Tofacitinib for the treatment for colchicine-resistant familial Mediterranean fever: case-based review.

Abstract	Familial Mediterranean fever is characterized by self-limited attacks of serositis and arthritis. However, substantial number of patients suffer from chronic complications of this disease, primarily involving musculoskeletal system. Treatment for these complications is challenging due to limited evidence. Interleukin-1 (IL-1) antagonists, tocilizumab and anti-tumor necrosis factor (anti-TNF) agents are off-label treatment options for the management of chronic manifestations of FMF, such as secondary (AA) amyloidosis, chronic arthritis and sacroiliitis. This paper presents a case series of four FMF patients who are refractory to IL-1 antagonists, anti-TNF agents and tocilizumab, who responded well to tofacitinib. The authors also conducted a comprehensive literature search for studies investigating tofacitinib use in FMF patients. Although still limited, current data suggest that tofacitinib could be a useful treatment option for FMF patients with associated inflammatory comorbid conditions and chronic manifestations of disease.
Authors	Hazan Karadeniz, Aslıhan Avanoğlu Güler, Nuh Atas, Hasan Satış, Reyhan Bilici Salman, Hakan Babaoglu, Abdurrahman Tufan
Journal	Rheumatology international (Rheumatol Int) Vol. 40 Issue 1 Pg. 169-173 (Jan 2020) ISSN: 1437-160X [Electronic] Germany
PMID	31813060 (Publication Type: Journal Article, Review)
Chemical References	Antibodies, Monoclonal, Humanized Antirheumatic Agents Interleukin 1 Receptor Antagonist Protein Janus Kinase Inhibitors Piperidines Pyrimidines Tubulin Modulators Tumor Necrosis Factor Inhibitors tofacitinib tocilizumab Colchicine
Topics	Adult Antibodies, Monoclonal, Humanized (therapeutic use) Antirheumatic Agents (therapeutic use) Colchicine (therapeutic use) Drug Resistance Familial Mediterranean Fever (drug therapy) Female Humans Interleukin 1 Receptor Antagonist Protein (therapeutic use) Janus Kinase Inhibitors (therapeutic use) Male Middle Aged Piperidines (therapeutic use) Pyrimidines (therapeutic use) Treatment Failure Treatment Outcome Tubulin Modulators (therapeutic use) Tumor Necrosis Factor Inhibitors (therapeutic use)

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