Non-adherence to colchicine treatment is a common misevaluation in familial  Mediterranean fever

Tekgöz, Emre; Çolak, Seda; Çınar, Fatma İlknur; Yılmaz, Sedat; Çınar, Muhammet

doi:10.3906/sag-2102-328

Cited by 11 publications

(5 citation statements)

References 22 publications

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“…Various factors like disease pattern, severity, administration route of the drug, side effects, patient demographics, socioeconomic status, knowledge and perception regarding the drug may affect the patient's compliance [10][11][12][13]. Similarly, in FMF adherence to colchicine varies between 33.3-51.5 % [14][15][16][17]. Furthermore, rate of true colchicine resistance reported to reduce to 5 % from 5-15 % in FMF, when patients were questioned for drug adherence and non-adherent patients were excluded [18][19][20].…”

Section: Discussionmentioning

confidence: 99%

Adherence to Colchicine During Pregnancy in Familial Mediterranean Fever Patients: Reasons for Cessation and Outcomes from a Single-Centre Experience

Doğan

Güven

Karakaş

et al. 2023

Aktuelle Rheumatologie

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Objective To evaluate the adherence to colchicine treatment during pregnancy and lactation in our Familial Mediterranean fever (FMF) patients and investigate the reasons for non-adherence and consequences. Methods Adult female FMF patients who were followed up in our rheumatology clinic and had a history of pregnancy after the diagnosis of FMF were consecutively enrolled to this cross-sectional study between November 2021 and June 2022. Only pregnancies occurring after the diagnosis of FMF were evaluated. Patients who did not stop using FMF treatment after pregnancy were considered to adhere to treatment. Results In 50 patients, a total of 88 pregnancies and 58 live births were observed after the diagnosis of FMF. 37 (74%) had at least one completed pregnancy, and 13 (26.0) were pregnant during the study. Among the 37 patients, 34 had at least one live birth. No significant differences were observed when rates of patients with a history of at least one live birth, abortus, Cesarean section (C/S), preterm labor, stillbirth, intrauterine anomaly, congenital malformation and fetal growth retardation were compared between colchicine users and non-users. 60% of the patients adhered to colchicine treatment during pregnancy and 73.4% did so while breastfeeding. The most common reason for colchicine cessation was concerns regarding potential harm to the fetus (70%), followed by the presumption that colchicine is contraindicated in pregnancy (15%) as well as absence of FMF attacks (10%). The most common source of the patients’ opinion was a physician (60%). Conclusions Both patients and attending physicians should be informed to be more adherent to colchicine to avoid adverse outcomes and FMF-related complications.

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Section: Discussionmentioning

confidence: 99%

Adherence to Colchicine During Pregnancy in Familial Mediterranean Fever Patients: Reasons for Cessation and Outcomes from a Single-Centre Experience

Doğan

Güven

Karakaş

et al. 2023

Aktuelle Rheumatologie

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“…Among the observed cohort of diabetic patients, the proportion of high-adherent patients diagnosed with several concomitant diseases exceeded the proportion of low- and middle-adherent patients. Other studies also found that medication adherence was higher among patients “with” in comparison with those “without” concomitant diseases, probably due to their increased concerns about worsening in their condition [ 29 , 30 ]. The odds of medication adherence among patients with chronic conditions taking four medicines are higher than those taking one medicine [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Medication Adherence among Patients with Diabetes Mellitus and Its Related Factors—A Real-World Pilot Study in Bulgaria

