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Association between colchicine resistance and vitamin D in familial Mediterranean fever
Ismail Ozer1, Turkan Mete2, Ozlem Turkeli Sezer3
1a Department of Nephrology , Samsun Training and Research Hospital, Ministry of Health , Samsun , Turkey .
Abstract:
Although colchicines are the only effective treatment of familial Mediterranean fever (FMF), resistance to colchicines (CR) which is observed in up to 30% of the patients is still a problem. Clinically, resistance to colchicine is defined as three or more attacks within the last 6 months period while using ≥2 mg/day colchicine. Previous studies have shown decreased vitamin D levels in FMF patients compared with healthy controls. The aim of this study is to evaluate whether vitamin D levels differ between CR and non-CR FMF patients. This study included 64 FMF patients who were being followed in Nephrology Clinic of Samsun Research and Education Hospital for at least 1 year. FMF was diagnosed according to the criteria defined by Livneh et al. Serum 25-hydroxy vitamin D (25-OHD) concentration (ng/mL) was detected in all FMF patients who were not in an acute attack period. From 64 patients 29 were accepted as CR. Mean 25-OHD level was 9.39 ± 1.00 ng/mL in CR patients and 18.48 ± 1.09 ng/mL in colchicine responsive patients (p < 0.001). Plasma vitamin D levels were significantly lower in colchicine resistant patients. Vitamin D deficiency may be a factor in etiopathogenesis of CR. Studies in larger patient samples that particularly evaluate the response to vitamin D replacement in CR FMF patients are needed.
Insights
Familial Mediterranean fever patients resistant to colchicine treatment have significantly lower vitamin D levels. This suggests vitamin D deficiency may contribute to colchicine resistance in FMF.
Area of Science:
- Rheumatology
- Genetics
- Endocrinology
Background:
- Familial Mediterranean fever (FMF) is an autoinflammatory disease treated with colchicine.
- Colchicine resistance (CR) affects up to 30% of FMF patients, posing a clinical challenge.
- Previous research indicates lower vitamin D levels in FMF patients compared to healthy individuals.
Purpose of the Study:
- To investigate the association between vitamin D levels and colchicine resistance in FMF patients.
- To determine if vitamin D levels differ between CR and colchicine-responsive (non-CR) FMF patient groups.
Main Methods:
- A cohort of 64 FMF patients from a nephrology clinic was studied.
- Serum 25-hydroxy vitamin D (25-OHD) levels were measured in patients not experiencing acute attacks.
- Patients were categorized as CR or non-CR based on established clinical criteria.
Main Results:
- A significant difference in mean 25-OHD levels was observed between the groups (9.39 ng/mL in CR vs. 18.48 ng/mL in non-CR patients).
- Colchicine-resistant FMF patients exhibited markedly lower plasma vitamin D concentrations.
- The difference in vitamin D levels between CR and non-CR FMF patients was statistically significant (p < 0.001).
Conclusions:
- Vitamin D deficiency may play a role in the etiopathogenesis of colchicine resistance in FMF.
- Further research with larger cohorts, focusing on vitamin D supplementation in CR FMF patients, is warranted.
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