期刊
BRITISH JOURNAL OF CLINICAL PHARMACOLOGY
卷 88, 期 6, 页码 2484-2499出版社
WILEY
DOI: 10.1111/bcp.15149
关键词
anakinra; canakinumab; children; colchicine; EMA; familial Mediterranean fever; FDA; interleukin-1 antagonists; rilonacept
Familial Mediterranean fever (FMF) is commonly diagnosed in childhood and is treated predominantly with colchicine, but in cases of intolerance or resistance, the use of biologics, especially interleukin-1 antagonists, should be considered.
Familial Mediterranean fever (FMF) is the most common monogenic autoinflammatory disease and is usually diagnosed in childhood, especially in the first decade of life. Paediatric FMF is characterized by a protean clinical expression and a variable therapeutic response, which can make its medical management very challenging. However, even if long-term complications of untreated FMF (e.g. amyloidosis and related organ damage) are less frequent in children compared to adults, they are not uncommon. Colchicine is the mainstay of the therapy in paediatric FMF; however, if children develop colchicine intolerance and/or resistance, biologics, particularly interleukin-1 antagonists, must be considered. Other conventional or biological therapeutic options do not currently have appropriate evidence-based support, except for some specific clinical presentations (e.g., arthritis). In this review, we discuss the biological basis and the clinical evidence for the current pharmacological treatment options available for paediatric FMF.
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