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Journal of Nephrology

, Volume 31, Issue 3, pp 453–455 | Cite as

Canakinumab treatment in renal transplant recipients with familial Mediterranean fever

  • Tolga Yildirim
  • Rahmi Yilmaz
  • Muge Uzerk Kibar
  • Yunus Erdem
Case Report

Abstract

Colchicine is the first-line treatment for familial Mediterranean fever (FMF), preventing both inflammatory attacks as well as the development of amyloidosis in the majority of the patients. However approximately 5–10% of patients are colchicine resistant/intolerant. Side effects of colchicine are more prominent in renal transplant recipients due to interaction with immunosuppressive drugs. Anti-interleukin (IL)-1 drugs (anakinra, canakinumab and rilonacept) have emerged as the most promising drugs in the treatment of colchicine-resistant and/or intolerant FMF. There are no existing reports in the literature on canakinumab use in renal transplant recipients with FMF. We report here the efficacy and safety of canakinumab in three renal transplant recipients who achieved a complete clinical response with elimination of attacks and normalization of serum C-reactive protein (CRP) levels without significant side effects. This highlights the advantage of use of this drug in this setting, which has a better tolerability compared to anakinra.

Keywords

Canakinumab Familial Mediterranean fever IL-1 Renal transplantation 

Notes

Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Padeh S, Berkun Y (2016) Familial Mediterranean fever. Curr Opin Rheumatol 28(5):523–529CrossRefPubMedGoogle Scholar
  2. 2.
    Lachmann HJ, Sengül B, Yavuzşen TU, Booth DR, Booth SE, Bybee A, Gallimore JR, Soytürk M, Akar S, Tunca M, Hawkins PN (2006) Clinical and subclinical inflammation in patients with familial Mediterranean fever and in heterozygous carriers of MEFV mutations. Rheumatology 45(6):746–750CrossRefPubMedGoogle Scholar
  3. 3.
    Moser C, Pohl G, Haslinger I, Knapp S, Rowczenio D, Russel T, Lachmann HJ, Lang U, Kovarik J (2009) Successful treatment of familial Mediterranean fever with Anakinra and outcome after renal transplantation. Nephrol Dial Transplant 24(2):676–678CrossRefPubMedGoogle Scholar
  4. 4.
    Lidar M, Scherrmann JM, Shinar Y, Chetrit A, Niel E, Gershoni-Baruch R, Langevitz P, Livneh A (2004) Colchicine nonresponsiveness in familial Mediterranean fever: clinical, genetic, pharmacokinetic, and socioeconomic characterization. Semin Arthritis Rheum 33(4):273–282CrossRefPubMedGoogle Scholar
  5. 5.
    Cerquaglia C, Diaco M, Nucera G, La Regina M, Montalto M, Manna R (2005) Pharmacological and clinical basis of treatment of familial Mediterranean fever (FMF) with colchicine or analogues: an update. Curr Drug Targets Inflamm Allergy 4(1):117–124CrossRefPubMedGoogle Scholar
  6. 6.
    van der Hilst JCH, Moutschen M, Messiaen PE, Lauwerys BR, Vanderschueren S (2016) Efficacy of anti-IL-1 treatment in familial Mediterranean fever: a systematic review of the literature. Biologics 10:75–80PubMedPubMedCentralGoogle Scholar
  7. 7.
    Hentgen V, Grateau G, Kone-Paut I, Livneh A, Padeh S, Rozenbaum M, Amselem S, Gershoni-Baruch R, Touitou I, Ben-Chetrit E (2013) Evidence-based recommendations for the practical management of familial Mediterranean fever. Semin Arthritis Rheum 43(3):387–391CrossRefPubMedGoogle Scholar
  8. 8.
    Ozen S, Demirkaya E, Erer B, Livneh A, Ben-Chetrit E, Giancane G, Ozdogan H, Abu I, Gattorno M, Hawkins PN, Yuce S, Kallinich T, Bilginer Y, Kastner D, Carmona L (2016) EULAR recommendations for the management of familial Mediterranean fever. Ann Rheum Dis 75(4):644–651CrossRefPubMedGoogle Scholar
  9. 9.
    Stankovic Stojanovic K, Delmas Y, Torres PU, Peltier J, Pelle G, Jéru I, Colombat M, Grateau G (2012) Dramatic beneficial effect of interleukin-1 inhibitor treatment in patients with familial Mediterranean fever complicated with amyloidosis and renal failure. Nephrol Dial Transplant 27(5):1898–1901CrossRefPubMedGoogle Scholar
  10. 10.
    Celebi ZK, Kucuksahin O, Sengul S, Tuzuner A, Keven K (2014) Colchicine-resistant familial Mediterranean fever in a renal transplantation patient: successful treatment with anakinra. Clin Kidney J 7(2):219–220CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Dinarello CA, van der Meer JWM (2013) Treating inflammation by blocking interleukin-1 in humans. Semin Immunol 25:469–484CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Hacıhamdioğlu DO, Ozen S (2012) Canakinumab induces remission in a patient with resistant familial Mediterranean fever. Rheumatology 51(6):1041CrossRefPubMedGoogle Scholar
  13. 13.
    Alpa M, Roccatello D (2015) Canakinumab as rescue therapy in familial Mediterranean fever refractory to conventional treatment. Drug Des Devel Ther 9:1983–1987PubMedPubMedCentralGoogle Scholar
  14. 14.
    Meinzer U, Quartier P, Alexandra JF, Hentgen V, Retornaz F, Koné-Paut I (2011) Interleukin-1 targeting drugs in familial Mediterranean fever: a case series and a review of the literature. Semin Arthritis Rheum 41(2):265–271CrossRefPubMedGoogle Scholar
  15. 15.
    Laskari K, Boura P, Dalekos GN, Garyfallos A, Karokis D, Pikazis D, Settas L, Skarantavos G, Tsitsami E, Sfikakis PP (2017) Longterm beneficial effect of Canakinumab in colchicine-resistant familial Mediterranean fever. J Rheumatol 44(1):102–109CrossRefPubMedGoogle Scholar

Copyright information

© Italian Society of Nephrology 2018

Authors and Affiliations

  1. 1.Nephrology DepartmentHacettepe University Medical Faculty, SihhiyeAnkaraTurkey

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