Improvement of liver involvement in familial Mediterranean fever after introduction of canakinumab: a case report

Maurizio Pompili, Donato Rigante, Maria Grazia Massaro, Ludovico Luca Sicignano, Fabrizio Pizzolante, Fabio Maria Vecchio, Raffaele Manna, E Verrecchia

Research output: Contribution to journalArticle

Abstract

Hepatic involvement in familial Mediterranean fever (FMF) ranges from a nonspecific increase in liver enzymes to cryptogenic cirrhosis, and the liver is mostly involved in patients bearing the M694V MEFV mutation in homozygosis. A 44-year-old Jewish woman with FMF developed nonalcoholic steatohepatitis during colchicine treatment (2,5 mg per day), confirmed by both elastography and liver biopsy. Therefore, combined therapy with the interleukin-1 (IL-1) blocking agent canakinumab (150 mg every four weeks) and colchicine (at a reduced dose of 1.5 mg per day) was started. Three months later, transaminases became normal, and after further six months, there was a marked improvement of liver fibrosis. IL-1 blockade has the power to halt or mitigate liver involvement in FMF patients. However, further experience is required to assess its therapeutic potential in the most severe patients with the hepatic disease who are partially responsive to long-term prophylaxis with colchicine.
Original languageEnglish
Pages (from-to)1-5
Number of pages5
JournalMediterranean Journal of Hematology and Infectious Diseases
Volume2020
DOIs
Publication statusPublished - 2020

Keywords

  • Canakinumab
  • Familial Mediterranean fever

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