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Non-response to colchicine in familial Mediterranean fever should be identified accurately.
[familial mediterranean fever]
Colchicine
prophylaxis
is
the
single
most
important
factor
in
ameliorating
familial
Mediterranean
fever
(
FMF
)
for
the
prevention
of
both
attacks
and
secondary
amyloidosis
.
The
aim
of
the
present
study
was
to
evaluate
the
exact
proportion
of
those
patients
who
do
not
respond
to
colchicine
and
to
characterize
their
demographic
,
sociodemographic
and
clinical
aspects
.
One
hundred
and
eight
patients
with
FMF
were
included
in
our
study
.
The
demographic
(
age
,
gender
)
,
socioeconomic
(
education
level
,
employment
status
,
economic
income
level
)
and
clinical
features
(
age
at
onset
of
FMF
,
age
at
FMF
diagnosis
,
family
history
of
FMF
,
mean
duration
of
colchicine
use
and
mean
daily
colchicine
dose
)
of
the
patients
were
evaluated
.
The
patients
unresponsive
to
colchicine
therapy
,
according
to
their
statements
,
were
recorded
.
Also
with
another
question
,
patients
'
routine
colchicine-consuming
habits
were
elucidated
in
a
self-answering
format
.
'
Non-responders
'
were
defined
as
patients
who
experienced
FMF
attacks
at
a
frequency
greater
than
once
every
3
Â
months
despite
treatment
with
2
Â
mg
colchicine
daily
.
Data
were
analyzed
with
the
chi
-square
test
and
Fisher
's
exact
test
.
There
were
50
female
and
58
male
patients
with
a
mean
age
of
42
.
4
Â
±
Â
11
.
3
Â
years
.
The
mean
age
at
FMF
onset
and
at
FMF
diagnosis
were
14
.
3
Â
±
Â
10
.
5
and
19
.
1
Â
±
Â
12
.
9
Â
years
,
respectively
.
Sixteen
percent
of
the
patients
defined
themselves
as
'
suffering
from
attacks
in
spite
of
regular
colchicine
'
.
Irregular
colchicine
usage
was
determined
in
11
%
of
the
patients
who
were
considered
as
'
unresponsive
to
colchicine
therapy
'
according
to
their
statements
.
In
spite
of
regular
colchicine
regimen
,
attacks
were
present
in
5
%
of
the
patients
in
our
study
.
Although
there
was
no
difference
in
demographic
and
clinical
aspects
,
patients
with
irregular
colchicine
usage
were
found
to
be
from
lower
socioeconomic
backgrounds
,
had
less
education
and
more
unemployment
(
P
Â
<
Â
0
.
001
)
.
Regular
colchicine
usage
anamnesis
may
be
misleading
in
the
first
evaluation
and
this
risk
seems
to
be
higher
in
patients
from
lower
socioeconomic
background
.
Routine
colchicine-consuming
habits
should
be
detailed
in
patients
with
FMF
before
claiming
its
failure
.
Diseases
Validation
Diseases presenting
"amyloidosis"
symptom
cadasil
fabry disease
familial mediterranean fever
hereditary cerebral hemorrhage with amyloidosis
lymphangioleiomyomatosis
phenylketonuria
systemic capillary leak syndrome
triple a syndrome
waldenström macroglobulinemia
This symptom has already been validated