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Published in: Arthritis Research & Therapy 1/2016

Open Access 01-12-2016 | Research article

Comparison of the efficacy of once- and twice-daily colchicine dosage in pediatric patients with familial Mediterranean fever – a randomized controlled noninferiority trial

Authors: Adem Polat, Cengizhan Acikel, Betul Sozeri, Ismail Dursun, Ozgur Kasapcopur, Nesrin Gulez, Dogan Simsek, Mehmet Saldir, Ipek Dokurel, Hakan Poyrazoglu, Sevcan Bakkaloglu, Ali Delibas, Zelal Ekinci, Nuray A. Ayaz, Yasar Kandur, Harun Peru, Yasemin G. Kurt, Safiye R. Polat, Erbil Unsal, Balahan Makay, Faysal Gok, Seza Ozen, Erkan Demirkaya, for the FMF Arthritis Vasculitis and Orphan Disease Research in Pediatric Rheumatology (FAVOR)

Published in: Arthritis Research & Therapy | Issue 1/2016

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Abstract

Background

In this study, we examined the efficacy and safety of a once-daily dosage schema of colchicine compared with a twice-daily dosage schema in pediatric patients with familial Mediterranean fever (FMF).

Methods

In this 24-week, multicenter, randomized controlled noninferiority trial, pediatric patients newly diagnosed with FMF carrying a homozygous or compound heterozygous mutation and not receiving any treatment were included. Patients were randomly assigned using a block randomization method to receive treatment with a once- or twice-daily dosage. Clinical and laboratory characteristics and medication side effects were recorded and compared between groups. The study was carried out in compliance with Good Clinical Practice and the Consolidated Standards for Reporting of Trials (CONSORT) statement.

Results

A total of 92 patients were selected, and 79 patients completed the study. There were 42 patients in the once-daily dosage group and 37 in the twice-daily dosage group. The results indicated that the once-daily dosage was not inferior to the twice-daily dosage regarding decrease in attack frequency and duration as well as improvement in clinical findings and Mor severity scores. Alterations in laboratory findings indicating inflammation, such as erythrocyte sedimentation rate, C-reactive protein, and serum amyloid A, were similar in both groups. The rates of drug side effects were similar between the once- and twice-daily dosage groups, implying comparable safety of colchicine, with the exception of diarrhea, which was slightly higher in the once-daily dosage group.

Conclusions

Using colchicine with either a once- or twice-daily dosage provides similar clinical and laboratory improvements. Considering both efficacy and safety, colchicine can be prescribed with a once-daily dosage.

