Amyloidosis awareness and colchicine adherence in patients with familial Mediterranean fever: a cross-sectional study in an endemic region

INTRODUCTION: Familial Mediterranean Fever (FMF) is the most common hereditary autoinflammatory disease, and secondary amyloidosis remains its most serious complication. We aimed to investigate amyloidosis awareness, colchicine adherence and related factors among FMF patients. METHODS: In this cross-sectional single-center study, patients with FMF completed a face-to-face questionnaire assessing amyloidosis awareness using structured questions and colchicine adherence through self-reported medication use. Demographic and clinical data were obtained from medical records. Factors associated with amyloidosis awareness and colchicine adherence were evaluated using univariate and multivariable analyses. RESULTS: A total of 185 patients were included; 64% were female. The median age was 38 years and disease duration was 13 years. Regular colchicine use was reported by 144 (78%) patients and was associated with awareness of its importance, older age, higher colchicine dose, and fewer attacks. Only 51 (27%) patients were completely or partially aware of amyloidosis, whereas 153 (83%) were aware of the risk of renal failure. Amyloidosis awareness was associated with younger age and higher education level. In multivariable analysis, regular colchicine use was independently associated with fewer attacks and a higher daily colchicine dose; while amyloidosis awareness was independently associated with awareness of the amyloidosis risk related to irregular colchicine use. CONCLUSION: Awareness of amyloidosis remains insufficient among patients with FMF, although colchicine adherence was high. Targeted educational strategies may be needed to improve awareness of amyloidosis and its prevention. Key Points • Awareness of amyloidosis was limited (27%) and was associated only with awareness of the amyloidosis risk related to irregular colchicine use. • Treatment adherence is closely linked to higher colchicine dose and fewer attacks.