Current trends in colchicine treatment in familial Mediterranean fever.
OBJECTIVE
Since the publication of the first reports on the efficiency of colchicine in familial Mediterranean fever (FMF), very few randomised studies have investigated issues related to its long-term use. Thus, different approaches taken by physicians involved in FMF care, are exclusively empiric, emulative, and based on case-reports or case-series. Problems such as colchicine intolerance and colchicine resistance have not been solved yet. This paper aims to evaluate trends in colchicine therapy among physicians taking care of FMF patients around the world.


METHODS
We conducted a survey by sending questionnaires to FMF research and treatment centres in Europe and Asia. Many issues (such as dosages, schedules, side effects, interactions, efficacy and toxicity monitoring, definition of colchicine intolerance, colchicine resistance and responsiveness, etc) have been investigated. When more than 70% of physicians responded giving similar answers to an item, the response was considered as a 'trend'. A comparison between answers of physicians from FMF-prevalent and non-prevalent countries was also made.


RESULTS
Thirty-five physicians from 11 countries filled the questionnaires, taking care of a total of more than 15000 FMF patients (pts). Different approaches were evident among the various physicians. Statistically significant different approaches between physicians from FMF-prevalent countries with respect to those from non-prevalent countries were found in items like colchicine during pregnancy, severity score and blood tests for disease monitoring. No consensus was found regarding the definition of colchicine resistance.


CONCLUSIONS
The current study demonstrated significant variations in the strategy of colchicine therapy for FMF around the world and re-emphasised the need for standardised definitions of colchicine resistance and colchicine intolerance.
Department of Internal Medicine, S. Andrea Hospital, ASL 5 Liguria, La Spezia, Italy. micaela.laregina@asl5.liguria.it.
Micaela
M
La Regina
Eldad
E
Ben-Chetrit
Armen Yuri
AY
Gasparyan
Avi
A
Livneh
Huri
H
Ozdogan
Raffaele
R
Manna
D001208:Asia / Q000453:epidemiology; D003078:Colchicine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005060:Europe / Q000453:epidemiology; D010505:Familial Mediterranean Fever / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000276:immunology; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D010818:Practice Patterns, Physicians' / Q000639:trends*; D011237:Predictive Value of Tests; D015995:Prevalence; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D003078:Colchicine