1. A survey of resistance to colchicine treatment for French patients with familial Mediterranean fever
- Author
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Véronique Hentgen, Sophie Georgin-Lavialle, Gilles Grateau, Pierre Quartier, Eric Hachulla, Linda Rossi-Semerano, Alice Corsia, Albert Faye, and Isabelle Koné-Paut
- Subjects
0301 basic medicine ,Adult ,Male ,medicine.medical_specialty ,Adolescent ,Genotype ,Anti interleukin 1 ,Familial Mediterranean fever ,Review ,Pharmacology ,Gene mutation ,Resistance to treatment ,Renal amyloidosis ,03 medical and health sciences ,chemistry.chemical_compound ,Young Adult ,0302 clinical medicine ,Internal medicine ,Colchicine ,Medicine ,Humans ,Genetics(clinical) ,Pharmacology (medical) ,Young adult ,Child ,Genetics (clinical) ,Aged ,030203 arthritis & rheumatology ,Aged, 80 and over ,Medicine(all) ,business.industry ,Standard treatment ,General Medicine ,Middle Aged ,MEFV ,medicine.disease ,030104 developmental biology ,chemistry ,Child, Preschool ,Mutation ,Female ,France ,business ,Compliance ,Interleukin-1 - Abstract
Background Colchicine is the standard treatment for familial Mediterranean fever (FMF), preventing attacks and inflammatory complications. True resistance is rare and yet not clearly defined. We evaluated physicians’ definition of colchicine resistance and report how they manage it. Patients and methods We recruited patients with a clinical diagnosis of FMF, one exon-10 Mediterranean fever (MEFV) gene mutation and considered resistant to colchicine, via networks of expert physicians. Clinical, biological characteristics and information about colchicine treatment (dose adjustment, compliance) were collected. The severity of FMF was assessed by the Tel Hashomer criteria. Results We included 51 patients, most females (55%), mean age 34 ± 23.1 years years (range 4.7–86.3). Overall, 58% (27/47) patients had homozygous M694 MEFV gene mutations. Seventeen of 42 patients (40%) declared full adherence to colchicine treatment, greater for children (48%) than adults (22%). Physicians considered colchicine resistance with > 6 attacks/year (n = 21/51, 42%), > 4 attacks in the last 6 months (n = 13/51, 26%), persistent inflammation (n = 23/51, 45%), renal amyloidosis in (n = 6/28, 22%) of adult patients and intolerance to an increase in colchicine dose (n = 10/51, 19%), and other reasons (n = 13/51, 23%), including chronic arthralgia (n = 6/51, 12%). Interleukin 1–targeting drugs represented the only alternative treatments in addition to daily colchicine. Conclusion Resistance to colchicine is rare (
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