Colchicine is the only drug known to effectively prevent familial Mediterranean fever (FMF) attacks, as well as FMF-associated amyloidosis. Unfortunately, colchicine is neither always effective nor always well tolerated, leaving some patients and their physicians with inadequate weaponry to fight this hazardous disease. We present a patient with recurrent episodes of abdominal, scrotal, and joint attacks, who was diagnosed with FMF and advised to take colchicine. Diarrhea prevented optimal treatment with this drug and led to a trial of etanercept, with resolution of FMF manifestations. This case adds to a growing body of evidence suggesting that tumor necrosis factor (TNF) blockade may result in resolution and prevention of further FMF attacks.
This inhibitor of TNF was effective in this patient who did not tolerate colchicine therapy.
From the *Department of Medicine, Division of Rheumatology, New York University School of Medicine/Hospital for Joint Diseases, New York, NY; the †Heller Institute of Medical Research, Sheba Medical Center, Tel-Hasomer; and the ‡Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Adam Mor, MD, and Michael H. Pillinger, MD, contributed equally to this work.
Reprints: Adam Mor, MD, Division of Rheumatology, Hospital for Joint Diseases, 301 East 17th Street, Room 1410, New York, NY 10003. E-mail: firstname.lastname@example.org.