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

KARADENİZ H., AVANOĞLU GÜLER A., Atas N., SATIŞ H., Salman R. B., Babaoglu H., ...More

RHEUMATOLOGY INTERNATIONAL, vol.40, no.1, pp.169-173, 2020 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Review
  • Volume: 40 Issue: 1
  • Publication Date: 2020
  • Doi Number: 10.1007/s00296-019-04490-7
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CAB Abstracts, EMBASE, MEDLINE, Veterinary Science Database
  • Page Numbers: pp.169-173
  • Keywords: Familial Mediterranean fever, Auto-inflammatory disease, Spondylarthritis, Tofacitinib, Janus kinase (JAK) inhibitor
  • Gazi University Affiliated: Yes


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.