Background: Familial Mediterranean Fever (FMF) is a condition marked by recurring episodes of polyserositis, and some patients may experience joint involvement either during attacks or in a chronic form. The presence of Spondyloarthropathy (SpA) and its common features alongside FMF is often observed study. In certain instances, chronic arthritis or other SpA findings does not show a response to colchicine treatment.

Objectives: In this study, we explored the connection between SpA, its musculoskeletal features, chronic arthritis, and resistance to colchicine in our FMF patient group.

Methods: We enrolled 243 adult patients with Familial Mediterranean Fever (FMF) in our study, all of whom met the Tel-Hashomer Criteria. Various data, including demographic information, disease-related features, smoking habits, and comorbidities, were collected. Additionally, we utilized The International Severity Scoring System for FMF (ISSF) scores to assess the severity of the disease. Colchicine resistance was identified in patients who continued to experience one or more attacks per month despite receiving the maximum tolerated dose for at least 6 months and/or ongoing subclinical inflammation. In our research, we categorized patients into two groups based on whether they exhibited resistance to colchicine. We initially compared FMF-related features between these groups. Next, we examined the variables that showed significance in the initial analysis using a more comprehensive multivariate approach to understand their relationship with colchicine resistance.

Results: Colchicine resistance was present in 54 (%22.2) of 243 patients included in the study. There was no difference between patients with and without colchicine resistance in terms of age (p=0.36), gender (p=0.94), disease duration (p=0.76), frequency of SpA (p=0.37), Charston comorbidity score (p=0.22), smoking (p=0.87), presence of musculoskeletal system findings (p=0.11), erysipelas-like rash (p=0.32), sacroiliitis (p=0.34), enthesitis (p=0.56) and presence of exon 10 MEFV mutation (p=0.05). However, the frequency of attacks (p<0.001), ISSF score (p<0.001), amyloidosis (p<0.001) and chronic arthritis (p=0.001) were more frequent in the colchicine resistant group. Mean colchicine dose was found to be higher in the resistant group (p=0.001). In multivariate analysis, ISSF score (p=0.003), attack frequency (p=0.03), resistant arthritis (p=0.002) and amyloidosis (p<0.001) were found to be associated with colchicine resistance (Table 1).

Conclusion: The study revealed that the occurrence of colchicine resistance is linked to the presence of chronic arthritis, along with amyloidosis,attack frequency and ISSF score, while no such association was identified with SpA or all other SpA features.

REFERENCES: NIL.

Acknowledgements: NIL. None

Disclosure of Interests: None declared.