Colchicine 0.5 MG Oral Tablet: Oral intake of 0.5 mg colchicine once daily
Placebo: Oral intake of matching placebo once daily
Study summary
The main aim of this trial is to determine whether there are fewer cardiovascular events when patients with coronary artery disease take a low dose of colchicine of 0.5 mg daily on top of optimal standard treatment after treatment with PCI, compared with placebo in combination with optimal standard treatment. More specifically, we aim to investigate the benefits of a daily low dose of colchicine in patients with coronary artery disease after treatment with PCI, to confirm that a daily low dose of colchicine helps prevent additional incidents in coronary artery disease, and to identify a subgroup of patients with CAD who are at increased risk for cardiovascular events and could benefit most from colchicine.
Eligibility
Sex
ALL
Min age
45 Years
Max age
—
Healthy volunteers
No
Inclusion Criteria:
1. Age ≥45 years.
2. Coronary artery disease treated with PCI and optimal medical therapy, with at least one additional risk factor (based on SMART):
1. Age ≥ year
2. Diabetes mellitus, on treatment or new diagnosis with HbA1c ≥6.5%
3. Current smoking
4. Treated hypertension or lood pressure systolic ≥ 4 mmHg or diastolic ≥ mmHg
5. Total cholesterol \>240 mg/dl untreated, or treated LDL \>70 mg/dl
6. HDL \<40 mg/dl
7. hsCRP \>2 mg/L AND chronic coronary syndrome (CCS)
8. eGFR \<60 ml/min (MDRD)
9. history of vascular disease:
* CAD (PCI prior to index, CABG, MI)
* stroke (ischemic or hemorrhagic)
* carotid artery revascularisation
* PAD (revascularisation, ABI \<0.85 at rest, amputation due to atherosclerotic disease)
* AAA (repair, distal aortic anteroposterior diameter \>3.0cm)
3. Able to be enrolled/randomized between 2 hour and 5 days post PCI.
4. Written informed consent.
Exclusion Criteria:
1. Women who are pregnant, breastfeeding, or of childbearing potential who are not using an effective method of contraception. Or women who intend to donate oocytes.
2. Men who plan to father children during the study period or who are unwilling to use effective forms of contraception. Or men who intend to donate sperm.
3. Any contraindication or known intolerance to colchicine.
4. Chronic use of -or need for- colchicine.
5. Auto-immune disease or other condition requiring current or planned chronic systemic steroids, immunosuppressant or biologic drug targeting the immune system (for example, TNF blockers, anakinra, rituximab, abatacept, tocilizumab etc.).
6. Creatinine clearance \<30 mL/min/1.73 m2.
7. Cirrhosis Child-Pugh stadium B and C, or acute severe liver disease
8. Neuromuscular disease or non-transient CK levels \> 5 x ULN (unless due to MI).
9. History of cancer or lymphoproliferative disease within the last 3 years, other than successfully treated non-metastatic cutaneous squamous cell or basal cell carcinoma, or localized cervix carcinoma in situ.
10. Current or planned use of any strong inhibitor of CYP3A4 or p-glycoprotein: macrolide antibiotics (clarithromycin, telithromycin), azole antifungal agents (ketoconazole, voriconazole, fluconazole, itraconazole), cyclosporine, HIV medication (ritonavir, lopinavir, tipranavir, atazanavir, darunavir, indinavir, saquinavir).
11. Chronic diarrhea, or inflammatory owel disease (Crohn's disease or ulcerative colitis).
12. Drug or alcohol abuse.
13. Planned cardiovascular intervention known on the day of screening.
14. Currently enrolled in another investigational trial.
15. Considered to be an unsuitable candidate by the investigator.
Primary outcome measure(s)
Time from randomisation to first occurrence of a composite endpoint consisting of: all-cause death, spontaneous (non-procedural) non-fatal myocardial infarction (Type 1, 4B & C), non-fatal stroke, or coronary revascularisation. — 44 months
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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