the effect of IFN-alpha in patients with colchicine-resistant FMF.


METHODS
In a prospective, patient self-controlled, open-label study evaluating the safety and efficacy of IFN-alpha in patients with FMF with a severe phenotype, refractory to intensified (oral plus intravenous) colchicine therapy, we advised patients to subcutaneously inject IFN-alpha, 3 million international units, at the onset of the FMF attack. Attacks not treated with IFN-alpha of the same patients and in the same sites served as control attacks. Features of each attack were recorded in a questionnaire, eventually used to compare between IFN-alpha-treated and non-treated attacks.


RESULTS
Ten patients with a total of 80 attacks were recruited. Compared to 22 untreated attacks, a > 20% and > 50% reduction in the duration of the attacks was noted in 100% and 90% of the 58 IFN-alpha-treated attacks, respectively (p < 0.001 for both). The severity (degree of pain) of the IFN-alpha-treated attacks was attenuated by > 20% and > 50% in 88% and 49% of these attacks, respectively (p < 0.001 for both). The most common drug-related adverse events were chills and fatigue.


CONCLUSIONS
Early intervention with IFN-alpha injections was associated with reduced attack length and/or severity in a substantial number of bouts, with an acceptable cost of adverse events.
Tweezer-Zaks
Nurit
N
Heller Institute of Medical Research, Sheba Medical Center, Tel-Hashomer, affiliated with Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Rabinovich
Einat
E
Lidar
Merav
M
Livneh
Avi
A
D000328:Adult; D003078:Colchicine / Q000627:therapeutic use; D010505:Familial Mediterranean Fever / Q000188:drug therapy*; D006074:Gout Suppressants / Q000627:therapeutic use; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects / Q000627:therapeutic use*; D016898:Interferon-alpha / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D010865:Pilot Projects; D017211:Treatment Failure; D016896:Treatment Outcome
D006074:Gout Suppressants; D007155:Immunologic Factors; D016898:Interferon-alpha; D003078:Colchicine