Autoinflammatory & rare systemic diseases

Non-canonical manifestations of FMF in homozygous M694V MEFV genotype: Insights from a large patient cohort

Semin Arthritis RheumPublished Retrospective cohort study

Authors' conclusion

This study expands the scope of the homozygous M694V-associated phenotype by identifying new non-canonical features and reinforcing previous knowledge on a larger scale.

Study context

Population
Patients followed at the FMF clinic of Sheba Medical Center, 2010–2020
Participants
3,866 patients
Exposure
Homozygous M694V vs other MEFV genotypes
  • Homozygous M694Vn = 517
  • Other genotypesn = 3,349reference
Outcome
Classical FMF features and non-canonical manifestations
Methodological detailshypothesis-generating, automated algorithm extraction from structured medical records, single-centre
  • Hypothesis-generating
  • Automated algorithm extraction from structured medical records
  • Single-centre

Main finding

As reported in the abstract

Higher rate of DVT in Homozygous M694V
p = 0.03
Higher rate of liver dysfunction in Homozygous M694V
p = 0.02
Higher rate of abnormal liver enzymes in Homozygous M694V
p < 0.001
Higher rate of congestive HF in Homozygous M694V
p = 0.01

Observational data: associations, not effects.

Further findings

More Homozygous M694V patients received biologic agents and had more ED visits and higher hospitalisation rates
P ≤ 0.001 in both

Original publication

Non-canonical manifestations of FMF in homozygous M694V MEFV genotype: Insights from a large patient cohort. Semin Arthritis Rheum. Published 29 August 2025. doi:10.1016/j.semarthrit.2025.152821

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