Evaluation of the effectiveness of colchicine therapy in preventing Renal Amyloidosis in patients with Familial Mediterranean Fever in Yerevan, Armenia

Abstract

Objectives The study aimed to determine the association between colchicine therapy including the effect of duration and initiation of the treatment, dose and mode of colchicine use and risk of amyloidosis among patients with familial Mediterranean fever in Yerevan, Armenia. Study Methods and Design The study utilized case-control design. Thirty-three FMF patients with amyloidosis developed during the period 08/2003-08/2005 and 66 randomly selected FMF patients without amyloidosis were included in the study as cases and controls, respectively. The study participants were genetically verified patients with FMF selected from the Center of Medical Genetics’ register. Both phone and face-to-face interviews were used for data collection. Results The analysis showed that the risk of amyloidosis decreased with adequate colchicine use versus non-adequate use (adjusted for gender and age: OR = 0.33; 95% CI 0.12-0.93); permanent colchicine use versus use with interruption (adjusted for gender and age: OR = 0.29; 95% CI 0.10-0.82), earlier versus later age at initiation of colchicine treatment (adjusted for FMF onset and gender: OR = 1.06; 95% CI 1.01-1.11); current colchicine users versus ever/never users (adjusted for gender and age: OR = 0.27; 95% CI 0.08-0.95). For current use and permanent use the protective effect was strengthening after controlling for age, gender, family history of amyloidosis and M694V mutation, OR = 0.20; 95% CI 0.05 -0.83 and OR = 0.14; 95% CI 0.04 -0.53, respectively. Conclusion The study demonstrated evidence that colchicine treatment is effective in preventing amyloidosis in Armenian FMF patients. Earlier start of initiation of colchicine treatment by FMF patients needs to be emphasized by the physicians. Regular and lifelong therapy with colchicine in adequate dose 1.2-1.8 mg per day has to be recommended to all FMF patients in order to prevent the FMF-associated amyloidosis development.