Colchicine kinetics in patients with familial Mediterranean fever

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Abstract
Serum colchicine levels were determined by radioimmunoassay after a 1 mg bolus injected i.v. in 4 patients with familial Mediterranean fever and in 6 normal subjects. Mean elimination half-life (t 1/2) (.+-.SEM, standard error of the mean) was 157 .+-. 20 min in the patients and 65 .+-. 15 min in the normal subjects (P < 0.005). Total clearance was 239 .+-. 50 ml/min in the patients and 601 .+-. 155 ml/min in the normal subjects (P < 0.05). Volume of distribution (Vdarea) was 76 .+-. 16 and 49 .+-. 91 and did not differ significantly. In 8 patients receiving colchicine prophylactically with good clinical response, serum colchicine ranged from 0.3-2.4 ng/ml after daily doses of 1 mg orally. In 2 responding patients, 2 mg doses orally induced levels from 4-10 ng/ml, and in 1 (a nonresponder) a 3 mg dose induced levels of 7.5-13 ng/ml. Of 3 patients receiving 2 mg daily with unsatisfactory clinical responses, serum levels were not detectable in 1 and in the low range of 1.5-5.4 ng/ml in the others. Lack of response to oral colchicine in some nonresponders could be due to inadequate absorption or altered disposition of colchicine.

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