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. 2018 Oct 19;2018(10):CD010893. doi: 10.1002/14651858.CD010893.pub3

De Benedetti 2018.

Methods RCT.
Placebo‐controlled, double blind.
 Parallel design.
Duration: 16 weeks.
Participants Participants with hereditary periodic fevers, including crFMF, hyper‐immunoglobulin D Syndrome (also mevalonate kinase deficiency (HIDS/MKD), and tumor necrosis factor receptor associated periodic syndrome (TRAPS). 1 cohort per disease.
crFMF was diagnosed with the Tel‐Hashomer criteria, and fulfil the following criteria:
• at least 1 known MEFV exon 10 mutation,
 • at least 1 fever episode per month despite a standard dose of colchicine (1.5 mg to 3.0 mg/day or equivalent paediatric‐adjusted regimen) or at least 1 fever episode per month with unacceptable side effects to colchicine.
63 participants with crFMF randomized.
Interventions Intervention: canakinumab 150 mg (or 2 mg/kg for participants weighing ≤ 40 kg) every 4 weeks for 16 weeks.
Control: placebo.
Outcomes Primary outcome measure
Proportion of participants who had a complete response, defined as resolution of the baseline flare at day 15 (PGA score of <2 plus CRP level of ≤10 mg/L or a reduction by ≥70% from baseline) and no new flare (PGA score of ≥2 and CRP level of ≥30 mg/L) until week 16.
 Secondary outcome measure
Proportion of participants who had a PGA score <2, a CRP level ≤10 mg/L, or a SAA level ≤10 mg/L at week 16.
Notes ClinicalTrials.gov Identifier: NCT02059291.
In the subsequent phase up to week 40, participants who had a complete response underwent a second randomization to receive canakinumab or placebo every 8 weeks. Participants who underwent a second randomization and had a subsequent flare and all other participants received open‐label canakinumab.

crFMF: colchicine resistant/intolerant familial Mediterranean fever
 CRP: C‐reactive protein
 PGA: physician's global assessment
 SAA: serum amyloid A