Colchicine for Prevention of Vascular Inflammation in Non-cardio Embolic Stroke (CONVINCE)
Ischemic Attack, Transient, Stroke
About this trial
This is an interventional prevention trial for Ischemic Attack, Transient
Eligibility Criteria
Inclusion Criteria:
- Written informed consent consistent with ICH-GCP guidelines and local laws signed prior to all trial-related procedures.
- Age 40 years or greater
Either,
- ischaemic stroke without major disability (modified Rankin score 3 or less)
- or high-risk TIA
- Qualifying stroke/TIA probably caused by large artery stenosis, small artery occlusion (lacunar stroke), or cryptogenic embolism, with cardiac embolism or other defined stroke mechanism deemed unlikely in the opinion of the treating physician.
- GFRgreater than or equal to 50 ml/min.
- In the opinion of the treating physician, patient is medically-stable, capable of participating in a randomised trial, and willing to attend follow-up.
Exclusion Criteria:
- Cardio-embolic stroke/TIA, probably caused by identified atrial fibrillation (permanent or paroxysmal), in the opinion of the treating physician.
- Cardio-embolic stroke/TIA probably caused by other identified cardiac source (intra-cardiac thrombus, endocarditis, metallic heart valve, low ejection fraction <30%), in the opinion of the treating physician.
- Stroke/TIA caused by dissection, endocarditis, paradoxical embolism, drug use, venous thrombosis, within 48 hours aftercarotid or cardiac surgery, hypercoagulability states, migraine, or inherited cerebrovascular disorders (eg. Fabry's disease, CADASIL), in the opinion of the treating physician.
- History of myopathy or myalgias with raised creatine kinase (CK) on statin therapy.
- Blood dyscrasia defined as anaemia (haemoglobin <10g/dL), thrombocytopenia (platelet count <150 x109/L) or leucopenia (white cell count <4 x109/L) at randomisation.
- Impaired hepatic function (transaminases greater than twice upper limit of normal) at randomisation.
- Concurrent treatment with moderate or strong CYP3A4 inhibitors (clarithromycin, erythromycin, telithromycin, other macrolide antibiotics, ketoconazole, itraconazole, voriconazole, ritonavir, atazanavir, indinavir, other HIV protease inhibitors, verapamil, diltiazem, quinidine, digoxin, disulfiram) or P-gp inhibitors (cyclosporine) at randomisation.
- Symptomatic peripheral neuropathy and pre-existing progressive neuromuscular disease
- Inflammatory bowel disease (Crohn's or ulcerative colitis) or chronic diarrhoea.
9. Dementia, sufficient to impair independence in basic activities of daily living.
10. Active malignancy, known hepatitis B or C, or HIV infection prior to qualifying stroke/TIA.
11. Impaired swallow preventing oral administration of study medication. 12. History of poor medication compliance. 13. Unlikely to comply with study procedures and follow-up visits due to severe or fatal comorbid illness or other factor (eg. inability to travel for follow up visits), in opinion of randomising physician.
14. Pregnancy, breast-feeding, or pre-menopausal women 15. Patient concurrently participating in another clinical trial with an investigational drug or device, or use of investigational drug within 30 days or 5 half-lives before the Screening visit (whichever is longer) 16. Known allergy or sensitivity to colchicine.
Sites / Locations
- Uza, Antwerpen
- AZ Sint Jan
- AZ St. Lucas, BRUGGE
- UCL, Brussels
- UZ Brussel
- UZ Gent
- AZ Groeninge Kortrijk
- UZ Leuven
- CHC Liege
- AZ Damiaan, OOSTENDE
- AZ Delta, ROESELARE
- Foothills Medical Centre, Calgary
- Kingston Hospital
- Vancouver General Hospital
- St. Anne´s University Hospital
- Hospital Jihlava
- Bispebjerg Hospital
- Rigshospitalet Glostrup
- Herlev Hospital
- Nordsjællands Hospital
- Astra Team Clinic
- Tartu University Hospital
- Rhön-Klinikum Campus Bad Neustadt
- Vivantes Auguste-Viktoria Klinikum
- Vivantes Humboldt-Klinikum
- Vivantes Klinikum Neukölln, Berlin
- Evangelisches Krankenhaus Bielefeld gGmbH
- St. Josef-Hospital Klinikum der Ruhr-Universität Bochum
- Universitätsklinikum Bonn
- Krankenhaus Buchholz
- Allgemeines Krankenhaus Celle
- Klinikum Dortmund gGmbH
- Universitätsklinikum Essen
- Frankfurt University Hospital
- Klinikum Fulda gAG, Universitätsmedizin Marburg-Campus Fulda
- SRH Wald-Klinikum Gera GmbH
- Krakenhaus Martha Maria Halle Dolau
- Universitätsklinikum Hamburg-Eppendorf
- Medizinische Hochschule Hannover
- Universitätsklinikum Heidelberg
- Universitätsklinikum Leipzig AöR
- Klinikum Main-Spessart, Standort Krankenhaus Lohr
- Universitätsklinikum Schleswig-Holstein, Campus Lübeck
- Universitätsklinikum Magdeburg A.ö.R.
