title: Effects of anti-tumor necrosis factor agents for familial mediterranean fever patients with chronic arthritis and/or sacroiliitis who were resistant to colchicine treatment.
abstract: BACKGROUND
  Effectiveness of anti-tumor necrosis factor (anti-TNF) agents in colchicine-resistant familial Mediterranean fever (FMF) patients has attracted attention in recent years.
  
  
  OBJECTIVE
  We analyzed the effect of anti-TNF agents on clinical findings of colchicine-resistant FMF patients with chronic arthritis and/or sacroiliitis.
  
  
  METHODS
  Data from 10 FMF patients (5 male and 5 female patients: mean age, 30.1 [SD, 8.5] years) with chronic arthritis and/or sacroiliitis who were on anti-TNF agents are reviewed. Frequency of FMF attacks before and after treatment with anti-TNF agents was recorded from hospital files. The effects of the anti-TNF treatment were determined by using the number of tender and/or swollen joints, serum acute phase reactant levels, and Bath Ankylosing Spondylitis Disease Activity Index scores. Change in urine protein loss was also evaluated in patients with amyloidosis. In 6 patients, FMF attacks had been considered to be unresponsive to colchicine, and 4 patients were partial responders before treatment with anti-TNF agents.
  
  
  RESULTS
  Mean attack frequency of the patients in the 3 months' period before anti-TNF agent treatment was 3.8 (SD, 3.1). After anti-TNF treatment, in 3 patients, FMF attack frequency decreased, and in the remaining 7 patients, no attack occurred. Serum acute phase reactant levels were decreased significantly at 3 and 6 months after anti-TNF treatment (P < 0.05 for all). After anti-TNF treatment Bath Ankylosing Spondylitis Disease Activity Index scores were also decreased significantly (6.2 [SD], 1.7 vs. 2.1 [SD], 1.7; P = 0.012). In all 3 patients with amyloidosis, urine protein loss decreased without any increase in serum creatinine levels.
  
  
  CONCLUSIONS
  Anti-TNF treatment can have beneficial effects for controlling FMF attacks in FMF patients with chronic arthritis and/or sacroiliitis.
authors.affiliation: From the Division of Rheumatology, Department of Internal Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: Sule Apras
authors.initials: SA
authors.lastname: Bilgen
authors.forename: Levent
authors.initials: L
authors.lastname: Kilic
authors.forename: Ali
authors.initials: A
authors.lastname: Akdogan
authors.forename: Sedat
authors.initials: S
authors.lastname: Kiraz
authors.forename: Umut
authors.initials: U
authors.lastname: Kalyoncu
authors.forename: Omer
authors.initials: O
authors.lastname: Karadag
authors.forename: Ihsan
authors.initials: I
authors.lastname: Ertenli
authors.forename: Ismail
authors.initials: I
authors.lastname: Dogan
authors.forename: Meral
authors.initials: M
authors.lastname: Calguneri
mesh_terms: D000209:Acute-Phase Proteins / Q000187:drug effects; D000068879:Adalimumab; D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000503:physiopathology; D003078:Colchicine / Q000008:administration & dosage*; D004351:Drug Resistance; D000068800:Etanercept; D010505:Familial Mediterranean Fever / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D006074:Gout Suppressants / Q000008:administration & dosage; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use; D000069285:Infliximab; D008297:Male; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D012189:Retrospective Studies; D058566:Sacroiliitis / Q000188:drug therapy* / Q000503:physiopathology; D012720:Severity of Illness Index; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*; D055815:Young Adult
chemical_list: D000209:Acute-Phase Proteins; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D006074:Gout Suppressants; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068879:Adalimumab; D000068800:Etanercept; D003078:Colchicine