IL-1 blockers together with colchicine may be administered as first line therapy in familial Mediterranean fever with amyloidosis.

Colchicine is the first choice of the treatment in familial Mediterranean fever (FMF). However, in FMF patients with amyloidosis, especially during creatinine level >1.5 mg/dL and nephrotic range proteinuria, colchicine may be ineffective. Interleukin-1 (IL-1) blockers could be used in colchicine resistant cases. However, starting IL-1 blocker treatment after colchicine failure may lose opportunity for effective treatment. Therefore, administering IL-1 blocker together with colchicine as first line therapy may increase the chance for suppressing the disease.