Ailevi Akdeniz Ateşi Hastalarının Tedavilere Göre Değişen Komorbidite Profili

Öz

Amaç: Komorbiditelerin hastanın yaşam kalitesi ve hatta sağkalımı üzerinde etkisi olabilir. Ailevi Akdeniz Ateşi (AAA) hastalarında tedaviye direnç/başarısızlık, şiddetli hastalığın dolaylı bir göstergesi olabilir. AAA hastalık şiddeti arttıkça, inflamasyon ve hasara bağlı komorbiditeler de artabilir. Literatürde AAA hastalarında, özellikle de tedaviye dirençli gruptaki erişkin hastalarda komorbiditelere ilişkin yeterli çalışma bulunmamaktadır. Bu çalışmada, AAA tedavi basamaklarına göre hastaların komorbid durumlarının değerlendirilmesi amaçlandı. Gereç ve Yöntem: Mayıs 2019 ile Mart 2024 tarihleri arasında romatoloji kliniğimizde tedavi edilen 740 AAA hastası retrospektif olarak incelendi. Hastaların demografik özellikleri, komorbiditeleri, ailede AAA öyküsü ve AAA tedavileri değerlendirildi. Hastalar AAA tedavilerine göre kaplanmış kolşisin, sıkıştırılmış kolşisin ve IL-1 inhibitörü olmak üzere 3 gruba ayrıldı. Hastalar, mevcut geri ödeme kılavuzlarına uygun olarak hastalık aktiviteleri ile uyumlu tedaviler almıştır. Bulgular: AAA hastalarının ortalama yaşı (SD) 40,7 (13,3) ve %62,4’ü kadındı. Hastaların %44,7’sinde en az bir komorbidite vardı. En sık görülen üç komorbidite hipertansiyon (%20), hiperlipidemi (%7) ve depresyondur (%6,8). Başlangıçtaki kaplanmış kolşisin tedavisi toplam %24,5 hastada sıkıştırılmış kolşisin olarak değiştirilmiş, %13,2 hastada ise IL-1 inhibisyonuna geçilmiştir. IL-1 inhibitörü tedavisi gören hastalarda hipertansiyon ve kronik böbrek hastalığı daha yaygındır. Sonuç: Retrospektif analizimiz, AAA hastalarının, özellikle IL-1 inhibitörü grubundakilerin, daha genç olmalarına rağmen, hipertansiyon, hiperlipidemi ve depresyon gibi komorbiditeleri sıklıkla yaşadığını göstermektedir ve bu da şiddetli hastalık ve kronik inflamasyon arasında potansiyel bir bağlantı olduğunu düşündürmektedir. Özellikle şiddetli hastalığı olanlarda komorbiditelerin kapsamlı bir şekilde değerlendirilmesi, komplikasyonları önlemek ve yaşam kalitesini artırmak için gereklidir.

Anahtar Kelimeler

• Ailevi akdeniz ateşi
• hipertansiyon
• kolşisin
• komorbidite

Comorbidity Profile of Familial Mediterranean Fever Patients Varies by Treatments

Öz

Objective: Comorbidities may have an impact on the patient’s quality of life and even survival. Treatment resistance in Familial Mediterranean Fever (FMF) may indirectly indicate severe disease, with inflammation-related comorbidities increasing as severity rises. In the literature, there are no sufficient studies regarding comorbidities in FMF patients. In this study, we aimed to evaluate the comorbid conditions of patients according to FMF treatment steps. Material and Method: We retrospectively reviewed 740 patients with FMF treated at our rheumatology clinic between May 2019 and March 2024. Patient characteristics, comorbidities, and FMF treatments of patients were evaluated. Patients were grouped according to their FMF treatment: coated colchicine, compressed colchicine, and IL-1 inhibition. Patients received treatments aligned with their disease activity, in accordance with current reimbursement guidelines. Results: The mean age (SD) of FMF patients was 40.7 (13.3) and 62.4% were female. Of the 44.7% all patients had at least one comorbidity. The three most common comorbidities are hypertension (20%), hyperlipidemia (7%), and depression (6.8%). The initial coated colchicine treatment was changed in a total of 24.5% to compressed colchicine, further step up was done in 13.2% patients to IL-1 inhibition. Hypertension and chronic kidney disease were more common in patients under IL-1 inhibitor treatment. Conclusion: Our retrospective analysis shows that FMF patients, especially those in the IL-1 inhibitor group, frequently experience comorbidities like hypertension, hyperlipidemia, and depression, even though these patients are younger, suggesting a potential link to severe disease. A comprehensive evaluation of comorbidities, especially in severe disease, is essential to prevent complications, and improve quality of life.

Anahtar Kelimeler

• Colchicine
• comorbidity
• Familial Mediterranean Fever
• hypertension.

Kaynakça

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