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Anakinra/canakinumab Allergic reactions and disease progression: 3 case reports

In a single centre retrospective study of 25 pediatric colchicine-resistant familial mediterranean fever (FMF) patients treated with anti-interleukin-1 (anti-IL-1) treatment conducted between 2013 and 2019, 3 patients (2 males and 1 patient) [exact ages and not all sex stated] were described, of whom, the two male patients developed worsening of attacks during treatment with canakinumab and the remaining patient developed allergic reaction during treatment with anakinra [dosages, routes, not all duration of treatment to reaction onset and outcomes not stated]. The patients, who had colchicine-resistant familial mediterranean fever (FMF) received treatment with canakinumab and anakinra. Two male patients received treatment with canakinumab and both the patients switched to anakinra for the increase in frequency of the attacks. One of the male patient, who switched from canakinumab to anakinra had a M694V homozygous mutation; the attacks of this patient included abdominal-chest pain and fever and, an increased incidence of attacks after 17 months of canakinumab use. After changing the treatmwnt to anakinra, his number of attack significantly reduced. The other male patient with M694V/M680I mutation had an increase in attack frequency and proteinuria after 6 months of canakinumab treatment. After changing the treatment to anakinra, a decrease in the number of attacks and improvement in proteinuria were observed. He developed renal amyloidosis at follow-up. The remaining patient developed allergic reactions in the form of severe disseminated urticarial rash with anakinra treatment. Kurt T, et al. Effect of anti-interleukin-1 treatment on quality of life in children with colchicine-resistant familial Mediterranean fever: A single-center experience. International Journal of Rheumatic Diseases 23: 977-981, No. 7, Jul 2020. Available from: URL: http://doi.org/10.1111/1756-185X.13891

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Reactions 5 Sep 2020 No. 1820