Therapeutic approach to patients with familial Mediterranean fever-related amyloidosis resistant to colchicine.

The frequency of FMF-related amyloidosis has been decreased by colchicine use over the past few decades. However, the beneficial effect of colchicine may differ in accordance with nephropathic stages. When used in proper doses and with compliance, colchicine is very effective in preclinical and proteinuric stages of FMF-related amyloidosis. Even so, a large number of patients with nephrotic range proteinuria, despite compliance and an ideal dose of colchicine, may still progress to end-stage renal failure (ESRF).We do not know exactly what we can do with such patients. This paper discusses the therapeutic approach to patients with FMF-related amyloidosis.