RT Journal Article
SR Electronic
T1 Mortality risk factors associated with familial Mediterranean fever among a cohort of 1.25 million adolescents
JF Annals of the Rheumatic Diseases
JO Ann Rheum Dis
FD BMJ Publishing Group Ltd and European League Against Rheumatism
SP 704
OP 709
DO 10.1136/annrheumdis-2012-202932
VO 73
IS 4
A1 Gilad Twig
A1 Avi Livneh
A1 Asaf Vivante
A1 Arnon Afek
A1 Ari Shamiss
A1 Estela Derazne
A1 Dorit Tzur
A1 Ilan Ben-Zvi
A1 Amir Tirosh
A1 Micha Barchana
A1 Tamy Shohat
A1 Eliezer Golan
A1 Howard Amital
YR 2014
UL http://ard.bmj.com/content/73/4/704.abstract
AB Objective There are limited data on long-term comorbidities and mortality among patients with familial Mediterranean fever (FMF). Our objective was to evaluate comorbidities and death rates among individuals with FMF. Methods We studied a nationwide, population-based, retrospective cohort of 1225 individuals with FMF (59% men) in a database of 1 244 350 adolescents (16–20 years of age) medically evaluated for military service between 1973 and 1997. This cohort was linked with the national mortality, cancer and end-stage renal disease (ESRD) registries in Israel. Study outcomes were all-cause mortality, occurrence of ESRD and malignancy by the age of 50 years. Results During 30 years of follow-up, death rates were 8.73/104 versus 4.32/104 person-years in the FMF and control groups, respectively (p=0.002). In a multivariable analysis adjusted for age, birth year, socio-economic status, education, ethnicity and body mass index, FMF was associated with increased mortality in men (HR=1.705 (95% CI 1.059 to 2.745), p=0.028) and women (HR=2.48 (1.032 to 5.992), p=0.042). Renal amyloidosis accounted for 35% and 60% of deaths in men and women, respectively. FMF was not associated with an increased incidence of cancer. Conclusions FMF is associated with increased all-cause mortality that is likely attributed to reduced colchicine compliance or responsiveness. Individuals with FMF do not have an increased incidence of cancer. These results support the awareness among medical community to decrease the higher than average mortality rate among participants with FMF.