T Kallinich1, N Blank2, T Braun3, E Feist4, U Kiltz5, U Neudorf6, P T Oommen7, C Weseloh8, H Wittkowski9, J Braun10,11. 1. Pädiatrie m.S. Pulmonologie und Immunologie, Universitätsmedizin Charité Berlin, Berlin, Deutschland. 2. Rheumatologie, Universitätklinikum Heidelberg, Heidelberg, Deutschland. 3. Innere Medizin, Sankt-Gertrauden Krankenhaus, Berlin, Deutschland. 4. Klinik für Rheumatologie und Klinische Immunologie, Charité Universitätsmedizin-Berlin, Berlin, Deutschland. 5. Rheumazentrum Ruhrgebiet, Claudiusstr. 45, 44649, Herne, Deutschland. 6. Zentrum für Kinder- und Jugendmedizin - Bereich Rheumatologie, Universität Essen, Essen, Deutschland. 7. Klinik für Kinder-Onkologie, -Hämatologie und Klinische Immunologie, Zentrum für Kinder- und Jugendmedizin, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland. 8. Deutsche Gesellschaft für Rheumatologie, Berlin, Deutschland. 9. Klinik für pädiatrische Rheumatologie und Immunologie, Universitätsklinikum Münster, Münster, Deutschland. 10. Rheumazentrum Ruhrgebiet, Claudiusstr. 45, 44649, Herne, Deutschland. juergen.braun@elisabethgruppe.de. 11. Ruhr-Universität Bochum, Bochum, Deutschland. juergen.braun@elisabethgruppe.de.
Abstract
BACKGROUND: Familial Mediterranean fever (FMF) in Germany is a rare, genetically linked disease of childhood and adolescence, which is characterized by recurrent febrile episodes and clinical signs of peritonitis, pleuritis and arthritis. Treatment with colchicine is effective and well-tolerated in the majority of patients; however, some patients do not sufficiently respond to this treatment or are intolerant to colchicine. For these patients first-line treatment with biologics which block interleukin-1 can be used. OBJECTIVE: The aim was to formulate evidence-based treatment recommendations for patients with an insufficient response and intolerance to colchicine treatment. METHODS: Based on a literature search and the European League Against Rheumatism (EULAR) recommendations on FMF from 2016 the appointed members of the Society for Pediatric and Adolescent Rheumatology (GKJR) and the German Society for Rheumatology (DGRh) convened to work out and form a consensus in a joint statement on evidence-based treatment recommendations on FMF. RESULTS: After intensive discussions all decisions were in concordance. A total of 5 superordinate principles and 10 recommendations were agreed upon. DISCUSSION: The joint activities of the GKJR and the DGRh were successfully concluded in a timely manner. The recommendations form a good basis for optimal treatment of all age groups of patients with FMF.
BACKGROUND:Familial Mediterranean fever (FMF) in Germany is a rare, genetically linked disease of childhood and adolescence, which is characterized by recurrent febrile episodes and clinical signs of peritonitis, pleuritis and arthritis. Treatment with colchicine is effective and well-tolerated in the majority of patients; however, some patients do not sufficiently respond to this treatment or are intolerant to colchicine. For these patients first-line treatment with biologics which block interleukin-1 can be used. OBJECTIVE: The aim was to formulate evidence-based treatment recommendations for patients with an insufficient response and intolerance to colchicine treatment. METHODS: Based on a literature search and the European League Against Rheumatism (EULAR) recommendations on FMF from 2016 the appointed members of the Society for Pediatric and Adolescent Rheumatology (GKJR) and the German Society for Rheumatology (DGRh) convened to work out and form a consensus in a joint statement on evidence-based treatment recommendations on FMF. RESULTS: After intensive discussions all decisions were in concordance. A total of 5 superordinate principles and 10 recommendations were agreed upon. DISCUSSION: The joint activities of the GKJR and the DGRh were successfully concluded in a timely manner. The recommendations form a good basis for optimal treatment of all age groups of patients with FMF.
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