autosomal recessive familial Mediterranean fever

disease
On this page

Also known as familial Mediterranean feverfamilial Mediterranean fever, ARfamilial Mediterranean fever, autosomal recessiveFMF

Summary

autosomal recessive familial Mediterranean fever (MONDO:0009572) is a disease caused by MEFV (GenCC Definitive), with 1 cohort gene and 59 clinical trials. Top therapeutic interventions include colchicine, anakinra, and rilonacept.

At a glance

  • Causal gene: MEFV (GenCC Definitive)
  • Cohort genes: 1
  • Clinical trials: 59

Clinical features

No curated clinical features (Orphanet) for this disease.

Identifiers

Disease identifiers

FieldValue
Canonical nameautosomal recessive familial Mediterranean fever
Mondo IDMONDO:0009572
OMIM249100
GARD0024682
Is cancer (heuristic)no

Also known as: autosomal recessive familial Mediterranean fever · familial Mediterranean fever · familial Mediterranean fever, AR · familial Mediterranean fever, autosomal recessive · FMF

Data availability: 1 GenCC gene-disease record · 9 cell lines.

Disease family

Classification path: disease › human disease › disease by etiologic mechanism › disease of genetic or genomic mechanism › hereditary disease › autosomal genetic disease › autosomal recessive diseaseautosomal recessive familial Mediterranean fever

