The use of telemedicine in the management of patients with familial mediterranean fever


Background: Long-term follow-up in rare diseases is critical for adequate clinical management. The pandemic represents a risk period, due to difficult routine workup in referral centers. We therefore aimed to verify the usefulness of telemedicine in a group of patients with Familial Mediterranean Fever (FMF), and to depict an overview of the health status in these subjects.

Materials and Methods: FMF patients followed at Clinica Medica “A. Murri”, Policlinico of Bari (Italy) were contacted by phone, video-calls and social networks during a 4-months period (March-July 2021). A specific questionnaire was used, and answers were recorded and analyzed.

Results: A total of 51 (20 males) out of 60 patients followed by our FMF outpatient clinic were successfully contacted. Overall, the mean age of symptom onset was 21.1 ± 2.5 years. The mean age of diagnosis was 31.1 ± 2.6 years, with a diagnostic delay of about 10 years. The majority of subjects (57.4%) were on colchicine, which caused mild side effects (mainly diarrhea) in a low number of cases (7/29). The average interval since the last visit was high (46,4  ±  8,2 months). However, the number of FMF attacks since the last visit remained low (0-1) in the majority of patients (74%). The 50% of subjects reported a trigger event preceding the last attack (mainly physical effort, stress, exposure to cold, infections). The 82% of subjects reported as “stable” health status since last visit. However, a progression towards a more severe clinical course was reported by 9% of subjects, requiring an urgent reassessment.

Conclusions: Telemedicine can be a useful tool in the management of FMF. In the majority of the examined subjects the health status was stable, despite the lack of recent visits. However, telemedicine can efficiently select patients reporting a worsening of the health status, who need an urgent reassessment.