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Defining colchicine resistance/intolerance in patients with familial Mediterranean fever: a modified-Delphi consensus

Seza Özen1, Erdal Sag1, Eldad Ben-Chetrit2

  • 1Department of Pediatrics, Division of Pediatric Rheumatology, Hacettepe University, Ankara 06100, Turkey.

Rheumatology (Oxford, England)
|December 17, 2020
PubMed
Abstract

Insights

New guidelines define colchicine resistance and intolerance in Familial Mediterranean Fever (FMF) patients. These evidence-based statements aid clinicians in managing FMF when colchicine treatment is ineffective or not tolerated.

Area of Science:

  • Rheumatology
  • Genetics
  • Internal Medicine

Background:

  • Familial Mediterranean Fever (FMF) is primarily treated with colchicine.
  • A lack of standardized definitions for colchicine resistance and intolerance complicates FMF management.
  • This study addresses the need for clear criteria to identify patients unresponsive to or unable to tolerate colchicine.

Framework:

  • A modified-Delphi consensus-based approach was employed to develop core statements.
  • Systematic literature review informed an initial questionnaire for expert rheumatologists.
  • An international panel of 11 FMF experts participated in the consensus process.

Implementation:

  • Eight core statements defining colchicine resistance/intolerance in FMF were established.
  • Resistance criteria include recurrent attacks (≥1/month for 3 months) or persistent inflammation.
  • Statements emphasize assessing treatment adherence and the impact of disease activity and intolerance on quality of life.

Implications:

  • These evidence-based statements provide a guide for clinicians and health authorities in FMF patient management.
  • Standardized definitions will improve the identification and treatment of colchicine-resistant/intolerant FMF cases.
  • Enhanced management strategies can improve outcomes for patients with FMF.
Keywords:
DMARDautoinflammatory conditionsinflammationoutcome measuresquality of life care

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