Trial Registration ID

ClinicalTrials.gov identifier NCT02602028. Registered 5 November 2015.
Literature
2.
go back to reference Simon A, van der Meer JW, Drenth JP. Familial Mediterranean fever—a not so unusual cause of abdominal pain. Best Pract Res Clin Gastroenterol. 2005;19:199–213.CrossRefPubMed Simon A, van der Meer JW, Drenth JP. Familial Mediterranean fever—a not so unusual cause of abdominal pain. Best Pract Res Clin Gastroenterol. 2005;19:199–213.CrossRefPubMed
3.
go back to reference Gedalia A, Adar A, Gorodischer R. Familial Mediterranean fever in children. J Rheumatol Suppl. 1992;35:1–9.PubMed Gedalia A, Adar A, Gorodischer R. Familial Mediterranean fever in children. J Rheumatol Suppl. 1992;35:1–9.PubMed
5.
go back to reference Girre C, Thomas G, Scherrmann J, Crouzette J, Fournier P. Model‐independent pharmacokinetics of colchicine after oral administration to healthy volunteers. Fundam Clin Pharmacol. 1989;3:537–43.CrossRefPubMed Girre C, Thomas G, Scherrmann J, Crouzette J, Fournier P. Model‐independent pharmacokinetics of colchicine after oral administration to healthy volunteers. Fundam Clin Pharmacol. 1989;3:537–43.CrossRefPubMed
6.
go back to reference Thomas G, Girre C, Scherrmann J, Francheteau P, Steimer J. Zero-order absorption and linear disposition of oral colchicine in healthy volunteers. Eur J Clin Pharmacol. 1989;37:79–84.PubMed Thomas G, Girre C, Scherrmann J, Francheteau P, Steimer J. Zero-order absorption and linear disposition of oral colchicine in healthy volunteers. Eur J Clin Pharmacol. 1989;37:79–84.PubMed
7.
go back to reference Chappey ON, Niel E, Wautier JL, Hung PP, Dervichian M, Cattan D, et al. Colchicine disposition in human leukocytes after single and multiple oral administration. Clin Pharmacol Ther. 1993;54:360–7.CrossRefPubMed Chappey ON, Niel E, Wautier JL, Hung PP, Dervichian M, Cattan D, et al. Colchicine disposition in human leukocytes after single and multiple oral administration. Clin Pharmacol Ther. 1993;54:360–7.CrossRefPubMed
8.
go back to reference Chappey O, Niel E, Dervichian M, Wautier J, Scherrmann J, Cattan D. Colchicine concentration in leukocytes of patients with familial Mediterranean fever. Br J Clin Pharmacol. 1994;38:87–9.CrossRefPubMedPubMedCentral Chappey O, Niel E, Dervichian M, Wautier J, Scherrmann J, Cattan D. Colchicine concentration in leukocytes of patients with familial Mediterranean fever. Br J Clin Pharmacol. 1994;38:87–9.CrossRefPubMedPubMedCentral
10.
go back to reference Goldfinger SE. Colchicine for familial Mediterranean fever. N Engl J Med. 1972;287:1302.PubMed Goldfinger SE. Colchicine for familial Mediterranean fever. N Engl J Med. 1972;287:1302.PubMed
11.
go back to reference Goldstein RC, Schwabe AD. Prophylactic colchicine therapy in familial Mediterranean fever: a controlled, double-blind study. Ann Intern Med. 1974;81:792–4.CrossRefPubMed Goldstein RC, Schwabe AD. Prophylactic colchicine therapy in familial Mediterranean fever: a controlled, double-blind study. Ann Intern Med. 1974;81:792–4.CrossRefPubMed
12.
go back to reference Rigante D, La Torraca I, Avallone L, Pugliese A, Gaspari S, Stabile A. The pharmacologic basis of treatment with colchicine in children with familial Mediterranean fever. Eur Rev Med Pharmacol Sci. 2006;10:173–8.PubMed Rigante D, La Torraca I, Avallone L, Pugliese A, Gaspari S, Stabile A. The pharmacologic basis of treatment with colchicine in children with familial Mediterranean fever. Eur Rev Med Pharmacol Sci. 2006;10:173–8.PubMed
13.
