Blood Group ”a“ Was Increased in FMF Patients and Blood Group ”0“ May be Associated with Colchicine Resistance

Abdulsamet Erden¹, Ezgi Deniz Batu², Berkan Armagan³, Hafize Emine Sonmez⁴, Alper Sari³, Selcan Demir⁴, Emre Bilgin⁵, Esra Fırat⁵, Levent Kilic¹, Yelda Bilginer⁶, Omer Karadag¹, Umut Kalyoncu¹ and Sedat Kiraz¹, ¹Department of Internal Medicine, Divison of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey, ²Department of Pediatrics, Divison of Rheumatology, Hacettepe University Faculty of Medicine, ANKARA, Turkey, ³Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey, ⁴Department of Pediatrics, Divison of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey, ⁵Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey, ⁶Department of Pediatrics, Division of Rheumatology, Hacettepe University Faculty of Medicine, ANKARA, Turkey

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: Autoinflammation and familial Mediterranean fever

Session Information

Date: Tuesday, November 7, 2017

Title: Miscellaneous Rheumatic and Inflammatory Diseases Poster II

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose: Colchicine is the main therapy for familial Mediterranean fever (FMF). However, about 5-10% of FMF patients are colchicine-resistant (1). The reason for colchicine resistance in FMF patients remains obscure. ABO genes are distributed differently among socioeconomic groups, and socioeconomic status is one of the risk factors for disease severity in FMF. To date, no report has evaluated this relation. Our aim was to investigate the association between blood groups and colchicine resistance in FMF patients.

Methods: This is a single-center, cross-sectional study. Between January and December 2016 385 FMF patients were assessed by the Adult and Pediatric Rheumatology outpatient clinics and 297 patients had blood groups (ABO and Rh) results. The blood groups in 1000 volunteer donors who admitted to the Turkish Red Crescent Blood Service in Ankara in 2015 were enrolled as healthy control group. Demographic and clinical data collected for each patient. Response to colchicine was evaluated by two experts (YB and UK). The patients were grouped into two groups: colchicine-responsive patients (Group CR) and colchicine-unresponsive patients (Group CUR).

Results: 297 patients were included in the study. As expected, the acute phase reactants were higher and arthralgia/arthritis, pleuritic chest pain, and erysipelas-like erythema were more frequent in group CUR (p<0.05). FMF patients had frequently blood group “A” than healthy controls (152/297 (51.2%) vs 420/1000 (42.0%), p=0.006). Patients with blood group “A” had 1.5 folds higher FMF compared to “non-A” blood group [OR 1.50 (95% CI 1.11-1.87)], particularly having “A” Rh (+) blood group [OR 1.47 (95% CI 1.13-1.91)]. Furthermore, patients with blood group “A” had a better response to colchicine treatment than “non-A” blood group OR 2.21 (95% CI 1.15-4.27). On the contrary, patients with blood group “0” had prominently associated with unresponsive to colchicine (Table 1).

Table 1. Comparison of blood groups between colchicine unresponsive and responsive familial Mediterranean fever (FMF)^a patients

ABO / Rh blood group	Colchicine unresponsive FMF^a patients (n=46)	Colchicine responsive FMF^a patients (n=251)	Odds ratio (95% CI)	P value
O	21 (45.7)	71 (28.3)	2.12 (1.12-4.04)	0. 019
Non- O	25 (54.3)	180 (71.7)	2.12 (1.12-4.04)	0. 019
O Rh (-)	6 (13.0)	7 (2.8)	5.31 (1.69-16.62)	0.002
Non- O Rh(-)	40 (87.0)	244 (97.2)	5.31 (1.69-16.62)	0.002

Conclusion: It is well known that blood group A is associated with some of the Cancer such as stomach (2). It may also be related to inflammatory diseases (3). Our results may support associations of blood groups and inflammatory diseases. We demonstrated the blood subgroups and colchicine responses, as well. ABO blood group phenogroups may be used in combination with other risk factors to identify FMF patients at high risk for colchicine resistance.

References

Gul A. Isr Med Assoc J 2014;16(5):281-284
Wang Z. Int J Mol Sci 2012;13(10):13308-13321
Melzer D. PLoS Genet 2008;4(5):e1000072

Disclosure: A. Erden, None; E. D. Batu, None; B. Armagan, None; H. E. Sonmez, None; A. Sari, None; S. Demir, None; E. Bilgin, None; E. Fırat, None; L. Kilic, None; Y. Bilginer, None; O. Karadag, None; U. Kalyoncu, None; S. Kiraz, None.

To cite this abstract in AMA style:

Erden A, Batu ED, Armagan B, Sonmez HE, Sari A, Demir S, Bilgin E, Fırat E, Kilic L, Bilginer Y, Karadag O, Kalyoncu U, Kiraz S. Blood Group ”a“ Was Increased in FMF Patients and Blood Group ”0“ May be Associated with Colchicine Resistance [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/blood-group-a-was-increased-in-fmf-patients-and-blood-group-0-may-be-associated-with-colchicine-resistance/. Accessed .

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