Autoinflammatory & rare systemic diseases
Predictive factors for therapeutic response and cluster analysis in syndrome of undifferentiated recurrent fever (SURF)
Authors' conclusion
These findings provide new insights into SURF, identifying predictors of colchicine resistance and supporting the efficacy of IL-1 blockade.
Study context
- Population
- Patients with syndrome of undifferentiated recurrent fever (SURF) in the Eurofever Registry, excluding PFAPA, FMF and other known monogenic recurrent feverscolchicine efficacy assessed in 77
- Participants
- 101 patients
- Outcome
- Factors associated with colchicine resistance
Methodological detailsregistry-based (Eurofever Registry), longitudinal, cluster analysis, univariable and multivariable analysis
- Registry-based (Eurofever Registry)
- Longitudinal
- Cluster analysis
- Univariable and multivariable analysis
Main finding
As reported in the abstract
- Complete response to colchicine (of 77 assessed)
- 61%
- Aphthous stomatitis associated with colchicine resistance (univariable)
- p=0.001
- Cervical lymphadenopathy associated with colchicine resistance (univariable)
- p=0.012
- Exudative tonsillitis associated with colchicine resistance (univariable)
- p=0.004
- Aphthous stomatitis independent predictor of resistance (multivariable)
- p=0.014
Observational data: associations, not effects.
Further findings
Other treatments and clustering
- Cluster analysis revealed three distinct subgroups with varying symptoms and colchicine responses
- 3
- Tonsillectomy was ineffective
- IL-1 inhibitors (anakinra, canakinumab) beneficial in refractory cases
Original publication
Predictive factors for therapeutic response and cluster analysis in syndrome of undifferentiated recurrent fever (SURF). RMD Open. Published 10 August 2025. doi:10.
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