Prevention of amyloidosis in familial Mediterranean fever with colchicine: a case-control study in Armenia

ABSTRACT

To determine whether or not the use of colchicine decreases the risk of amyloidosis among Armenian patients with familial Mediterranean fever [FMF]. 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. 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, Cl, 0.16-1.43], continuous colchicine use rather than interrupted use [adjusted OR 0.15, 95% Cl 0.04-0.53], earlier rather than later initiation age of colchicine treatment [adjusted OR 0.95, 95% Cl 0.90-1.01], current colchicine rather than ever/never colchicine use [adjusted OR 0.20,95% Cl 0.05-0.89]. 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