Session Information
Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose: Familial Mediterranean fever (FMF) is an autoinflammatory disease. Colchicine is used in FMF patients for preventing attacks and amyloidosis. There were conflicting reports as to existence of proarrhythmic electrocardiographic (ECG) findings in FMF(1,2). Furthermore, studies showed that colchicine might be protective in non FMF patients against atrial fibrillation(3). Besides, its effect on FMF patients was not evaluated. In the present study, in order to evaluate effect of colchicine treatment on arrhythmia risk in FMF patients, we assessed ECG of the new diagnosed FMF patients for arrhythmatogenic anomalies at baseline and after one year of colchicine treatment.
Methods: Twenty eight new diagnosed FMF patients who fulfilled Modified Tel-hashomer criteria were recruited to study. After baseline measurements, colchicine treatment was started. ECG, laboratory parameters, demographic and disease related parameters of the patients were obtained at the first visit and after one year of treatment.We evaluated the risk of atrial arrhythmia with P dispersion and risk of ventricular arrhythmia with Tp-E, Tp-E/Qt, Tp-E/Qtc (2). P dispersion ≥ 40 ms was accepted as arrhythmatogenic anomaly for atrial arrhythmias(2).
Results: Demographic, laboratory and disease related characteristics of the patients at baseline were shown in Table 1. There was no statistical difference between the number of patient with arrhythmatogenic P dispersion at baseline and after one year of treatment. Furthermore, Tp-E, Tp-E/Qt values decreased with treatment (Table 2).
Table 1. Demographic, laboratory and disease related characteristics of the FMF patients at baseline
|
Patients (n=28) |
|
|
Gender (M/F) |
8/20 |
|
Age |
31.4± 8.2 |
|
Age at first attack |
6.2±3.7 |
|
BMI (kg/m2) |
26.4±3.4 |
|
Smoking (%) |
7 (25.0%) |
|
Co-morbid illnesses* (%) |
3 (10.7%) |
|
Frequency of attacks (/year) |
10.6±7.0 |
|
Duration of attacks (day) |
3.3±1.5 |
|
Main FMF symptom |
|
|
Peritonitis (%) |
21(75.0%) |
|
Fever (%) |
2(7.1%) |
|
Musculoskeletal symptoms (%) |
5(17.9 %) |
|
Creatinine (mg/dL) |
0.62±0.17 |
|
ALT (IU/L) |
21.68±10.39 |
|
AST(IU/L) |
20.93±7.93 |
|
Albumin (g/dL) |
4.55±0.26 |
|
CRP (mg/L) |
19.17±31.97 |
|
Sedimentation rate (mm/h) |
23.75±16.60 |
|
Spot urine protein/creatinine |
0.14±11.22 |
|
WBC (/mcL) |
7182.14±1701.86 |
|
Hemoglobin (g/dL) |
12.55±1.81 |
|
Platelet (x103/mcL) |
266.43±89.19 |
|
Documented tachycardia (%) |
6(21.4%) |
|
BMI: Body mass index; ALT: Alanin aminotransferase; AST: Aspartate aminotransferase; CRP: C-reactive protein; WBC: White blood cell *Hypertension, hypothyroidism, hyperthyroidism cardiovascular diseases, coronary artery diseases, cerebrovascular diseases, chronic renal disease, chronic obstructive pulmonary disease, diabetes mellitus |
|
Table 2. Electrocardiographic findings and disease parameters of the patients at baseline and after one year of colchicine treatment
|
Pretreatment ( n=28) |
Treatment* (n=28) |
P value |
|
|
Tp-E interval (ms) |
69.93±14.68 |
66.21±14.35 |
0.022 |
|
Tp-E/Qt ratio |
0.21±0.04 |
0.19±0.03 |
0.014 |
|
Tp-E/Qtc |
0.17±0.37 |
0.16±0.03 |
0.507 |
|
P dispersion |
31.64±11.67 |
32.93±10.33 |
0.437 |
|
P dispersion ≥ 40 ms n(%) |
7 (25.0%) |
10 (35.7%) |
0.207 |
|
CRP (mg/L) |
19.17±31.97 |
9.46±17.12 |
0.059 |
|
Sedimentation rate (mm/h) |
23.75±16.60 |
16.79±14.93 |
0.006 |
|
Frequency of attacks (/year) |
10.60±7.00 |
0.80±1.24 |
<0.001 |
|
Colchicine dosage (mg)** |
|
1.23±0.31 |
|
|
* Electrocardiographic measurements and disease parameters of the patients evaluated after one year of colchicine treatment **Actual colchicines dosage at the first year of the treatment p<0.05 shown with bold numbers |
|||
Conclusion: We found that colchicine treatment may have no effect on atrial arrhythmia risk. Furthermore, it might have favorable effect on ventriculer repolarization indices and might be protective against ventricular arrhythmias and sudden death in FMF patients.
References:
1) Ahbap E, Sakaci T, Kara E, Sahutoglu T, Ozturk S, Basturk T et all.Familial Mediterranean Fever is associated with abnormal ventricular repolarization indices. Rev Med Chil. 2015;143(12):1560-8.
2) Giese A, Ornek A, Kurucay M, Kara K, Wittkowski H, Gohar F, et all.P wave dispersion and QT dispersion in adult Turkish migrants with familial mediterranean fever living in Germany. Int J Med Sci. 2014;11(11):1140-6.
3) Casanova P, Artola RT, Mihos CG, Pineda AM, Santana O. The cardiovascular effects of . 2015;23(6):317-22.
To cite this abstract in AMA style:
Gozek Ocal A, Ocal L, Tezcan ME. Colchicine Treatment May be Protective Against Ventricular Arrhythmias in FMF Patients [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/colchicine-treatment-may-be-protective-against-ventricular-arrhythmias-in-fmf-patients/. Accessed .« Back to 2017 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/colchicine-treatment-may-be-protective-against-ventricular-arrhythmias-in-fmf-patients/