Predictive Factors for Therapeutic Response and Cluster Analysis in Syndrome of Undifferentiated Recurrent Fever (SURF)

    July 2025 in “ RMD Open ”
    Serena Palmeri, Marta Ponzano, Giada Recchi, Chiara Conti, Saverio La Bella, Diana Sutera, Marta Bustaffa, Caterina Matucci‐Cerinic, Roberta Bertelli, Federica Penco, Ignazia Prigione, Riccardo Papa, Isabella Ceccherini, Stefano Volpi, Roberta Caorsi, Marco Gattorno
    TLDR IL-1 blockade is effective for treating SURF, and personalized treatment is needed.
    The study on 101 patients with the syndrome of undifferentiated recurrent fever (SURF) identified predictors of colchicine resistance, notably PFAPA-like features such as aphthous stomatitis, which was confirmed as an independent predictor. Colchicine showed a complete response in 61% of patients, while IL-1 inhibitors were effective in refractory cases. Cluster analysis revealed three distinct subgroups, highlighting the heterogeneity within SURF and the need for refined diagnostic criteria and personalized treatment strategies. The study supports recognizing SURF as a distinct clinical entity and suggests IL-1 inhibitors as a beneficial second-line treatment.
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