Evidence-based recommendations for the practical management of Familial Mediterranean Fever

Semin Arthritis Rheum. 2013 Dec;43(3):387-91. doi: 10.1016/j.semarthrit.2013.04.011. Epub 2013 Jun 3.


Aim: Familial Mediterranean Fever (FMF) is the most common recurrent autoinflammatory fever syndrome. Still, many issues-e.g.: colchicine dosage adjustment, maximum dosage of colchicine in children and adults, definition of colchicine resistance, alternative treatment solutions in colchicine-resistant patients, and genetic screening for asymptomatic siblings-have not yet been standardized. The current paper aims at summarizing consensus recommendations to approach these issues.

Methods: A literature review concerning these practical management questions was performed through PubMed. On the basis of this analysis, expert recommendations were developed during a consensus meeting of caregivers from France and Israel.

Results: A patient experiencing more than four FMF attacks a year needs colchicine dose adjustment. In case of persistent attacks (≥6 per year) in patients with maximum doses of colchicine (2 mg in children; 3 mg in adults), alternative treatment to colchicine with IL1 inhibitors should be considered. Routine genetic testing for MEFV mutations in asymptomatic siblings of an index case is not recommended.

Conclusion: This is a first attempt to resolve practical questions in the daily management of FMF patients.

Keywords: Biological agents; Colchicine; Colchicine resistance; Consensus development conference; Familial Mediterranean fever; Genetic analysis; Guidelines; Review; Siblings; Therapy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Child
  • Colchicine / administration & dosage
  • Colchicine / adverse effects
  • Colchicine / therapeutic use*
  • Consensus
  • Drug Administration Schedule
  • Evidence-Based Medicine*
  • Familial Mediterranean Fever / drug therapy*
  • Humans


  • Colchicine