go back to reference Ozen S, Demirkaya E, Erer B, Livneh A, Ben-Chetrit E, Giancane G, et al. EULAR recommendations for the management of familial Mediterranean fever. Ann Rheum Dis. 2016;75:644–51.CrossRefPubMed Ozen S, Demirkaya E, Erer B, Livneh A, Ben-Chetrit E, Giancane G, et al. EULAR recommendations for the management of familial Mediterranean fever. Ann Rheum Dis. 2016;75:644–51.CrossRefPubMed
14.
go back to reference Eisen SA, Miller DK, Woodward RS, Spitznagel E, Przybeck TR. The effect of prescribed daily dose frequency on patient medication compliance. Arch Intern Med. 1990;150:1881–4.CrossRefPubMed Eisen SA, Miller DK, Woodward RS, Spitznagel E, Przybeck TR. The effect of prescribed daily dose frequency on patient medication compliance. Arch Intern Med. 1990;150:1881–4.CrossRefPubMed
15.
go back to reference Knieper A, Klotsche J, Föll D, Wittkowski H, Lainka E, Kallinich T. Colchicine therapy in children with FMF. Pediatr Rheumatol Online J. 2015;13(1):O44.CrossRefPubMedCentral Knieper A, Klotsche J, Föll D, Wittkowski H, Lainka E, Kallinich T. Colchicine therapy in children with FMF. Pediatr Rheumatol Online J. 2015;13(1):O44.CrossRefPubMedCentral
16.
go back to reference Schulz KF, Altman DG, Moher D, the CONSORT Group. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMC Med. 2010;8:18.CrossRefPubMedPubMedCentral Schulz KF, Altman DG, Moher D, the CONSORT Group. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMC Med. 2010;8:18.CrossRefPubMedPubMedCentral
17.
go back to reference Yalçınkaya F, Özen S, Özçakar ZB, Aktay N, Çakar N, Düzova A, et al. A new set of criteria for the diagnosis of familial Mediterranean fever in childhood. Rheumatology. 2009;48:395–8.CrossRefPubMed Yalçınkaya F, Özen S, Özçakar ZB, Aktay N, Çakar N, Düzova A, et al. A new set of criteria for the diagnosis of familial Mediterranean fever in childhood. Rheumatology. 2009;48:395–8.CrossRefPubMed
18.
go back to reference Livneh A, Langevitz P, Zemer D, Zaks N, Kees S, Lidar T, et al. Criteria for the diagnosis of familial Mediterranean fever. Arthritis Rheum. 1997;40:1879–85.CrossRefPubMed Livneh A, Langevitz P, Zemer D, Zaks N, Kees S, Lidar T, et al. Criteria for the diagnosis of familial Mediterranean fever. Arthritis Rheum. 1997;40:1879–85.CrossRefPubMed
19.
go back to reference Ozen S, Aktay N, Lainka E, Duzova A, Bakkaloglu A, Kallinich T. Disease severity in children and adolescents with familial Mediterranean fever: a comparative study to explore environmental effects on a monogenic disease. Ann Rheum Dis. 2009;68:246–8.CrossRefPubMed Ozen S, Aktay N, Lainka E, Duzova A, Bakkaloglu A, Kallinich T. Disease severity in children and adolescents with familial Mediterranean fever: a comparative study to explore environmental effects on a monogenic disease. Ann Rheum Dis. 2009;68:246–8.CrossRefPubMed
20.
go back to reference Kallinich T, Haffner D, Niehues T, Huss K, Lainka E, Neudorf U, et al. Colchicine use in children and adolescents with familial Mediterranean fever: literature review and consensus statement. Pediatrics. 2007;119:474–83.CrossRef Kallinich T, Haffner D, Niehues T, Huss K, Lainka E, Neudorf U, et al. Colchicine use in children and adolescents with familial Mediterranean fever: literature review and consensus statement. Pediatrics. 2007;119:474–83.CrossRef
21.
go back to reference Duzova A, Bakkaloglu A, Besbas N, Topaloglu R, Ozen S, Ozaltin F, et al. Role of A-SAA in monitoring subclinical inflammation and in colchicine dosage in familial Mediterranean fever. Clin Exp Rheumatol. 2003;21:509–14.PubMed Duzova A, Bakkaloglu A, Besbas N, Topaloglu R, Ozen S, Ozaltin F, et al. Role of A-SAA in monitoring subclinical inflammation and in colchicine dosage in familial Mediterranean fever. Clin Exp Rheumatol. 2003;21:509–14.PubMed
