Scandinavian journal of rheumatology · 2025
Prophylactic colchicine for familial Mediterranean fever: response rates revisited.
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Wiener A, Shinar Y, Pras E
Аннотация
OBJECTIVE: Complete response to colchicine is reported in 60-65% of patients with familial Mediterranean fever (FMF), partial response in 30-35%, and poor response in 5-10% of patients. The objective of our study was to revisit colchicine response rates for the common FMF gene (MEFV) genotypes in view of newly available treatments.
METHOD: Data were retrieved from medical files of 106 consecutive FMF patients, who were divided into four groups: patients with complete response, having had no attacks in the past year; near complete, with one or two attacks; fairly controlled, with three to six attacks; and poorly controlled, with more than six attacks in the past year.
RESULTS: Only 34% of M694V homozygotes were adequately controlled, having had zero to two attacks in the past year, compared to 66% of the patients with all other genotypes combined (p < 0.002). Furthermore, 42% of M694V homozygotes were poorly controlled compared to 13% of all other genotypes combined (p < 0.001). Patients categorized as adequately controlled received a lower dose of colchicine compared to the rest of the cohort (p = 0.042). None of the patients had amyloidosis.
CONCLUSION: We found a relatively large group of FMF patients with inadequate response to colchicine. This underlines the importance of improving disease control and quality of life for patients with FMF.
METHOD: Data were retrieved from medical files of 106 consecutive FMF patients, who were divided into four groups: patients with complete response, having had no attacks in the past year; near complete, with one or two attacks; fairly controlled, with three to six attacks; and poorly controlled, with more than six attacks in the past year.
RESULTS: Only 34% of M694V homozygotes were adequately controlled, having had zero to two attacks in the past year, compared to 66% of the patients with all other genotypes combined (p < 0.002). Furthermore, 42% of M694V homozygotes were poorly controlled compared to 13% of all other genotypes combined (p < 0.001). Patients categorized as adequately controlled received a lower dose of colchicine compared to the rest of the cohort (p = 0.042). None of the patients had amyloidosis.
CONCLUSION: We found a relatively large group of FMF patients with inadequate response to colchicine. This underlines the importance of improving disease control and quality of life for patients with FMF.