Real-World Experience with Canakinumab in Familial Mediterranean Fever: A Single-Center Study

Familial Mediterranean fever (FMF) is an autoinflammatory disorder caused by mutations in the Mediterranean fever gene (MEFV), leading to excessive interleukin-1 beta (IL-1β) production. While colchicine is the primary treatment for FMF, a subset of patients exhibits resistance or intolerance, necessitating alternative therapeutic strategies. Canakinumab, a selective IL-1β inhibitor, has emerged as a potential treatment option. This study aims to evaluate canakinumab's real-world efficacy and safety in colchicine-resistant or colchicine-intolerant FMF patients. A retrospective, single-center study was conducted on FMF patients aged over 18 who initiated canakinumab treatment between January 2013 and October 2023. A total of 34 patients experiencing colchicine resistance or intolerance criteria were analyzed. Clinical and laboratory parameters, including Pras scores, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and serum amyloid A (SAA), were assessed before and after canakinumab treatment. Statistical analyses were performed using the Wilcoxon test and paired sample t-test. Canakinumab treatment significantly reduced Pras scores (p