Background: Identifying the triggers of attack and coping strategies in patients with Familial Mediterranean Fever (FMF) is important for preventing subsequent attacks.

Objectives: The aim of this study is to identify the factors that trigger attacks and coping strategies when FMF patients experience attacks.

Methods: The FMF patients who meet Tel-Hashomer criteria were included in this cross-sectional observational study. The “data collection form” including demographic data, attack characteristics, medications used, laboratory parameters, genetic mutations, attack triggers, and coping factors were recorded with a face-to-face interview.

Results: 100 patients were invited to the study and 87 patients [mean age = 37.8±13.7 years, and female= 53 (60.9%)] agreed to participate in the study. The most common attack features were peritonitis (75, 86.2%) and fever (72, 82.8%) (Table 1). Genetic analysis results were available for 61 patients. The most prevalent mutation in patients was M694V [homozygous = 11 (18%), heterozygous = 11 (18%) and compound heterozygous= 21 (34%)]. Patients identified the most frequent attack triggers as fatigue (73, 83.9%), emotional stress (71, 81.6%), and cold exposure (62, 71.3%) (Table 2). The foods that patients thought most frequently triggered their attacks were, spices (12, 13.8%), milk (12, 13.8%), white floured bread (11, 12.6%), garlic (10, 11.5%), onion (10, 11.5%), red pepper (10, 11.5%), melon (9, 10.3%), peanut (8, 9.2%), red meat (7, 8.0%), eggplant (7, 8.0%), legumes (7,8.0%) tomato (6, 6.9%). They stated that resting 45 (51.7%), walking outside with moderate intensity 12 (13.8%), and consuming banana (7, 8.0%), watermelon (5, 5.7%), grapes (5, 5.7%), yoghurt (5, 5.7%), green leafy vegetables (4, 4.6%) were helpful in coping with attacks.

Conclusion: This study demonstrates the importance of questioning dietary aspects, as well as physical and emotional situations, as triggers and preventers of attacks in FMF patients.

REFERENCES: [1] Karadag O, Tufan A, Yazisiz V et al. The factors considered as trigger for the attacks in patients with familial Mediterranean fever. Rheumatol Int. 2013;33(4):893-7.

[2] Farisogullari B, Kilic L, Yardimci GK, Akdogan A. Do we consider enough the presence of triggering factors in the evaluation of patients with FMF? Triggering factors are highly prevalent in colchicine-resistant FMF patients. Intern Emerg Med. 2024;19(2):391-397.

[3] Parlar K, Ates MB, Onal ME et al. Factors triggering familial mediterranean fever attacks, do they really exist? Intern Emerg Med. 2024;19(4):1007-1013.

Acknowledgements: NIL.

Disclosure of Interests: None declared.

© The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.