Adherence to Colchicine During Pregnancy in Familial Mediterranean Fever Patients: Reasons for Cessation and Outcomes from a Single-Centre Experience

Abstract

Abstract Objective To evaluate the adherence to colchicine treatment during pregnancy and lactation in our Familial Mediterranean fever (FMF) patients and investigate the reasons for non-adherence and consequences. Methods Adult female FMF patients who were followed up in our rheumatology clinic and had a history of pregnancy after the diagnosis of FMF were consecutively enrolled to this cross-sectional study between November 2021 and June 2022. Only pregnancies occurring after the diagnosis of FMF were evaluated. Patients who did not stop using FMF treatment after pregnancy were considered to adhere to treatment. Results In 50 patients, a total of 88 pregnancies and 58 live births were observed after the diagnosis of FMF. 37 (74%) had at least one completed pregnancy, and 13 (26.0) were pregnant during the study. Among the 37 patients, 34 had at least one live birth. No significant differences were observed when rates of patients with a history of at least one live birth, abortus, Cesarean section (C/S), preterm labor, stillbirth, intrauterine anomaly, congenital malformation and fetal growth retardation were compared between colchicine users and non-users. 60% of the patients adhered to colchicine treatment during pregnancy and 73.4% did so while breastfeeding. The most common reason for colchicine cessation was concerns regarding potential harm to the fetus (70%), followed by the presumption that colchicine is contraindicated in pregnancy (15%) as well as absence of FMF attacks (10%). The most common source of the patients’ opinion was a physician (60%). Conclusions Both patients and attending physicians should be informed to be more adherent to colchicine to avoid adverse outcomes and FMF-related complications.