THU0528 DISCONTINUATION OF COLCHICINE THERAPY IN CHILDREN WITH FAMILIAL MEDITERRANEAN FEVER

Background Clinical phenotype of FMF exists in some carriers of MEFV mutation. These patients tend to have a mild disease. Prolonged colchicine free remission was reported in a small group of FMF patients. Objectives To describe and characterize a group of children with FMF in whom colchicine was discontinued. Methods The study cohort consisted of all children with FMF followed at 2 referral centers in Israel in whom colchicine was discontinued following prolonged attack free period. Clinical presentation, mutations in MEFV gene and disease outcome of patients who successfully ceased colchicine therapy were compared with patients with relapse of FMF attacks. We performed a retrospective study in two referral centers in Israel of 43 patients with FMF with 1 or non-mutated MEFV allele who ceased colchicine therapy following prolonged attack free period. The phenotype of the patients was investigated in detail, and the MEFV mutations, laboratory findings, clinical picture and outcome of 30 (70%) patients that successfully ceased colchicine therapy were compared to 13 (30%) patients who failed. Results 47 patients (55% males), mean age 6±3.2 years at the diagnosis, were enrolled in the study, of them 4 patients were excluded due to poor follow up. Fever (93%), abdominal pain (79%), arthralgia (19%) and arthritis (12%) were the most common symptom at attack. The average period free of attacks before enrolment was 11.3±9.2 months. The average follow-up after ceasing colchicine was 5.1± 2.9 years. Thirteen patients (30.2%) had an attack during follow up with most common symptoms of fever (92%) and abdominal pain (77%) and colchicine therapy was restarted within 10.1 months (1.1-36.4months). There were no differences between the groups of patients that were able to stop colchicine and the group that needed to renew therapy in demographic, genetic and most clinical parameters, including the age (13.4±3.9 vs 11.9±3.7p-0.26), level of SAA at enrolment (4±3.6 vs 3.3±2.4p-0.7) and time of last attack prior to enrolment (12.6±9.6 vs 8.6±8.2 months p-0.08). Myalgia and arthritis were more common among children that required to renew therapy compared to the group that didn’t (31% vs 6.7% p-0.058 and 31% vs 3% p-0.024 respectively). Conclusion Cessation of colchicine therapy following prolonged remission in selected group of patients who are not homozygous for MEFV mutation could be considered. Patients with arthritis or arthralgia are more likely to have an attack after ceasing colchicine therapy. References [1] Discontinuing colchicine in symptomatic carriers for MEFV (Mediterranean FeVer) variants. [2] Sonmez HE, Batu ED, Bilginer Y, Ozen S. [3] Clin Rheumatol. 2017 Feb;36(2):421-425. d Disclosure of Interests None declared