Treatment Adherence in Familial Mediterranean Fever Patients: Real-Life Data from Central Anatolia

Objective: Familial Mediterranean Fever (FMF) is a hereditary autoinflammatory disorder characterized by recurrent febrile episodes and serosal inflammation. Colchicine remains the cornerstone of FMF treatment, and adherence to therapy is critical to prevent disease flares and long-term complications such as amyloidosis. However, studies on treatment adherence in FMF are limited and report varying rates. This study aimed to evaluate treatment adherence in FMF patients and its association with clinical variables using real-life data from Central Anatolia. Methods: This retrospective cross-sectional study included FMF patients aged 18 years and older who were followed at a tertiary rheumatology outpatient clinic and met the Tel-Hashomer diagnostic criteria. Demographic and clinical data were collected through structured interviews and medical record reviews. Treatment adherence was assessed via self-report. Associations between adherence and variables such as attack frequency, disease duration, drug adverse events, and follow-up visits were analyzed using Mann-Whitney U, Chi-square, and Spearman correlation tests as appropriate. Results: 70 patients (64.3% female, median age 33.5 years) were included. The majority (89.2%) reported regular adherence to treatment. Colchicine was the most commonly used drug, with a median dose of 1.5 mg/day. A weak, non-significant positive correlation was found between colchicine dose and the number of attacks in the last 6 months (ρ = 0.229, p = 0.071). There was no statistically significant association between treatment adherence and attack frequency (p = 0.622), disease duration (p = 0.134), follow-up frequency (p = 0.779), side effects (p = 0.582), proteinuria (p = 1.000), or marital status (p = 0.105). Discussion: Despite high levels of reported adherence to colchicine among FMF patients, this did not consistently correlate with improved clinical outcomes. These findings highlight the complex nature of treatment adherence and underscore the need for individualized support strategies and objective adherence assessment tools in FMF management.