Etanercept in the treatment of arthritis in a patient with familial Mediterranean fever

Familial Mediterranean fever (FMF) patients may present with different joint complaints, one being the 'protracted attack' that lasts for weeks. We present a 15 year-old boy with polyarthritis (right wrist, knee, shoulder, and both ankles) while on colchicine treatment,for FMF His polyarthritis was resistant to treatment with prednisolone and methotrexate, and etanercept was instituted (0.8 mg/kg/week). He responded dramatically to etanercept and remained in full remission, although the drug was stopped at 4 months due to social and financial causes. We suggest that anti-TNF drugs may be an alternative for resistant attacks. However the timing and dosage, as well as efficacy, need to be,further studied.