Related subtypes (218): immunodeficiency-centromeric instability-facial anomalies syndrome, hypercalcemia, infantile, Ochoa syndrome, autosomal recessive Ehlers-Danlos syndrome, vascular type, hydrolethalus syndrome, 3-M syndrome, isolated hyperchlorhidrosis, dacryocystitis-osteopoikilosis syndrome, Hutchinson-Gilford progeria syndrome, achalasia microcephaly syndrome, acrorenal syndrome, autosomal recessive, beta-ketothiolase deficiency, autosomal recessive Alport syndrome, Alstrom syndrome, microphthalmia with limb anomalies, camptodactyly-arthropathy-coxa vara-pericarditis syndrome, Behr syndrome, bifid nose, autosomal recessive, Bloom syndrome, Bowen-Conradi syndrome, camptodactyly with fibrous tissue hyperplasia and skeletal dysplasia, heart defects-limb shortening syndrome, autosomal recessive palmoplantar keratoderma and congenital alopecia, COFS syndrome, craniometaphyseal dysplasia, autosomal recessive, Fraser syndrome, cystic fibrosis, polycystic lipomembranous osteodysplasia with sclerosing leukoencephaly, persistent hyperplastic primary vitreous, autosomal recessive, Donnai-Barrow syndrome, Schöpf-Schulz-Passarge syndrome, cleft lip/palate-ectodermal dysplasia syndrome, Ellis-van Creveld syndrome, Wolcott-Rallison syndrome, autosomal recessive faciodigitogenital syndrome, acromesomelic dysplasia 2B, brittle cornea syndrome, triple-A syndrome, autosomal recessive humeroradial synostosis, multinucleated neurons-anhydramnios-renal dysplasia-cerebellar hypoplasia-hydranencephaly syndrome, hydrocephalus, nonsyndromic, autosomal recessive 1, autosomal recessive hydrocephalus due to congenital stenosis of aqueduct of Sylvius, hypertelorism, microtia, facial clefting syndrome, hypoparathyroidism-retardation-dysmorphism syndrome, Vici syndrome, Johanson-Blizzard syndrome, autosomal recessive Kenny-Caffey syndrome, Papillon-Lefevre disease, Haim-Munk syndrome, Laurence-Moon syndrome, Donohue syndrome, lipase deficiency, combined, thiamine-responsive megaloblastic anemia syndrome, cartilage-hair hypoplasia, Nijmegen breakage syndrome, pseudo-TORCH syndrome, Galloway-Mowat syndrome, mulibrey nanism, myotonia congenita, autosomal recessive, Schwartz-Jampel syndrome, proteosome-associated autoinflammatory syndrome, Netherton syndrome, Niemann-Pick disease type A, oculodentodigital dysplasia, autosomal recessive, odonto-onycho-dermal dysplasia, autosomal recessive omodysplasia, osteoporosis-pseudoglioma syndrome, Shwachman-Diamond syndrome, phenylketonuria, Bjornstad syndrome, Laron syndrome, autosomal recessive polycystic kidney disease, autosomal recessive inherited pseudoxanthoma elasticum, autosomal recessive multiple pterygium syndrome, rapadilino syndrome, short-rib thoracic dysplasia 9 with or without polydactyly, autosomal recessive Robinow syndrome, Sjogren-Larsson syndrome, scapuloperoneal spinal muscular atrophy, autosomal recessive, spondyloepiphyseal dysplasia tarda, autosomal recessive, inherited threoninemia, Pendred syndrome, autosomal recessive spondylocostal dysostosis, Werner syndrome, ABCD syndrome, Naxos disease, autosomal recessive amelia, human HOXA1 syndromes, sickle cell disease, autosomal recessive proximal renal tubular acidosis, hyper-IgM syndrome type 2, temtamy preaxial brachydactyly syndrome, TH-deficient dopa-responsive dystonia, craniosynostosis syndrome, autosomal recessive, Niemann-Pick disease type B, skin fragility-woolly hair-palmoplantar keratoderma syndrome, CoQ-responsive OXPHOS deficiency, familial adenomatous polyposis 2, Pierson syndrome, palmoplantar keratoderma-XX sex reversal-predisposition to squamous cell carcinoma syndrome, cardiomyopathy-hypotonia-lactic acidosis syndrome, PHARC syndrome, Kahrizi syndrome, cutis laxa with severe pulmonary, gastrointestinal and urinary anomalies, congenital prothrombin deficiency, immunodeficiency 31B, dyskeratosis congenita, autosomal recessive 2, dyskeratosis congenita, autosomal recessive 3, Nestor-Guillermo progeria syndrome, leukoencephalopathy with calcifications and cysts, mitochondrial pyruvate carrier deficiency, branched-chain keto acid dehydrogenase kinase deficiency, dyskeratosis congenita, autosomal recessive 5, hypohidrosis-enamel hypoplasia-palmoplantar keratoderma-intellectual disability syndrome, alacrima, achalasia, and intellectual disability syndrome, hyperlipoproteinemia, type 1D, microcephaly and chorioretinopathy 2, congenital stationary night blindness 1G, combined oxidative phosphorylation deficiency 29, hypermanganesemia with dystonia 2, growth