Dinkova,

Marinov,

Doneva

et al. 2023

Medicina

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Background and Objectives: The objective is to evaluate medication adherence level (MA) and the relevant determinants of MA among patients with type 2 diabetes mellitus (T2DM) monitored in ambulatory settings by general practitioners. Materials and Methods: A cross-sectional study was conducted among patients with T2DM monitored in a GP practice in Sofia, Bulgaria (September–December 2022). All patients were interviewed according to a predesigned questionnaire after granting informed consent. MA level was evaluated through the Morisky–Green four-item questionnaire, and health-related quality of life was evaluated by EQ-5D-5L and VAS (visual analogue scale). Data were aggregated and statistically evaluated. Results: The total number of observed patients was 93. Around 48.4% of patients were female, and 90.3% of patients were between 50 and 80 years of age. Multimorbidity was identified among 70% (n = 65) of the respondents. High and medium levels of MA were revealed in 64.51% and 33.3% of respondents, respectively. Patients treated with insulin secretagogues were most adherent to the therapy (n = 83.3%) in comparison with the other treatment groups. The onset of the disease, professional status, age, gender, number of therapies, and quality of life did not affect the level of MA (p > 0.05). VAS scores among nonsmokers (VAS = 63.16 ± 20.45 vs. 72.77 ± 14.3) and non-consumers of alcohol (VAS = 63.91 ± 19.34 vs. VAS = 72.54 ± 15.98) were statistically significant lower (p < 0.05). A significant related factor for MA was years lived with diabetes (OR = 3.039, 95% CI 1.1436–8.0759, p = 0.0258). The longer the disease duration, the more the odds for a high MA level increased. Conclusions: The number of nonadherent diabetic patients in Bulgaria is low, which might be evidence of patients’ concern about their own health and understanding about the importance of prescribed therapy. Further comprehensive study with additional patients is required to confirm the results and investigate the predicting factors for a high level of MA.

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“…However, many factors could contribute to insufficient response to colchicine: lack of compliance, the occurrence of side effects, drug interactions, genetic factors, and environmental factors (infections, stress, and diet) ( 131 ). All studies and definitions agree that a maximum tolerated dosing of colchicine ( 132 ) and the assessment of compliance are the prerequisites before discussing crFMF ( 133 ), but finding a standardized way is challenging ( 134 ). Missing tablet count, Morisky score ( 135 ), and colchicine dosage in the hair were rarely reported in our study.…”

Section: Discussionmentioning

confidence: 99%

Real-Life Indications of Interleukin-1 Blocking Agents in Hereditary Recurrent Fevers: Data From the JIRcohort and a Literature Review

et al. 2021

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BackgroundInterleukin (IL)-1 inhibitors represent the main treatment in patients with colchicine-resistant/intolerant familial Mediterranean fever (crFMF), mevalonate kinase deficiency (MKD), and tumor necrosis factor receptor-associated periodic syndrome (TRAPS). However, the reasons for the use of IL-1 inhibitors in these diseases are still not completely clarified.ObjectiveIdentify real-life situations that led to initiating anakinra or canakinumab treatment in hereditary recurrent fevers (HRFs), combining data from an international registry and an up-to-date literature review.Patients and MethodsData were extracted from the JIRcohort, in which clinical information (demographic data, treatment, disease activity, and quality of life) on patients with FMF, MKD, and TRAPS was retrospectively collected. A literature search was conducted using Medline, EMBASE, and Cochrane databases.ResultsComplete data of 93 patients with HRF (53.8% FMF, 31.2% MKD, and 15.1% TRAPS) were analyzed. Data from both the registry and the literature review confirmed that the main reasons for use of IL-1 blockers were the following: failure of previous treatment (n = 57, 61.3% and n = 964, 75.3%, respectively), persistence of disease activity with frequent attacks (n = 44, 47.3% and n = 1,023, 79.9%) and/or uncontrolled inflammatory syndrome (n = 46, 49.5% and n = 398, 31.1%), severe disease complication or associated comorbidities (n = 38, 40.9% and n = 390, 30.4%), and worsening of patients’ quality of life (n = 36, 38.7% and n = 100, 7,8%). No reasons were specified for 12 (16.4%) JIRcohort patients and 154 (12%) patients in the literature.ConclusionIn the absence of standardized indications for IL-1 inhibitors in crFMF, MKD, and TRAPS, these results could serve as a basis for developing a treat-to-target strategy that would help clinicians codify the therapeutic escalation with IL-1 inhibitors.

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Non-adherence to colchicine treatment is a common misevaluation in familial Mediterranean fever

Cited by 11 publications

References 22 publications

Adherence to Colchicine During Pregnancy in Familial Mediterranean Fever Patients: Reasons for Cessation and Outcomes from a Single-Centre Experience

Adherence to Colchicine During Pregnancy in Familial Mediterranean Fever Patients: Reasons for Cessation and Outcomes from a Single-Centre Experience

Medication Adherence among Patients with Diabetes Mellitus and Its Related Factors—A Real-World Pilot Study in Bulgaria

Real-Life Indications of Interleukin-1 Blocking Agents in Hereditary Recurrent Fevers: Data From the JIRcohort and a Literature Review

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