22.
go back to reference Blackwelder WC. “Proving the null hypothesis” in clinical trials. Control Clin Trials. 1982;3(4):345–53.CrossRefPubMed Blackwelder WC. “Proving the null hypothesis” in clinical trials. Control Clin Trials. 1982;3(4):345–53.CrossRefPubMed
23.
go back to reference Dinarello CA, Wolff SM, Goldfinger SE, Dale DC, Alling DW. Colchicine therapy for familial Mediterranean fever: a double-blind trial. N Engl J Med. 1974;291:934–7.CrossRefPubMed Dinarello CA, Wolff SM, Goldfinger SE, Dale DC, Alling DW. Colchicine therapy for familial Mediterranean fever: a double-blind trial. N Engl J Med. 1974;291:934–7.CrossRefPubMed
24.
go back to reference Amaryan G, Astvatsatryan V, Gabrielyan E, Panossian A, Panosyan V, Wikman G. Double-blind, placebo-controlled, randomized, pilot clinical trial of ImmunoGuard – a standardized fixed combination of Andrographis paniculata Nees, with Eleutherococcus senticosus Maxim., Schizandra chinensis Bail. and Glycyrrhiza glabra L. extracts in patients with familial Mediterranean fever. Phytomedicine. 2003;10:271–85.CrossRefPubMed Amaryan G, Astvatsatryan V, Gabrielyan E, Panossian A, Panosyan V, Wikman G. Double-blind, placebo-controlled, randomized, pilot clinical trial of ImmunoGuard – a standardized fixed combination of Andrographis paniculata Nees, with Eleutherococcus senticosus Maxim., Schizandra chinensis Bail. and Glycyrrhiza glabra L. extracts in patients with familial Mediterranean fever. Phytomedicine. 2003;10:271–85.CrossRefPubMed
25.
go back to reference Wright DG, Wolff SM, Fauci AS, Alling DW. Efficacy of intermittent colchicine therapy in familial Mediterranean fever. Ann Intern Med. 1977;86:162–5.CrossRefPubMed Wright DG, Wolff SM, Fauci AS, Alling DW. Efficacy of intermittent colchicine therapy in familial Mediterranean fever. Ann Intern Med. 1977;86:162–5.CrossRefPubMed
26.
go back to reference Mor A, Shinar Y, Zaks N, Langevitz P, Chetrit A, Shtrasburg S, et al. Evaluation of disease severity in familial Mediterranean fever. Semin Arthritis Rheum. 2005;35:57–64.CrossRefPubMed Mor A, Shinar Y, Zaks N, Langevitz P, Chetrit A, Shtrasburg S, et al. Evaluation of disease severity in familial Mediterranean fever. Semin Arthritis Rheum. 2005;35:57–64.CrossRefPubMed
27.
go back to reference Lachmann H, Şengül B, Yavuzşen T, Booth D, Booth S, Bybee A, et al. Clinical and subclinical inflammation in patients with familial Mediterranean fever and in heterozygous carriers of MEFV mutations. Rheumatology. 2006;45:746–50.CrossRefPubMed Lachmann H, Şengül B, Yavuzşen T, Booth D, Booth S, Bybee A, et al. Clinical and subclinical inflammation in patients with familial Mediterranean fever and in heterozygous carriers of MEFV mutations. Rheumatology. 2006;45:746–50.CrossRefPubMed
Metadata
Title
Comparison of the efficacy of once- and twice-daily colchicine dosage in pediatric patients with familial Mediterranean fever – a randomized controlled noninferiority trial
Authors
Adem Polat
Cengizhan Acikel
Betul Sozeri
Ismail Dursun
Ozgur Kasapcopur
Nesrin Gulez
Dogan Simsek
Mehmet Saldir
Ipek Dokurel
Hakan Poyrazoglu
Sevcan Bakkaloglu
Ali Delibas
Zelal Ekinci
Nuray A. Ayaz
Yasar Kandur
Harun Peru
Yasemin G. Kurt
Safiye R. Polat
Erbil Unsal
Balahan Makay
Faysal Gok
Seza Ozen
Erkan Demirkaya
for the FMF Arthritis Vasculitis and Orphan Disease Research in Pediatric Rheumatology (FAVOR)
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Arthritis Research & Therapy / Issue 1/2016
Electronic ISSN: 1478-6362
DOI
https://doi.org/10.1186/s13075-016-0980-7

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