Canakinumab treatment in kidney transplant recipients with AA amyloidosis due to familial Mediterranean fever

Background: Familial Mediterranean fever (FMF) is an autoinflammatory disease characterized by recurrent serosal inflammation with fever, which can result in amyloid deposition. Anti-interleukin-1 drugs emerge as a therapeutic option for colchicine-resistant patients. In this study, we aimed to document our experience with canakinumab use in kidney transplant recipients who developed AA amyloidosis due to FMF. Methods: A total of nine patients with FMF amyloidosis treated with canakinumab were enrolled. Laboratory and clinical data were collected from the patient files, electronic database of the hospital and with interviews. Results: Five of the patients were male and four were female (median age: 33, range: 27-62 years). All of the patients had rapid or gradual disappearance of FMF attacks. The following changes in the laboratory parameters were observed before and after the treatment: C-reactive protein: 18.31 +/- 13.58 mg/L vs 9.98 +/- 11.66 mg/L, creatinine clearance: 45.27 +/- 21.5 mL/min vs 50.71 +/- 22.48 mL/min, and 24-hour proteinuria: 2381.8 +/- 3910.4 mg vs 710.0 +/- 1117.5 mg; there were no statistically significant differences on those parameters. One patient developed a reaction to injection while another showed symptoms of Cytomegalovirus pneumonia. Conclusion: Canakinumab can be considered as a safe and efficient drug in preventing the FMF attacks in kidney transplant recipients.