retardation, intellectual developmental disorder, hypotonia, and hepatopathy, gnb5-related intellectual disability-cardiac arrhythmia syndrome, autosomal recessive spastic paraplegia type 78, autosomal recessive limb-girdle muscular dystrophy, Bardet-Biedl syndrome, autosomal recessive cerebellar ataxia, neuronopathy, distal hereditary motor, autosomal recessive, UV-sensitive syndrome, Ehlers-Danlos syndrome, kyphoscoliotic type 1, Cockayne syndrome, hyperphenylalaninemia due to tetrahydrobiopterin deficiency, leukoencephalopathy-palmoplantar keratoderma syndrome, autosomal recessive hypohidrotic ectodermal dysplasia, Warburg micro syndrome, autosomal recessive primary microcephaly, autosomal recessive progressive external ophthalmoplegia, Meier-Gorlin syndrome, autosomal recessive sideroblastic anemia, autosomal recessive intermediate Charcot-Marie-Tooth disease, Perrault syndrome, autosomal recessive hypophosphatemic rickets, de Barsy syndrome, leukocyte adhesion deficiency, Senior-Loken syndrome, autosomal recessive spastic ataxia, childhood-onset autosomal recessive myopathy with external ophthalmoplegia, autosomal recessive cerebral atrophy, GM3 synthase deficiency, autosomal recessive distal renal tubular acidosis, pigmentation defects-palmoplantar keratoderma-skin carcinoma syndrome, autosomal recessive brachyolmia, Aicardi-Goutieres syndrome, homocystinuria without methylmalonic aciduria, Niemann-Pick disease type C, nephronophthisis, autosomal recessive osteopetrosis, peroxisome biogenesis disorder, congenital non-bullous ichthyosiform erythroderma, Seckel syndrome, Usher syndrome, autosomal recessive cutis laxa type 1, autosomal recessive cutis laxa type 2, hearing loss, autosomal recessive, microcephaly, growth restriction, and increased sister chromatid exchange 2, encephalopathy, progressive, early-onset, with brain edema and/or leukoencephalopathy, 1, congenital vertebral-cardiac-renal anomalies syndrome, hair defect with photosensitivity and intellectual disability syndrome, autosomal recessive severe congenital neutropenia, severe combined immunodeficiency due to CARMIL2 deficiency, extraoral halitosis due to methanethiol oxidase deficiency, neurodevelopmental disorder with microcephaly, impaired language, epilepsy, and gait abnormalities, mitochondrial complex 2 deficiency, nuclear type 3, mitochondrial complex 2 deficiency, nuclear type 4, mismatch repair cancer syndrome, spondyloepimetaphyseal dysplasia with joint laxity, type 3, Kilquist syndrome, Duane anomaly-myopathy-scoliosis syndrome, autosomal recessive axonal charcot-marie-tooth disease due to copper metabolism defect, immune dysregulation-inflammatory bowel disease-arthritis-recurrent infections-lymphopenia syndrome, optic atrophy-ataxia-peripheral neuropathy-global developmental delay syndrome, congenital myopathy with reduced type 2 muscle fibers, NAD(P)HX dehydratase deficiency, autosomal recessive ocular albinism, ichthyosis linearis circumflexa, eosinophil peroxidase deficiency, hyperphenylalaninemia due to DNAJC12 deficiency, autosomal recessive epidermolytic ichthyosis, Ehlers-Danlos syndrome, classic-like, 2, joint laxity, short stature, and myopia, HELIX syndrome, auditory neuropathy-optic atrophy syndrome, glycosylphosphatidylinositol biosynthesis defect 15, neurodegeneration, childhood-onset, stress-induced, with variable ataxia and seizures, SCN4A-related myopathy, autosomal recessive, Uner Tan Syndrome, nephropathic cystinosis, Imerslund-Grasbeck syndrome type 1, Imerslund-Grasbeck syndrome type 2, permanent neonatal diabetes mellitus 1, growth hormone insensitivity with immune dysregulation 1, autosomal recessive, Rajab interstitial lung disease with brain calcifications 1, Roberts-SC phocomelia syndrome, neurodevelopmental disorder with microcephaly, impaired language, and gait abnormalities, RPE65-related recessive retinopathy, GUCY2D-related recessive retinopathy, autosomal recessive titinopathy, intellectual disability, autosomal recessive, ALPL-related autosomal recessive hypophosphatasia, spastic paraplegia 18b, autosomal recessive, CEP164-related ciliopathy, RP1-related recessive retinopathy, pseudohypoaldosteronism, type IB2, autosomal recessive, pseudohypoaldosteronism, type IB3, autosomal recessive, spastic paraplegia 30B, autosomal recessive, cerebral arteriopathy, autosomal recessive, with subcortical infarcts and leukoencephalopathy 1, brain small vessel disease 2B, autosomal recessive, IMPG1-related recessive retinopathy, PROM1-related recessive retinopathy

