Treatment options in colchicine resistant familial Mediterranean fever patients: thalidomide and etanercept as adjunctive agents

Clin Exp Rheumatol. 2006 Sep-Oct;24(5 Suppl 42):S99-103.


Objective: Regular colchicine treatment cannot control the typical febrile attacks of FMF in about 5-10% of the compliant patients. Here we report the effect of thalidomide and etanercept in 5 colchicine-resistant cases.

Methods: Five (4M/ 1F) FMF patients between April 2005 and March 2006, who were experiencing at least 2 attacks per month, despite regular colchicine were included to the study. Four male patients were given thalidomide 100 mg/d initially. Two of these patients unresponsive to thalidomide were prescribed subcutaneous injections of etanercept 25 mg, twice a week. The female patient received etanercept as the first choice due to potential side effects. She then had to be converted to thalidomide due to a severe injection site reaction.

Results: The median follow up period with thalidomide and etanercept was 8 months. Both thalidomide and etanercept lowered the number of the abdominal attacks.

Conclusion: Thalidomide and etanercept might be effective as additional treatment in colchicine-resistant cases of FMF.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Colchicine / pharmacology
  • Drug Resistance
  • Drug Therapy, Combination
  • Etanercept
  • Familial Mediterranean Fever / drug therapy*
  • Female
  • Humans
  • Immunoglobulin G / therapeutic use*
  • Immunosuppressive Agents / therapeutic use*
  • Male
  • Receptors, Tumor Necrosis Factor / therapeutic use*
  • Thalidomide / therapeutic use*
  • Tubulin Modulators / pharmacology


  • Immunoglobulin G
  • Immunosuppressive Agents
  • Receptors, Tumor Necrosis Factor
  • Tubulin Modulators
  • Thalidomide
  • Etanercept
  • Colchicine