The Preferential Use of Anakinra in Various Settings of FMF: A Review Applied to an Updated Treatment-Related Perspective of the Disease

Eitan Giat, Ilan Ben-Zvi, Merav Lidar, Avi Livneh*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

Familial Mediterranean fever (FMF), the most frequent monogenic autoinflammatory dis-ease, is manifested with recurrent and chronic inflammation and amyloid A (AA) amyloidosis, driven by overproduction of interleukin 1 (IL-1) through an activated pyrin inflammasome. Consequently, non-responsiveness to colchicine, the cornerstone of FMF treatment, is nowadays addressed by IL-1-blockers. Each of the two IL-1 blockers currently used in FMF, anakinra and canakinumab, has its own merits for FMF care. Here we focus on anakinra, a recombinant form of the naturally occurring IL-1 receptor antagonist, and explore the literature by using PubMed regarding the utility of anakinra in certain conditions of FMF. Occasionally we enrich published data with our own experience. To facilitate insights to anakinra role, the paper briefs some clinical, genetic, pathogenetic, and management aspects of FMF. The clinical settings of FMF covered in this review include colchicine resistance, AA amyloidosis, renal transplantation, protracted febrile myalgia, on-demand use, leg pain, arthritis, temporary suspension of colchicine, pediatric patients, and pregnancy and lactation. In many of these instances, either because of safety concerns or a necessity for only transient and short-term use, anakinra, due to its short half-life, is the preferred IL-1 blocker.

Original languageEnglish
Article number3956
JournalInternational Journal of Molecular Sciences
Volume23
Issue number7
DOIs
StatePublished - 1 Apr 2022

Keywords

  • AA amyloidosis
  • anakinra
  • chronic renal failure
  • colchicine failure
  • exertional leg pain
  • familial Mediterranean fever (FMF)
  • interleukin 1 blockers
  • kidney transplantation
  • protracted febrile myalgia
  • safety

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