Genetics & variants

GWAS landscape

No GWAS associations recorded — common-variant (GWAS) studies don’t cover this disease (typical for Mendelian / rare diseases). See the curated gene cohort and Mendelian overlap below.

Variant details and genetic-evidence tiers

No tiered GWAS variants or ClinVar records for this disease.

Genes & proteins

Mendelian disease overlap and somatic drivers

GenCC: 5 · Orphanet: 4 · OMIM-shared: 0 · Dual-evidence (GWAS+Mendelian): 0

GenCC gene–disease validity (cohort genes)

the Disease column is the GenCC-asserted condition — a cohort gene’s strongest validity may be for a related predisposition syndrome.

GeneClassificationInheritanceDiseaseRecords
MEFVDefinitiveAutosomal recessivefamilial Mediterranean fever5

Orphanet rare-disease linkage (cohort genes)

GeneOrphanet IDRare disease
MEFVOrphanet:117Behçet disease
MEFVOrphanet:3243Sweet syndrome
MEFVOrphanet:329967Intermittent hydrarthrosis
MEFVOrphanet:342Familial Mediterranean fever

Cohort genes → proteins

1 cohort genes, 1 distinct canonical proteins.

Evidence partition

SubsetGenes
multi_evidence1

Cohort genes (full)

SymbolHGNCEnsemblUniProtNameEvidence
MEFVHGNC:6998ENSG00000103313O15553Pyringencc

Cohort function summary

Lead sentence per gene, UniProt-curated.

SymbolProtein nameFunction (lead sentence)
MEFVPyrinInvolved in the regulation of innate immunity and the inflammatory response in response to IFNG/IFN-gamma.

Protein-family classification

Druggable: 0 · Difficult: 1 · Unknown: 0 · Druggable fraction: 0.0

Family distribution

Cohort families vs a genome-wide background (hypergeometric, BH-FDR; fold = observed/expected). Counts kept; sorted by enrichment, so the catch-all Other/Unknown bucket no longer leads.

FamilyGenesFoldFDR
Transcription factor18.3×0.121

Per-gene assignment

SymbolFamilyDruggable?ECInterPro (top 3)
MEFVTranscription factornoZnf_B-box, B30.2/SPRY, SPRY_dom

Expression context

Cohort genes with no expression data: 0.

1 cohort gene are a single-cell marker in ≥1 SCXA experiment.

Breadth distribution (Bgee present_calls)

BucketGenes
narrow (1-5 tissues)0
moderate (6-20)0
broad (>20)1
unknown0

Top tissues across cohort

TissueCohort genes
buccal mucosa cell1
monocyte1
mononuclear cell1

Per-gene tissue summary (top 30)

SymbolBgee breadthFANTOM5 breadthSCXATop tissues
MEFV153broadmarkerbuccal mucosa cell, monocyte, mononuclear cell

Protein interactions among cohort

Intra-cohort edges: 0.

Hub genes (top 10 by interactor count)

SymbolInteractor count
MEFV2,217

Structural data

PDB: 1 · AlphaFold-only: 0 · No structure: 0

Cohort genes with PDB structures (top 30)

SymbolUniProtPDB entries
MEFVO1555311

Function

Pathway analysis

Distinct Reactome pathways touched by cohort: 11. Enrichment computed across 1 evidence-associated genes (1 with Reactome annotation).

Pathways by enrichment

Over-representation of cohort genes vs the genome-wide background (hypergeometric test, Benjamini-Hochberg FDR; fold = observed/expected over 1 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.

PathwayCohort genesFoldFDRSample cohort genes
Inflammasomes11142.0×0.005MEFV
Cell recruitment (pro-inflammatory response)11142.0×0.005MEFV
The NLRP3 inflammasome1671.8×0.005MEFV
Purinergic signaling in leishmaniasis infection1423.0×0.006MEFV
Nucleotide-binding domain, leucine rich repeat containing receptor (NLR) signaling pathways1356.9×0.006MEFV
Leishmania infection1163.1×0.010MEFV
Parasitic Infection Pathways1163.1×0.010MEFV
Innate Immune System125.5×0.049MEFV
Infectious disease124.8×0.049MEFV
Disease113.1×0.077MEFV
Immune System113.0×0.077MEFV

GO biological processes by enrichment

Over-representation of cohort genes vs the genome-wide background (hypergeometric test, Benjamini-Hochberg FDR; fold = observed/expected over 1 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.

GO termCohort genesFoldFDRSample cohort genes
pyroptosome complex assembly18426.0×0.002MEFV
negative regulation of macrophage inflammatory protein 1 alpha production15617.3×0.002MEFV
regulation of interleukin-1 beta production12106.5×0.003MEFV
negative regulation of interleukin-12 production11053.2×0.003MEFV
pattern recognition receptor signaling pathway1991.3×0.003MEFV
negative regulation of NLRP3 inflammasome complex assembly1991.3×0.003MEFV
response to type II interferon1526.6×0.004MEFV
negative regulation of interleukin-1 beta production1510.7×0.004MEFV
pyroptotic inflammatory response1510.7×0.004MEFV
negative regulation of cytokine production involved in inflammatory response1421.3×0.004MEFV
positive regulation of interleukin-1 beta production1259.3×0.006MEFV
positive regulation of autophagy1208.1×0.007MEFV
positive regulation of inflammatory response1145.3×0.009MEFV
negative regulation of inflammatory response1137.0×0.009MEFV
regulation of gene expression183.4×0.014MEFV
inflammatory response137.7×0.028MEFV
innate immune response133.6×0.030MEFV

Therapeutics

Drug target analysis

Approved (phase 4): 0 · Phase ≥3: 0 · Phased (≥1): 0 · Undrugged: 1

Druggability breadth: 1 of 1 evidence-associated genes (100%) have a ChEMBL target (buckets above are over the deeply-mined display cohort).

