Mortality Risk Factors Associated with Familial Mediterranean Fever Among a Cohort of 1.25 Million Adolescents

Overview

Journal Ann Rheum Dis

Specialty Rheumatology

Date 2013 Mar 19

PMID 23505237

Citations 28

Authors

Gilad Twig

Avi Livneh

Asaf Vivante

Arnon Afek

Ari Shamiss

Estela Derazne

Dorit Tzur

Ilan Ben-Zvi

Amir Tirosh

Micha Barchana

Tamy Shohat

Eliezer Golan

Howard Amital

Affiliations

Soon will be listed here.

Abstract

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 8.73/10(4) versus 4.32/10(4) 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.

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