Prevention of Amyloidosis in Familial Mediterranean Fever with Colchicine: A Case-Control Study in Armenia

Abstract

Objective: To determine whether or not the use of colchicine decreases the risk of amyloidosis among Armenian patients with familial Mediterranean fever (FMF). Subjects and Methods: The study included 99 Armenian patients from the Center of Medical Genetics database with genetically ascertained FMF; 33 had renal amyloidosis and 66 were randomly selected control patients without renal amyloidosis. Self- reported colchicine use was assessed by interviewer-based questionnaire. Results: The patients with incident amyloidosis were more likely to be older men, but younger at the time of disease onset, and more likely to have had a family history of amyloidosis and M694F mutation in the MEFV gene compared to patients without amyloidosis. The risk of amyloidosis decreased with adequate colchicine use rather than nonadequate use (adjusted odds ratio, OR, 0.48, 95% confidence interval, CI, 0.16–1.43), continuous colchicine use rather than interrupted use (adjusted OR 0.15, 95% CI 0.04–0.53), earlier rather than later initiation age of colchicine treatment (adjusted OR 0.95, 95% CI 0.90–1.01), current colchicine rather than ever/never colchicine use (adjusted OR 0.20, 95% CI 0.05–0.89). Conclusion: The study demonstrated that colchicine treatment is effective in preventing amyloidosis among Armenian patients with FMF and that earlier initiation and continuous therapy at an adequate dose of 1.2–1.8 mg/day may be associated with a decreased amyloidosis risk among Armenian patients with FMF.

S1000A12, Chitotriosidase, and Resolvin D1 as Potential Biomarkers of Familial Mediterranean Fever

“…On suitable genetic background, inappropriately activated innate immune system cells are supposed to cause unprovoked short-lived bursts of systemic inflammation that gives to the rise clinical presentation of FMF ( 5 ). The most feared long term complication is development of amyloidosis that occurs mostly in untreated patients owing to late diagnosis of disease ( 3 6 ). Despite colchicine treatment, some patients still develop complications of disease due to unapparent chronic subclinical inflammation ( 7 ).…”

Amyloid Goiter Due to Familial Mediterranean Fever in a Patient with Byler Syndrome: A Case Report

“…Accumulation of amyloid A protein (AA) occurs in secondary amyloidosis associated with FMF. Colchicine treatment prevents and retards episodes as well as renal failure when it is initiated early after FMF diagnosis and used regularly (5). In a multicenter study by the Turkish FMF Working Group conducted on 2838 cases, it was reported that the mean age at onset of FMF was 9 years and the mean age at diagnosis was 16 years (6 amyloidosis that might cause chronic renal failure.…”

Familial Mediterranean Fever Presenting as Anti-Cyclic Citrullinated Peptide Antibody Negative Palindromic Rheumatism

“…11 It is recommended that colchicine should be given even in non or partial responders in FMF patients with AA amyloidosis. [12][13][14][15] Proteinuria of more than 0.5 g/24 hours is suggestive of amyloidosis. Nonresponders of colchicine can be treated with anakinra, IL-1 inhibitor.…”