Top cohort targets by molecule count

SymbolMoleculesMax phase
MEFV00

Bioactivity and enzyme data

Enzyme cohort genes (≥1 EC): 0.

Cohort genes with ChEMBL bioactivity (full, sorted by assay count)

SymbolAssaysType breakdown
MEFV1Binding:1

Pharmacogenomics

Cohort genes with a PharmGKB record: 1; with CPIC/DPWG dosing guidelines: 0.

No cohort gene has a CPIC/DPWG genotype-guided dosing guideline (PharmGKB).

Chemical tractability of cohort targets

0 approved/phased compounds have measured bioactivity against a cohort gene (and aren’t yet in disease-level trials). This is a research / tractability signal, NOT a therapeutic recommendation — a bioactivity row often reflects off-target or screening binding (e.g. promiscuous kinase inhibitors against a cohort kinase), implying no disease mechanism.

Druggability pyramid

Cohort genes binned by druggability tier (high → low):

TierDefinitionGenesSymbols
AApproved (phase 4 drug)0
BPhased (≥1) drug, not yet approved0
CDruggable family + PDB, no drug0
DDruggable family + AlphaFold only, no drug0
EDifficult family or no structure, no drug1MEFV

Undrugged target profiles

1 cohort genes are undrugged. Ranked by ‘starting-point quality’ (assay depth + drugged-partner adjacency).

SymbolChEMBL assaysDrugged partners (top 3)
MEFV1

Clinical trials & evidence

Clinical trials

Clinical trials: 59.

Phase distribution (across all retrieved trials)

