Different Pharmaceutical Preparations of Colchicine can be an Alternative Treatment Before Switching to Biological Agents in Patients with Familial Mediterranean Fever

Colchicine is the mainstay of treatment of Familial Mediterranean Fever (FMF). In Türkiye, imported compressed colchicine tablets are commonly used before switching to biological treatments in cases where domestic film or sugar-coated colchicine tablets are ineffective or have adverse effects. We aimed to compare different pharmaceutical preparations of colchicine in terms of treatment efficacy and frequency of adverse effects in Turkish FMF patients. Our study included 75 Turkish adult FMF patients followed at the Bursa Uludağ University Faculty of Medicine rheumatology outpatient clinic serving as a single center between January 2016 and December 2019, who were switched from domestic sugar- or film-coated colchicine preparations to imported compressed colchicine tablets due to resistance or adverse effects. Our study included 75 Turkish adult FMF patients followed up in a single center, who were switched to imported compressed colchicine tablets due to resistance or adverse effects while using a sugar or film-coated domestic colchicine preparation. Patient files were accessed retrospectively from the hospital database. The change in pharmaceutical preparation was due to resistance in 84% of patients, and the post-change resistance rate decreased to 17.3%. After the treatment change, the annual median attack frequency and duration, the median C-reactive protein and erythrocyte sedimentation rate in the attack-free period decreased compared to before, and all changes were statistically significant (p<0.001). The preparation was changed due to adverse effects in 29.3% of patients, and the adverse effect rate decreased by 5.3% after the drug change (p<0.001). FMF patients who are resistant to domestically produced coated colchicine tablets or cannot use them due to adverse effects may benefit from imported compressed colchicine tablets. Therefore, the option of imported compressed colchicine should be kept in mind before switching to biological treatments.