Colchicine Therapy for Familial Mediterranean Fever

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Abstract
Eleven patients with long standing familial Mediterranean fever were studied in a double-blind trial using daily colchicine or placebo. During 60 courses of placebo, 38 attacks of familial Mediterranean fever occurred. In contrast, during 60 courses of colchicine only seven attacks occurred (p<0.001, by chi-square test). The seven attacks on colchicine were evenly distributed throughout the study period. Although the initial dose was three tablets daily, most patients were maintained on two tablets of colchicine per day. The efficacy of the drug in preventing attacks of familial Mediterranean fever was dose related. There were no major side effects from daily colchicine except frequent loose stools, which were correctable by reduction of the dose. This study demonstrates that daily colchicine is highly effective in preventing attacks in this disorder. (N Engl J Med 291:934–937, 1974)