{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,19]],"date-time":"2026-07-19T17:28:20Z","timestamp":1784482100476,"version":"3.55.0"},"reference-count":25,"publisher":"The Journal of Rheumatology","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Rheumatol"],"accepted":{"date-parts":[[2025,12,10]]},"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to investigate real-world clinical practices regarding biologic therapy in colchicine-resistant familial Mediterranean fever (FMF), focusing on treatment initiation, tapering, discontinuation strategies, and related challenges.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A 29-item English-language survey was distributed to pediatric and adult rheumatologists via email. The target population consisted of rheumatologists from T\u00fcrkiye, Israel, and Italy (countries with a high prevalence of FMF) as well as Germany, where migrants of eastern Mediterranean origin live. The survey addressed preferences for biologic agents, colchicine compliance, tapering strategies, injection-site reaction management, and responses to trigger-related attacks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 126 clinicians responded. In the absence of regulatory constraints, 72.2% preferred canakinumab for colchicine-resistant FMF. The majority (94.4%) considered the standard dose of 2 mg\/kg\/day sufficient. Gradual extension of dose intervals was the most common tapering strategy. Whereas canakinumab was often tapered to dosing intervals of every 3-4 months, anakinra was tapered by extending the dosing interval to weekly administration in some cases. More than half (53.9%) observed a decline in colchicine compliance after starting biologics. Although 51.7% and 53.3% reported full efficacy after restarting anakinra and canakinumab, respectively, some clinicians noted reduced responses. Adult rheumatologists were more likely than pediatricians to support lifelong biologic therapy and reported greater concerns regarding colchicine compliance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Pediatric rheumatologists tended to favor discontinuation of biologic therapy rather than lifelong use. On-demand use of biologics also emerged as a treatment approach among treating physicians. Issues such as colchicine compliance, disease-specific triggers, and the potential to maintain efficacy upon reintroduction of interleukin 1 inhibitors after discontinuation should be prioritized in future research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3899\/jrheum.2025-0804","type":"journal-article","created":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T13:25:27Z","timestamp":1768483527000},"page":"556-561","source":"Crossref","is-referenced-by-count":1,"title":["How Physicians Manage Colchicine-Resistant Familial Mediterranean Fever: Insights From a Multinational Survey in High-Prevalence Countries"],"prefix":"10.3899","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6629-3967","authenticated-orcid":false,"given":"Veysel","family":"Cam","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dilara","family":"Unal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6542-2656","authenticated-orcid":false,"given":"Erdal","family":"Sag","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8748-7322","authenticated-orcid":false,"given":"Ozlem","family":"Satirer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saverio","family":"La Bella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ozge","family":"Basaran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yelda","family":"Bilginer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yosef","family":"Uziel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Gattorno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2883-7868","authenticated-orcid":false,"given":"Seza","family":"Ozen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2262","published-online":{"date-parts":[[2026,1,15]]},"reference":[{"key":"2026050105301094000_53.5.556.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0092-8674(00)80539-5"},{"key":"2026050105301094000_53.5.556.2","doi-asserted-by":"publisher","DOI":"10.1038\/ni.3457"},{"key":"2026050105301094000_53.5.556.3","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1186\/s13023-017-0609-1","article-title":"A survey of resistance to colchicine treatment for French patients with familial Mediterranean fever","volume":"12","author":"Corsia","year":"2017","journal-title":"Orphanet J Rare Dis"},{"key":"2026050105301094000_53.5.556.4","doi-asserted-by":"crossref","first-page":"3799","DOI":"10.1093\/rheumatology\/keaa863","article-title":"Defining colchicine resistance\/intolerance in patients with familial Mediterranean fever: a modified-Delphi consensus approach","volume":"60","author":"\u00d6zen","year":"2021","journal-title":"Rheumatology"},{"key":"2026050105301094000_53.5.556.5","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1186\/s12969-023-00925-5","article-title":"Is it possible to extend the dose interval of canakinumab treatment in children with familial Mediterranean fever? PeRA group experience","volume":"21","author":"Kavrul Kayaalp","year":"2023","journal-title":"Pediatr Rheumatol Online J"},{"key":"2026050105301094000_53.5.556.6","doi-asserted-by":"crossref","first-page":"2211","DOI":"10.1007\/s00296-022-05199-w","article-title":"Real-life data on tapering or discontinuation of canakinumab therapy in patients with familial Mediterranean fever","volume":"42","author":"Karabulut","year":"2022","journal-title":"Rheumatol