Colchicine Use in Children and Adolescents With Familial Mediterranean Fever: Literature Review and Consensus Statement

Abstract

The daily application of colchicine is the standard therapy for prophylaxis of attacks and amyloid deposition in familial Mediterranean fever. However, because of many issues (eg, dosage, time of introduction, etc), no standardized treatment recommendations have been established. In this work we review the available literature on colchicine use with respect to its indication, efficacy, mode of application, and safety in children and adolescents with familial Mediterranean fever. On the basis of this analysis, a consensus statement on the application of colchicine in children and adolescents with familial Mediterranean fever was developed by caregivers from Germany, Austria, and Turkey.

Familial Mediterranean Fever in the World

“…Colchicine can be given to children with the disease even before the age of 1 year. It was shown that children younger than 5 years of age might need colchicine dosages ranging from 0.03 to 0.07 mg/kg/day (42). Children weighing more than 10 kg can take 1 mg of colchicine daily.…”

Treatment of Colchicine-Resistant Familial Mediterranean Fever With Anakinra

“…In most of the cases, treatment with colchicine to prevent attacks of fever and systemic amyloidosis is very effective (15). In general, continuous treatment with colchicine is more effective than intermittent treatment during attacks.…”

Effect of Colchicine-Resistant Familial Mediterranean Fever on Growth Parameters

“…Almost 5% of patients did not respond to this treatment. [9,10] The dose of colchicine used varied between 1 to 2 mg/day. Prior studies reported that 0.5 mg/day of colchicine in children <5 years of age, 1 mg/day for children between five and 10 years of age, and 1.5 mg/day for children >10 years of age was successful in the majority of children.…”

“…[11,12] Failure to respond to 2 mg/day usually predicts a failure of higher doses which also increases the risk of drug toxicity. [10,13] Substantial subclinical inflammation occurs widely and over prolonged periods in patients with FMF, [14] and young patients with chronic inflammatory disease are predisposed to associated growth retardation. Serum amyloid A (SAA) is sensitive for detecting inflammation in such patients.…”