Untreated FMF may cause secondary amyloidosis (potentially fatal), suppressed growth, miscarriage, and infertility. Colchicine has been shown to reduce these risks, as well as preventing flares.[46]Simon A, van der Meer JW. Pathogenesis of familial periodic fever syndromes or hereditary autoinflammatory syndromes. Am J Physiol Regul Integr Comp Physiol. 2007 Jan;292(1):R86-98.
https://journals.physiology.org/doi/full/10.1152/ajpregu.00504.2006?rfr_dat=cr_pub++0pubmed&url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org
http://www.ncbi.nlm.nih.gov/pubmed/16931648?tool=bestpractice.com
[108]Ben-Chetrit E, Levy M. Colchicine prophylaxis in familial Mediterranean fever: reappraisal after 15 years. Semin Arthritis Rheum. 1991 Feb;20(4):241-6.
http://www.ncbi.nlm.nih.gov/pubmed/2042056?tool=bestpractice.com
[109]Kallinich T, Haffner D, Niehues T, et al. Colchicine use in children and adolescents with familial Mediterranean fever: literature review and consensus statement. Pediatrics. 2007 Feb;119(2):e474-83.
http://www.ncbi.nlm.nih.gov/pubmed/17242135?tool=bestpractice.com
[113]Dinarello CA, Wolff SM, Goldfinger SE, et al. Colchicine therapy for familial mediterranean fever: a double-blind trial. N Engl J Med. 1974 Oct 31;291(18):934-7.
http://www.ncbi.nlm.nih.gov/pubmed/4606353?tool=bestpractice.com
[114]Ben-Chetrit E, Berkun Y, Ben-Chetrit E, et al. The outcome of pregnancy in the wives of men with familial mediterranean fever treated with colchicine. Semin Arthritis Rheum. 2004 Oct;34(2):549-52.
http://www.ncbi.nlm.nih.gov/pubmed/15505771?tool=bestpractice.com
Colchicine nonresponders, protracted myalgia, or arthritis may be treated with certain biologic treatments, but more clinical evidence is needed before such treatments become first-line options for such potentially painful and destructive complications.[104]Hentgen V, Grateau G, Kone-Paut I, et al. Evidence-based recommendations for the practical management of familial Mediterranean fever. Semin Arthritis Rheum. 2013 Dec;43(3):387-91.
http://www.ncbi.nlm.nih.gov/pubmed/23742958?tool=bestpractice.com
In the future, it may be possible to identify those who might respond to specific biologic therapies based on specific markers or genetic testing.