2025 American Academy of Neurology Abstract Website

Merve Iris¹, Mesude Tutuncu², Batuhan Ayci¹, Melih Tutuncu¹, Ugur Uygunoglu¹, Sabahattin Saip¹, serdal ugurlu³, Aksel Siva¹
¹Neurology, Department of Neurology, Cerrahpaşa Medical Faculty, Istanbul University-Cerrahpaşa, ²Bakirkoy Prof. Dr. Mazhar Osman Training and Research Hospital for Psychiatry and Neurological Disorders, ³Division of Rheumatology, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa

Objective:

To investigate the influence of FMF on MS course, severity and disability.

Background:

Familial Mediterranean Fever (FMF) is an autoinflammatory disease, while Multiple Sclerosis (MS) is autoimmune in nature. We hypothesize that the underlying autoinflammatory processes and treatments used in FMF could potentially influence the pathogenesis and progression of MS, leading to variations in disease expression. This hypothesis explores the intersection of autoinflammation and autoimmunity, providing insights into how such interactions may affect the clinical outcomes of patients with both conditions.

Design/Methods:

In this retrospective, prospective comparative case study, two groups were established. The FMF-MS group included 41 patients, and the control group consisted of 54 isolated MS (iMS) patients who were selected through a full randomization process. Demographic and clinical characteristics were compared between groups. The risk of developing a second relapse was determined using survival analysis.

Results:

Mean follow-up duration was 69 months in FMF-MS group. The age and gender distribution of the groups were similar. However, the number of patients with a family history of other autoimmune diseases was significantly higher in the FMF-MS group. (p:0.001) The presence of oligoclonal bands was comparable between the groups. In the FMF-MS group, 2.4% of patients met the criteria for primary progressive MS (PPMS), compared to 7.8% in the iMS group. The analysis revealed that in relapsing remitting MS patients FMF comorbidity did not pose a risk for the development of a second attack. The annual relapse rate was similar between the groups, with comparable follow-up durations. The EDSS at last follow up was similar between the groups. However, during the follow-up period, the proportion of patients requiring high-efficacy drugs due to relapse or MRI activity was significantly higher in the iMS group. (p:0.03)

Conclusions:

Although FMF comorbidity appeared to be associated with lower disease activity, demographic and clinical characteristics were comparable with iMS.