PhaseTrials
Not specified46
PHASE28
PHASE42
PHASE32
PHASE11

Top trials by phase / activity

NCTPhaseStatusTitle
NCT06666335PHASE4NOT_YET_RECRUITINGA Study to Evaluate Efficacy and Safety of Anakinra in Chinese Patients With Colchicine-resistent FMF
NCT02602028PHASE4COMPLETEDThe Comparison of the Efficacy of Once and Twice Daily Colchicine Dosage in Pediatric Patients With FMF
NCT06336733PHASE3RECRUITINGRandomized Controlled Trial in Patients on Long-term Colchicine With Colchicine-resistant Familial Mediterranean Fever (FMF) to Evaluate the Efficacy of On-demand Anakinra Treatment for Painful Attacks in Patients Who Refuse Continuous Daily Therapy
NCT01705756PHASE3COMPLETEDKineret (Anakinra), in Adult Patients With Colchicine-Resistant Familial Mediterranean Fever
NCT05092776PHASE2ACTIVE_NOT_RECRUITINGEfficacy and Safety of RPH-104 for Resolution and Prevention of Recurring Attacks in Adult Subjects With Familial Mediterranean Fever With Resistance to or Intolerance of Colchicine
NCT05190991PHASE2RECRUITINGSafety and Efficacy of RPH-104 Used to Prevent Recurrent Fever Attacks in Adult Patients With Colchicine Resistant or Colchicine Intolerant Familial Mediterranean Fever
NCT00094900PHASE2COMPLETEDInterleukin-1 Trap to Treat Autoinflammatory Diseases
NCT00582907PHASE2COMPLETEDRilonacept for Treatment of Familial Mediterranean Fever (FMF)
NCT01088880PHASE2COMPLETEDEfficacy and Safety of Canakinumab in Patients With Colchicine Resistant Familial Mediterranean Fever
NCT02175589PHASE2UNKNOWNControlled Ceasing of Colchicine Therapy in Familial Mediterranean Fever (FMF) Patients With Single MEFV (Mediterranean Fever) Gene Mutation
NCT03446209PHASE2COMPLETEDTocilizumab for the Treatment of Familial Mediterranean Fever
NCT05448391PHASE2WITHDRAWNA Study to Evaluate RIST4721 in Familial Mediterranean Fever (FMF)
NCT01075906PHASE1COMPLETEDPharmacokinetics Study of Colchicine in Familial Mediterranean Fever (FMF) Patients
NCT00001373Not specifiedRECRUITINGFamilial Mediterranean Fever and Related Disorders: Genetics and Disease Characteristics
NCT04478409Not specifiedRECRUITINGCharacterization of a Functional Test for Mediterranean Family Fever Screening - 2
NCT05292768Not specifiedNOT_YET_RECRUITINGAre Mast Cells Involved in Autoinflammatory Diseases
NCT06257342Not specifiedACTIVE_NOT_RECRUITINGPhysical Abilities of Teenagers With Familial Mediterranean Fever
NCT06338891Not specifiedRECRUITINGCan Gluten/Wheat or Other Foods be Responsible for FMF Attacks
NCT06583304Not specifiedNOT_YET_RECRUITINGHematological Indices in Pediatric Diagnosed With Familial Mediterranean Fever
NCT06705673Not specifiedNOT_YET_RECRUITINGGait Profile and Variables in Pediatric Rheumatic Disease Using a Smart Insole System
NCT06725849Not specifiedNOT_YET_RECRUITINGBarriers to Physical Activity in Familial Mediterranean Fever
NCT06743152Not specifiedNOT_YET_RECRUITINGComparison of the Effects of Synchronous and Asynchronous Telerehabilitation in Patients with Juvenile Familial Mediterranean Fever
NCT06830213Not specifiedNOT_YET_RECRUITINGInvestigation of the Validity, Reliability and Responsiveness of the BETY-BQ in FMF
NCT06974942Not specifiedNOT_YET_RECRUITINGPhysical Activity in Adolescents With Familial Mediterranean Fever
NCT06981520Not specifiedNOT_YET_RECRUITINGCaspase-1 Activity, IL-1beta, and IL-18 in Patients With FMF
NCT07013045Not specifiedENROLLING_BY_INVITATIONComparing Structured Neuromuscular Exercise and Exergaming Program in Adolescents With Familial Mediterranean Fever
NCT07077473Not specifiedRECRUITINGObserving the Efficacy and Safety of Different Drugs Used in Real-world Familial Mediterranean Fever (FMF) Cases
NCT07128225Not specifiedACTIVE_NOT_RECRUITINGHealth-related Quality of Life, Electrocardiographic and Holter Findings in Children With Familial Mediterranean Fever
NCT07129538Not specifiedRECRUITINGOutcomes of Inspiratory Muscle Training in FMF Adolescents
NCT07130305Not specifiedRECRUITINGis There an Effect of Adding Body Vibration to Intake of Vitamin D on Some Outcomes of Familial Mediterranean Fever
NCT07130318Not specifiedRECRUITINGMediterranean Diet in Familial Mediterranean Fever: Is Fatty Liver Affected by Addition of Aerobic Exercise
NCT07212764Not specifiedENROLLING_BY_INVITATIONMobile App-Based Infection Monitoring in Familial Mediterranean Fever
NCT07329556Not specifiedNOT_YET_RECRUITINGSkin Autofluorescence Assessment of Advanced Glycation End Products in Rheumatic Diseases
NCT07439341Not specifiedNOT_YET_RECRUITINGAGE and CALLY Index in Familial Mediterranean Fever
NCT07517250Not specifiedRECRUITINGA Study on the Use of Canakinumab Among Familial Mediterranean Fever and Still’s Disease Patients
NCT00323440Not specifiedWITHDRAWNInflammatory Proteins in Familial Mediterranean Fever During Attack and Remission
NCT00658060Not specifiedUNKNOWNMagnetic Resonance (MR) Spectroscopy In Familial Mediterranean Fever (FMF) Patients
NCT01059279Not specifiedTERMINATEDHeat Intolerance in the Group of FMF Patients
NCT02021084Not specifiedWITHDRAWNThe Effect of Probiotics on Response to Therapy and on Adverse Effect in Patients Treated With Colchicine for Familial Mediterranean Fever.
NCT02466217Not specifiedCOMPLETEDPhenomics in Autoimmune and Inflammatory Diseases

Drugs tested across these trials (top 30)

MoleculeMax phaseTrials referencing
COLCHICINE44
ANAKINRA43
RILONACEPT42
CANAKINUMAB41
GOFLIKICEPT32
VIMNERIXIN21
CHEMBL522061802
CHEMBL236877001