Department of Pediatric Rheumatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Department of Pediatric Rheumatology, University of Health Sciences, Umraniye Research and Training Hospital, Istanbul, Turkey.
Pediatr Rheumatol Online J. 2023 Nov 23;21(1):140. doi: 10.1186/s12969-023-00925-5.
There is no clear data on the optimal duration of treatment with anti-interleukin-1 drugs in colchicine-resistant familial Mediterranean fever patients, as well as on the dose interval. This study aimed to assess patients whose canakinumab dose interval was adjusted according to a specific protocol, with the objective of evaluating the effectiveness of implementing this protocol for the patient care.
The files of 45 patients whose canakinumab treatment interval was opened with a standard protocol previously determined by the Delphi method were retrospectively reviewed.
Canakinumab treatment was initiated once a month for all patients. In the sixth month of canakinumab treatment, a dose interval extension was introduced; however, 7 patients (15.5%) experienced an attack, and consequently, no further interval extension was administered to them. For 29 patients, the dose interval was successfully extended to once every three months, as they remained attack-free for a year after the first interval extension. Nine patients continued receiving the drug every 2 months, as they had not yet completed one year since the first extension. The study found no significant correlation between experiencing an attack during the dose interval extension protocol and the number, duration of attacks, or autoinflammatory diseases activity index score.
Extending treatment intervals with canakinumab in colchicine-resistant familial Mediterranean fever shows promise for favorable outcomes.
对于秋水仙碱抵抗的家族性地中海热患者，抗白细胞介素-1 药物的最佳治疗持续时间以及剂量间隔尚无明确数据。本研究旨在评估根据特定方案调整卡那奴单抗剂量间隔的患者，目的是评估实施该方案对患者护理的有效性。
回顾性分析了 45 名患者的病历，这些患者的卡那奴单抗治疗间隔是按照之前通过德尔菲法确定的标准方案进行开放的。
所有患者均每月接受一次卡那奴单抗治疗。在卡那奴单抗治疗的第六个月，引入了剂量间隔延长方案；然而，7 名患者（15.5%）出现了发作，因此，不再对他们进行进一步的间隔延长。对于 29 名患者，成功地将剂量间隔延长至每三个月一次，因为他们在第一次间隔延长后一年都没有发作。9 名患者继续每两个月接受一次药物治疗，因为他们自第一次延长以来还没有满一年。研究发现，在剂量间隔延长方案期间发作与发作次数、发作持续时间或自身炎症性疾病活动指数评分之间没有显著相关性。
在秋水仙碱抵抗的家族性地中海热中延长卡那奴单抗的治疗间隔有望获得良好的结果。
