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Batu ED, Şener S, Arslanoglu Aydin E, Aliyev E, Bagrul İ, Türkmen Ş, Akgün Ö, Balık Z, Tanatar A, Bayındır Y, Kızıldağ Z, Torun R, Günalp A, Coşkuner T, İşgüder R, Aydın T, Haşlak F, Kasap Cüceoğlu M, Esen E, Akçay U, Başaran Ö, Pac Kısaarslan A, Akal F, Yüce D, Özdel S, Bülbül M, Bilginer Y, Aktay Ayaz N, Sözeri B, Kasapçopur Ö, Ünsal E, Özen S. A score for predicting colchicine resistance at the time of diagnosis in familial Mediterranean fever: data from the TURPAID registry. Rheumatology (Oxford) 2024; 63:791-797. [PMID: 37228026 PMCID: PMC10907807 DOI: 10.1093/rheumatology/kead242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 03/12/2023] [Accepted: 05/22/2023] [Indexed: 05/27/2023] Open
Abstract
OBJECTIVES Colchicine forms the mainstay of treatment in FMF. Approximately 5-10% of FMF patients are colchicine resistant and require anti-IL-1 drugs. We aimed to compare the characteristics of colchicine-resistant and colchicine-responsive patients and to develop a score for predicting colchicine resistance at the time of FMF diagnosis. METHODS FMF patients (0-18 years) enrolled in the Turkish Paediatric Autoinflammatory Diseases (TURPAID) registry were included. The predictive score for colchicine resistance was developed by using univariate/multivariate regression and receiver operating characteristics analyses. RESULTS A total of 3445 FMF patients [256 (7.4%) colchicine-resistant and 3189 colchicine-responsive) were included (female:male ratio 1.02; median age at diagnosis 67.4 months). Colchicine-resistant patients had longer, more frequent attacks and were younger at symptom onset and diagnosis (P < 0.05). Fever, erysipelas-like erythema, arthralgia, arthritis, myalgia, abdominal pain, diarrhoea, chest pain, comorbidities, parental consanguinity and homozygosity/compound heterozygosity for exon 10 MEFV mutations were significantly more prevalent among colchicine-resistant than colchicine-responsive patients (P < 0.05). Multivariate logistic regression analysis in the training cohort (n = 2684) showed that age at symptom onset, attack frequency, arthritis, chest pain and having two exon 10 mutations were the strongest predictors of colchicine resistance. The score including these items had a sensitivity of 81.3% and a specificity of 49.1%. In the validation cohort (n = 671), its sensitivity was 93.5% and specificity was 53.8%. CONCLUSION We developed a clinician-friendly and practical predictive score that could help us identify FMF patients with a greater risk of colchicine resistance and tailor disease management individually at the time of diagnosis.
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Affiliation(s)
- Ezgi Deniz Batu
- Department of Pediatrics, Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Seher Şener
- Department of Pediatrics, Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Elif Arslanoglu Aydin
- Department of Pediatrics, Division of Rheumatology, Dr. Sami Ulus Maternity and Child Health and Diseases Research and Training Hospital, Ankara, Turkey
| | - Emil Aliyev
- Department of Pediatrics, Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - İlknur Bagrul
- Department of Pediatrics, Division of Rheumatology, Dr. Sami Ulus Maternity and Child Health and Diseases Research and Training Hospital, Ankara, Turkey
| | - Şeyma Türkmen
- Department of Pediatrics, Division of Rheumatology, Umraniye Research and Training Hospital, Istanbul, Turkey
| | - Özlem Akgün
- Department of Pediatrics, Division of Rheumatology, Istanbul University Faculty of Medicine, Istanbul, Turkey
| | - Zeynep Balık
- Department of Pediatrics, Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ayşe Tanatar
- Department of Pediatrics, Division of Rheumatology, Istanbul University Faculty of Medicine, Istanbul, Turkey
| | - Yağmur Bayındır
- Department of Pediatrics, Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Zehra Kızıldağ
- Department of Pediatrics, Division of Rheumatology, Dokuz Eylül University Faculty of Medicine, Izmir, Turkey
| | - Rüya Torun
- Department of Pediatrics, Division of Rheumatology, Dokuz Eylül University Faculty of Medicine, Izmir, Turkey
| | - Aybüke Günalp
- Department of Pediatrics, Division of Rheumatology, Istanbul University Cerrahpasa Faculty of Medicine, Istanbul, Turkey
| | - Taner Coşkuner
- Department of Pediatrics, Division of Rheumatology, Umraniye Research and Training Hospital, Istanbul, Turkey
