Outcomes of Canakinumab Treatment in Recipients of Kidney Transplant With Familial Mediterranean Fever: A Case Series

<p>The Efficacy, Safety and Tolerability of Canakinumab in the Treatment of Familial Mediterranean Fever: A Systematic Review of the Literature</p>

“…Data on previous immunosuppressive therapy were available for 100 patients. [13][14][15][16][17][18][19][20][21] Forty-four patients used Anakinra prior to initiation of Canakinumab therapy. Of them, 26 had an intolerance to Anakinra and in 16 patients Anakinra was ineffective in preventing attacks.…”

“…Of them, 26 had an intolerance to Anakinra and in 16 patients Anakinra was ineffective in preventing attacks. One patient had a good response to anakinra but was switched to Canakinumab due to ease of use, 17 whereas the reason for the switch was not given in one. 16 One hundred and seventy-four patients continued to use colchicine in association with Canakinumab.…”

“…The most common dose of Canakinumab was 2mg/kg in patients <40kg, or 150mg in those above. 13,17,18,[20][21][22][23][24][25][26][27][28] In case of inadequate disease control, an increase in dose to 3-4mg/kg in those below 40kg or 300mg in those over was used in 8 studies. 10,14,15,19,23,[29][30][31] In 8 studies, 10,19,22,[25][26][27][28]31 Canakinumab was given at 4-weekly intervals, in 3 studies 18,21,24 it was given at 8-weekly intervals, whereas the remaining studies had dosing frequencies tailored to clinical needs and/or protocols, with the medication being given every 4, 6 or 8 weeks.…”

“…Information about the presence of renal or systemic amyloidosis could be obtained from 121 patients in 11 of the assessed studies. 14,17,24,[26][27][28] Twenty-four patients had type AA amyloidosis at the start of treatment. Of those, six had Notes: Data are provided as mean ± standard deviation or median and range.…”

“…Four patients had end-stage renal disease requiring dialysis when Canakinumab was started, of whom 2 experienced improvement in renal function, one discontinued Canakinumab due to disease progression, and one of them continued to renal transplantation without evidence of recurrence under Canakinumab treatment. 17 A further 14 patients were renal allograft recipients following amyloid-induced end-stage renal failure. 17,26,28 Of these, 7 had evidence of amyloid deposition in the allograft, leading to the introduction of Canakinumab, 28 whilst poorly controlled inflammatory attacks were the indication for implementation of Canakinumab in the remaining patients.…”