Prevention of amyloidosis in familial Mediterranean fever with colchicine: a case-control study in Armenia.
OBJECTIVE
To determine whether or not the use of colchicine decreases the risk of amyloidosis among Armenian patients with familial Mediterranean fever (FMF).


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).


CONCLUSIONS
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.
Sevoyan
Maria K
MK
American University of Armenia, Yerevan, Republic of Armenia. maria_sevoyan@yahoo.co.uk
Sarkisian
Tamara F
TF
Beglaryan
Ara A
AA
Shahsuvaryan
Gohar R
GR
Armenian
Haroutune K
HK
D000328:Adult; D000367:Age Factors; D000686:Amyloidosis / Q000209:etiology / Q000517:prevention & control*; D001136:Armenia; D016022:Case-Control Studies; D003078:Colchicine / Q000008:administration & dosage*; D003598:Cytoskeletal Proteins / Q000235:genetics; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D010505:Familial Mediterranean Fever / Q000150:complications / Q000188:drug therapy* / Q000235:genetics; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation; D016017:Odds Ratio; D000071198:Pyrin; D050257:Tubulin Modulators / Q000008:administration & dosage*; D055815:Young Adult
D003598:Cytoskeletal Proteins; C000604192:MEFV protein, human; D000071198:Pyrin; D050257:Tubulin Modulators; D003078:Colchicine