| | - Rana İşgüder
- Department of Pediatrics, Division of Rheumatology, Dokuz Eylül University Faculty of Medicine, Izmir, Turkey
| | - Tuncay Aydın
- Department of Pediatrics, Division of Rheumatology, Dokuz Eylül University Faculty of Medicine, Izmir, Turkey
| | - Fatih Haşlak
- Department of Pediatrics, Division of Rheumatology, Istanbul University Cerrahpasa Faculty of Medicine, Istanbul, Turkey
| | - Müşerref Kasap Cüceoğlu
- Department of Pediatrics, Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Esra Esen
- Department of Pediatrics, Division of Rheumatology, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Ulaş Akçay
- Department of Pediatrics, Division of Rheumatology, Umraniye Research and Training Hospital, Istanbul, Turkey
| | - Özge Başaran
- Department of Pediatrics, Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Aysenur Pac Kısaarslan
- Department of Pediatrics, Division of Rheumatology, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Fuat Akal
- Department of Computer Engineering, Hacettepe University, Ankara, Turkey
| | - Deniz Yüce
- Department of Preventive Oncology, Hacettepe University, Ankara, Turkey
| | - Semanur Özdel
- Department of Pediatrics, Division of Rheumatology, Dr. Sami Ulus Maternity and Child Health and Diseases Research and Training Hospital, Ankara, Turkey
| | - Mehmet Bülbül
- Department of Pediatrics, Division of Rheumatology, Dr. Sami Ulus Maternity and Child Health and Diseases Research and Training Hospital, Ankara, Turkey
| | - Yelda Bilginer
- Department of Pediatrics, Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Nuray Aktay Ayaz
- Department of Pediatrics, Division of Rheumatology, Istanbul University Faculty of Medicine, Istanbul, Turkey
| | - Betül Sözeri
- Department of Pediatrics, Division of Rheumatology, Umraniye Research and Training Hospital, Istanbul, Turkey
| | - Özgür Kasapçopur
- Department of Pediatrics, Division of Rheumatology, Istanbul University Cerrahpasa Faculty of Medicine, Istanbul, Turkey
| | - Erbil Ünsal
- Department of Pediatrics, Division of Rheumatology, Dokuz Eylül University Faculty of Medicine, Izmir, Turkey
| | - Seza Özen
- Department of Pediatrics, Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Albayrak B, Sebin E. A novel inflammatory marker for extensive ulcerative colitis; Endocan. BMC Gastroenterol 2023; 23:118. [PMID: 37041496 PMCID: PMC10091589 DOI: 10.1186/s12876-023-02720-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 03/13/2023] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND & AIMS Ulcerative colitis (UC) is an inflammatory bowel disease characterized by mucosal inflammation. Endocan, a proteoglycan secreted by endothelial cells in response to inflammatory cytokines, has been reported to be overexpressed in inflammatory conditions. In this study, we aimed to evaluate the utility of endocan level in determining the extent and severity of disease in patients with ulcerative colitis and to determine whether it can be a candidate marker for noninvasive evaluation and monitoring since there is not enough data in the literature. MATERIALS AND METHODS Sixty-five people were included in the study, including thirty-five with ulcerative colitis and thirty in the control group. Patients with first diagnosed ulcerative colitis clinically, endoscopically, and histopathologically, without any treatment, and with normal liver and kidney tests were included in the study. Endoscopic scoring of all patients was performed according to the Mayo endoscopic scoring (MES) system. Blood samples for CRP (C-reactive protein) and endocan were taken from the patients simultaneously. RESULTS There was a significant statistical difference between all patients with ulcerative colitis and the control group in both endocan level and CRP level (p < 0.001). There was a statistically significant difference between endocan levels and CRP levels between the left-distal group and pancolitis (diffuse colitis) patients, but there was no statistical difference between age and MES. CONCLUSION Serum endocan level can be useful in determining the extent of ulcerative colitis and planning treatment.
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Affiliation(s)
- Bulent Albayrak
- Department of Gastroenterology, Ataturk University, Erzurum, Turkey.
| | - Engin Sebin
- Biochemistry Department, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
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