Introduction
Various levels of oral colchicine resistance is still an unmet challenge of FMF treatment. IV colchicine was shown to be effective and safe answer, but its long term outcomes are not known.
Objectives
To determine long term effectiveness and safety of IV colchicine treatment in oral colchicine refractory or intolarant FMF patients.
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Methods
Included were all patients, experiencing ≥1 attack per month, or intolerant to adequate dose of oral colchicin, for which they receive IV colchicine (pharmacy preparation under government control) for at least 1 year. Retrieval of data was based on patient interviews, files and a detailed questionnaire, focusing on clinical, demographic and genetic data. Effect of colchicine was determined, by computing attack rate, duration and intensity, the later with 1-10 scale.
Results
Ten of 11 identified patients, on long term IV colchicine treatment, consented to partake. Treatment lasted 3.6 ±2.7 (1- 10) years. More than 50% reduction in the rate of abdominal, chest, joint and skin attacks was noted by 8 of 10 patients. The intensity of the attacks dropped by a mean of 50±22% and the duration by 40±20%. In 4 patients the favorable effect has decreased partially, but in only one treatment was stopped for this reason. Treatment was terminated in another 2 for loss of venous access (1) and for paresthesis. Adverse effects included diarrhea (1 patient), vomiting (2), injection site pain (3), headache (1), muscle pain (1), injection site phlebitis (1) and arm paresthesis (1).
Conclusion
Long term parenteral colchicine treatment proved effective and safe. Downloading I.V. colchicine off the shelves due to intoxication associated with uncontrolled and unjustified use for back pain, had serious negative impact on our armamentarium for oral colchicine nonresponsiveness and intolerance.
Disclosure of interest
None declared.
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Open Access
This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution License (
https://creativecommons.org/licenses/by/2.0
), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (
https://creativecommons.org/publicdomain/zero/1.0/
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