Colchicine therapy and the cognitive status of elderly patients with familial Mediterranean fever.

BACKGROUND [corrected] Colchicine is widely used for treating gout and familial Mediterranean fever. However, studies in animal models have reported ill effects of colchicine on the central nervous system, including cognitive function. OBJECTIVES To evaluate the cognitive status of elderly FMF patients on long-term colchicine treatment. METHODS The study group consisted of 55 FMF patients aged 74 +/- 5, attending an FMF outpatient clinic and receiving colchicine treatment for 25.1 +/- 8.9 years. The Mini-Mental State Examination was used for cognitive evaluation. Patients' scores were compared with accepted age- and education-adjusted cutoff scores, population-based norms, and scores of a matched control group of 56 subjects. RESULTS Individually, all colchicine-treated FMF patients scored well above the age- and education-corrected cutoff scores. Overall, there was a large difference, 5.0 +/- 1.6, from the expected cutoff points, in favor of the study group scores (P < 0.001). The individual scores of the control group were also above the cutoff points, however with a lower but still statistically significant difference (3.71 +/- 1.15 points, P < 0.001). Compared to population-based norms adjusted by age and education, the study group had significantly higher mean MMSE scores (27.2 +/- 2.2 vs. 25.5 +/- 2.4, P < 0.001). The control group's scores were also somewhat higher than expected, but not significantly so. CONCLUSIONS Our results do not support the view that prolonged colchicine treatment may be associated with cognitive impairment. On the contrary, it is possible that long-term colchicine treatment may even confer protection against cognitive decline in patients with FMF.