Int"},{"key":"2026050105301094000_53.5.556.7","doi-asserted-by":"crossref","first-page":"3700","DOI":"10.1093\/rheumatology\/kead128","article-title":"Feasibility of canakinumab withdrawal in colchicine-resistant familial Mediterranean fever","volume":"62","author":"Sener","year":"2023","journal-title":"Rheumatology"},{"key":"2026050105301094000_53.5.556.8","doi-asserted-by":"crossref","first-page":"4064","DOI":"10.1093\/rheumatology\/keaf154","article-title":"Long-term follow-up after discontinuation of anti-IL1 treatment in colchicine-resistant familial Mediterranean fever","volume":"64","author":"Cam","year":"2025","journal-title":"Rheumatology"},{"key":"2026050105301094000_53.5.556.9","doi-asserted-by":"publisher","DOI":"10.1016\/S0049-0172(96)80012-6"},{"key":"2026050105301094000_53.5.556.10","doi-asserted-by":"crossref","first-page":"252","DOI":"10.5152\/eurasianjmed.2019.18396","article-title":"The spectrum of MEFV gene mutations and genotypes in the middle northern region of Turkey","volume":"51","author":"Celep","year":"2019","journal-title":"Eurasian J Med"},{"key":"2026050105301094000_53.5.556.11","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1093\/rheumatology\/kead514","article-title":"Efficacy and safety of anti-interleukin-1 treatment in familial Mediterranean fever patients: a systematic review and meta-analysis","volume":"63","author":"Kilic","year":"2024","journal-title":"Rheumatology"},{"key":"2026050105301094000_53.5.556.12","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2020.00971"},{"key":"2026050105301094000_53.5.556.13","unstructured":"TEB. [Turkish Pharmacists\u2019 Association.] [Website in Turkish. Internet. Accessed January 13, 2026.] Available from: https:\/\/www.teb.org.tr\/versions_latest\/700\/ut_20190904"},{"key":"2026050105301094000_53.5.556.14","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1007\/s10067-018-4230-z","article-title":"On demand use of anakinra for attacks of familial Mediterranean fever (FMF)","volume":"38","author":"Babaoglu","year":"2019","journal-title":"Clin Rheumatol"},{"key":"2026050105301094000_53.5.556.15","unstructured":"ClinicalTrials.gov . Randomized controlled trial in patients on long-term colchicine with colchicine-resistant familial Mediterranean fever (FMF) to evaluate the efficacy of on-demand anakinra treatment for painful attacks in patients who refuse continuous daily therapy (KIN-ATTACK-FMF). [Internet. Accessed January 5, 2026.] Available from: https:\/\/clinicaltrials.gov\/study\/NCT06336733"},{"key":"2026050105301094000_53.5.556.16","unstructured":"European Medicines Agency . Kineret. Annex 1: summary of product characteristics. [Internet. Accessed January 5, 2026.] Available from: https:\/\/www.ema.europa.eu\/en\/documents\/product-information\/kineret-epar-product-information_en.pdf"},{"key":"2026050105301094000_53.5.556.17","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-011-2096-3"},{"key":"2026050105301094000_53.5.556.18","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kev416"},{"key":"2026050105301094000_53.5.556.19","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2011.152728"},{"key":"2026050105301094000_53.5.556.20","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1097\/BOR.0000000000000948","article-title":"When to stop medication in juvenile idiopathic arthritis","volume":"35","author":"Abel","year":"2023","journal-title":"Curr Opin Rheumatol"},{"key":"2026050105301094000_53.5.556.21","doi-asserted-by":"crossref","first-page":"111491","DOI":"10.1016\/j.intimp.2024.111491","article-title":"Colchicine-intolerant familial Mediterranean fever patients: a comparative study between different colchicine doses and IL-1 inhibitor monotherapy","volume":"128","author":"Yildirim","year":"2024","journal-title":"Int Immunopharmacol"},{"key":"2026050105301094000_53.5.556.22","doi-asserted-by":"crossref","first-page":"152211","DOI":"10.1016\/j.semarthrit.2023.152211","article-title":"Adherence to colchicine prophylaxis among patients with familial Mediterranean fever treated with interleukin-1 inhibitors","volume":"61","author":"Levinsky","year":"2023","journal-title":"Semin Arthritis Rheum"},{"key":"2026050105301094000_53.5.556.23","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1016\/j.ard.2025.01.028","article-title":"EULAR\/PReS endorsed recommendations for the management of familial Mediterranean fever (FMF): 2024 update","volume":"84","author":"Ozen","year":"2025","journal-title":"Ann Rheum Dis"},{"key":"2026050105301094000_53.5.556.24","first-page":"303","article-title":"A clearer vision: insights into juvenile idiopathic arthritis-associated uveitis","volume":"37","author":"M Bani Khalaf","year":"2024","journal-title":"Proceedings"},{"key":"2026050105301094000_53.5.556.25","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-015-0016-z"}],"container-title":["The Journal of Rheumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.3899\/jrheum.2025-0804","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T12:30:52Z","timestamp":1777638652000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.jrheum.org\/lookup\/doi\/10.3899\/jrheum.2025-0804"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,15]]},"references-count":25,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5,1]]},"published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.3899\/jrheum.2025-0804"],"URL":"https:\/\/doi.org\/10.3899\/jrheum.2025-0804","relation":{},"ISSN":["0315-162X","1499-2752"],"issn-type":[{"value":"0315-162X","type":"print"},{"value":"1499-2752","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,15]]}}}