Liver Disease Complicating Familial Mediterranean Fever: A Study on 66 Patients Out of 533 Adult From the JIR Cohort

The association between familial Mediterranean fever and incident cirrhosis: A population-based matched cohort study

OBJECTIVE

The association between FMF and incident liver cirrhosis is not widely studied. In this study, we aimed to examine the association between FMF and incident liver cirrhosis in a population-based cohort.

METHODS

Patients with FMF aged≥18 in the Maccabi Healthcare Services (MHS) database were identified according to ICD-9 code 277.31 between January 1st, 2000 and December 31st, 2022. A control group was 1:1 age and gender-matched. Patients with chronic liver disease or cirrhosis were excluded, as well as patients who were treated with methotrexate, amiodarone or tamoxifen and patients with less than 12 months of follow-up. Incident cirrhosis was defined as a new diagnosis of cirrhosis according to ICD-9 code (571.5), newly diagnosed major cirrhotic complications or liver transplantation. The Cox proportional hazards models were used to examine the association between FMF and incident cirrhosis and the Kaplan-Meier curves to study the event-free survival.

RESULTS

Incident cirrhosis was detected among 2.1% and 0.4% in the study and control groups, respectively, P<0.01. Being in the FMF group was associated with a significantly increased risk of incident cirrhosis (HR=2.60, 95% CI: 1.54-4.38, P<0.01). At 7 years, the cirrhosis-free survival rate was 98.2% in the study group and 99.6% in the control group (P<0.01).

CONCLUSION

FMF was associated with incident cirrhosis, irrespective of the traditional risk factors for metabolic syndrome, suggesting the contribution of the inflammatory state to the development of cirrhosis.