- Klinikum der Universität München
- Mediclin-Fachklinik Rhein/Ruhr
- Medinos Kliniken des Landkreises Sonneberg
- Universitätsklinikum Würzburg
- Cavan General Hospital
- Cork University Hospital
- Beaumont Hospital
- Connolly Hospital, Blanchardstown
- Mater Misericordiae University Hospital
- St James's Hospital
- St Vincent's University Hospital
- Tallaght University Hospital
- Galway University Hospital
- St Lukes General Hospital
- University Hospital Limerick
- Our Lady of Lourdes, Drogheda
- Sligo University Hospital
- South Tipperary General Hospital, Clonmel
- University Hospital Waterford
- Lithuanian University Hospital of Health Sciences Kaunos Klinikos
- Republican Vilnius University Hospital
- Vilnius University Hospital Santaros Clinics
- Academic Medical Center
- Gelre Ziekenhuis Apeldoorn
- Reinier de Graaf Hospital
- University Medical Centre
- Hospital Nicholas Copernicus
- Specialist Hospital of Saint Luke
- Medical University of Silesia Hospital No7
- Institute of Psychiatry and Neurology
- Centro Hospitalar e Universitario de Coimbra
- Hospital Beatriz Angelo
- Hospital de Santa Maria, Centro Hospitalar Lisboa Norte
- Hospital Egas Moniz
- Hospital Universitario de Sao Jao
- H. de Albacete
- Hospital de Sant Pau
- Hospital del Mar
- Hospital Moises Broggi. Comprehensive Health Consortium
- Complejo Hospitalario Universitario A Coruña
- H U. Josep Trueta, Girona
- Hospital Universitari Arnau de Vilanova de Lleida
- H. U. Ramón y Cajal, Madrid
- Centro Medico de Asturias
- H Parc Taulí de Sabadell
- H U. Virgen del Rocío, Sevilla
- Hospital Virgen Macarena Sevilla
- H Joan XXIII, Tarragona
- University Hospital Bern
- Bronglais General Hospital
- Aintree University Hospital
- Monklands Hospital
- Antrim Area Hospital
- William Harvey Hospital
- Royal Victoria Hospital
- Royal Blackburn Hospital
- Pilgrim Hospital
- Royal Bournemouth Hospital
- West Suffolk Hospital
- Addenbrookes Hospital
- Kent and Canterbury Hospital
- Chesterfield Royal Hospital
- Countess of Chester Hospital
- St Richards Hospital
- Craigavon Area Hospital
- Northumbria Specialist Emergency Care Hospital
- Croydon University Hospital
- Royal Derby Hospital
- Altnagelvin Area Hospital
- North Durham University Hospital
- South West Acute Hospital
- Royal Devon & Exeter Hospital
- Queen Elizabeth Hospital Gateshead
- Medway Maritime Hospital
- Hairmyres Hospital
- Queen Elizabeth University Hospital Glasgow
- Wycombe Hospital
- Raigmore Hospital
- Kingston Hospital
- Leicester Royal Infirmary
- University Hospital Lewisham
- Lincoln County Hospital
- Royal Liverpool University Hospital
- Charing Cross Hospital
- King's College Hospital
- Royal London Hospital
- St George's Hospital
- St Thomas' Hospital
- University College London Hospital
- Luton & Dunstable University Hospital
- Maidstone & District General Hospital
- Queen Elizabeth the Queen Mother Hospital
- Norfolk and Norwich Hospital
- Nottingham City Hospital
- Peterborough Hospital
- Derriford Hospital
- Royal Hallamshire Hospital
- Southend University Hospital
- Stepping Hill Hospital
- Royal Stoke University Hospital
- Sunderland Royal Hospital
- King's Mill Hospital
- Great Western Hospital
- Princess Royal Hospital
- Royal Cornwall Hospital
- Whiston Hospital
- New Cross Hospital
- Worthing Hospital
- Yeovil District Hospital
Arms of the Study
Arm 1
Arm 2
Active Comparator
No Intervention
Colchicine treatment
Usual Standard of care alone
Colchicine 0.5mg/day plus usual care for 60 months
Normal standard of care remains for these patients