Adherence to best practice consensus guidelines for familial Mediterranean fever: a modified Delphi study among paediatric rheumatologists in Turkey
| Autor: | Şerife Gül Karadağ, Semanur Özdel, Rukiye Eker Omeroglu, Deniz Gezgin Yıldırım, Betül Sözeri, Nuray Aktay Ayaz, Elif Çelikel, Mustafa Çakan, Nihal Şahin, Gülçin Otar Yener, Ferhat Demir, Esra Bağlan, Hafize Emine Sönmez, Gülşah Kavrul Kayaalp, Kubra Ozturk |
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| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
medicine.medical_specialty
Consensus Delphi Technique Turkey genetic structures Best practice Immunology Modified delphi Drug Resistance Familial Mediterranean fever Observational Research 03 medical and health sciences Biological agents 0302 clinical medicine Rheumatology Internal medicine medicine otorhinolaryngologic diseases Immunology and Allergy Humans 030212 general & internal medicine Family history Adverse effect Child Children 030203 arthritis & rheumatology business.industry Amyloidosis medicine.disease Tubulin Modulators Colchicine resistance COLCHICINE RESISTANCE Guideline Adherence Rheumatologists business Colchicine psychological phenomena and processes |
| Zdroj: | Rheumatology International |
| Popis: | Background Although not validated fully, recommendations are present for diagnosis, screening and treatment modalities of patients with familial Mediterranean fever (FMF). Objective To review the current practices of clinicians regarding FMF and reveal their adherence to consensus guidelines. Methods Fifteen key points selected regarding the diagnosis and management of FMF were assessed by 14 paediatric rheumatologists with a three-round modified Delphi panel. Results Consensus was reached on the following aspects: genetic analysis should be ordered to all patients when clinical findings support FMF, but its result is not decisive alone. In the absence of clinical features, colchicine should be commenced when two pathogenic alleles and family history of amyloidosis are present. Serum amyloid A testing at each visit is recommended in patients resistant to colchicine, with subclinical inflammation and family history of amyloidosis. Consensus was reached on both the definition of colchicine resistance and starting biologic in resistant cases. Cost, efficiency, ease of use, treatment adherence, accessibility and emergence of adverse events are the factors affecting the choice of biologic agents. In patients without any attack and evidence of subclinical inflammation within the last 6 months following initiation of biologics, treatment dose intervals can be prolonged. Conclusion A consensus was achieved regarding the routine diagnosis and screening and treatment of FMF patients. The definition of colchicine resistance was made and a protocol was created for prolongation of treatment intervals of biologic agents. We anticipate that the results of the study reveal real-life data on the approach to patients in clinical practice. Supplementary Information The online version contains supplementary material available at 10.1007/s00296-020-04776-1. |
| Databáze: | OpenAIRE |
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