Colchicine as a therapeutic option in periodic fever, aphthous stomatitis, pharyngitis, cervical adenitis (PFAPA) syndrome

Abstract Objective To evaluate the efficacy of colchicine in reducing the frequency of attacks in patients with PFAPA. Study design We conducted a 6-month open label, randomized, controlled study among patients with PFAPA who attend the Pediatric Rheumatology Clinic at the Rambam Medical Center in I...

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Bibliographic Details
Published in:Seminars in arthritis and rheumatism 2016-02, Vol.45 (4), p.471-474
Main Authors: Butbul Aviel, Yonatan, MD, Tatour, Sameh, MD, Gershoni Baruch, Ruth, MD, Brik, Riva, MD
Format: Article
Language:English
Subjects:
Child
Child, Preschool
Colchicine
Colchicine - therapeutic use
Female
Fever - drug therapy
Humans
Lymphadenitis - drug therapy
Male
Periodic fever, aphthous stomatitis, pharyngitis, cervical adenitis (PFAPA)
Pharyngitis - drug therapy
Rheumatology
Stomatitis, Aphthous - drug therapy
Syndrome
Treatment Outcome
Tubulin Modulators - therapeutic use
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Summary:Abstract Objective To evaluate the efficacy of colchicine in reducing the frequency of attacks in patients with PFAPA. Study design We conducted a 6-month open label, randomized, controlled study among patients with PFAPA who attend the Pediatric Rheumatology Clinic at the Rambam Medical Center in Israel. A total of 18 patients aged4 –11 years (males:females ratio = 11:7) were randomized into a control group (I, 10 children) and a study group (II, 8 children). Group I was followed for 6 months without any intervention, and group II was initially followed for 3 months and was thereafter treated with colchicine for 3 additional months, according to standard regimen. During the 6-month period of the study the patients and their physician recorded all the episodes of PFAPA in a constructed log. DNA analyses for the 5 common FMF mutations in Israel were performed in 17 out of the 18 patients. Results The number of episodes during the first 3 months was similar in both groups (group I 3.2 ± 1.5, group II 4.9 ± 2.3; p ≤ 0.12). Group II had significantly less PFAPA attacks in the second period while on colchicine therapy (4.9 ± 2.3 vs. 1.6 ± 1.2; p ≤ 0.01), in opposition to group I, where no difference in the number of attacks was noted between the first and second period of follow-up (3.2 ± 1.5 vs. 2.7 ± 1.5; p = 0.33). Of the 17 patients tested, 8 were carriers for FMF mutations (2 in group I and 6 in group II). Conclusion Colchicine prophylaxis seems to be effective in reducing the number of attacks in PFAPA.
ISSN:0049-0172
1532-866X
DOI:10.1016/j.semarthrit.2015.07.005