Effect of MEFV gene variants and treatment modalities on attack-free period acute phase reactants of patients with familial Mediterranean fever Ailevi Akdeniz ateşi hastalarında MEFV gen varyantları ve tedavi yöntemlerinin ataksız dönemdeki akut faz reaktanları üzerindeki etkisi

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Torun E. S., Birinci D., FINDIK E., Ertaş E.

Journal of Turkish Society For Rheumatology, cilt.17, sa.3, ss.162-173, 2025 (Scopus, TRDizin)

Özet

Objective: Attack-free period C-reactive protein (CRP) and serum amyloid A (SAA) are reliable indicators of subclinical inflammation in familial Mediterranean fever (FMF). We aimed to compare the acute phase reactants during the attack-free period, and the presence of subclinical inflammation in FMF patients with different gene variants and different treatment modalities. Methods: CRP and SAA levels during a symptom-free period of at least 2 weeks were obtained, and the median CRP and SAA levels were calculated during the attack-free period. “Subclinical inflammation” was defined as “median attack-free CRP >10 mg/L or median attack-free SAA >10 mg/L.” Patients were classified according to MEFV variants (two, one, or zero exon 10 variants) and treatments (colchicine-only or colchicine+interleukin 1 inhibitors). Results: Seventy-six patients had two exon 10 variants, 79 had one exon 10 variant, and 17 had non-exon 10 variants. Most patients used colchicine (n=155), and 17 patients used colchicine + interleukin-1 inhibitors. Attack-free CRP, SAA, and rate of subclinical inflammation were significantly different among variant groups, higher among patients with 2 exon 10 variants. Patients receiving combination treatment had higher levels of attack-free CRP and SAA compared to the colchicine-only group. CRP and SAA were strongly correlated. Conclusion: Patients with two exon 10 variants had higher attack-free acute phase reactants and more frequent subclinical inflammation, which reflects the pathogenicity of exon 10 variants. Patients receiving interleukin 1+colchicine continue to have higher attack-free acute phase reactants, which reflects their higher inflammatory burden and severe clinical features.