Randomized Double-blind Trial to Study the Benefit of Colchicine in Patients With Acutely Decompensated Heart Failure (COLICA)
Primary Purpose
HEART FAILURE
Status
Recruiting
Phase
Phase 3
Locations
Spain
Study Type
Interventional
Intervention
Colchicine 0.5 MG
Placebo
Sponsored by
About this trial
This is an interventional treatment trial for HEART FAILURE
Eligibility Criteria
Inclusion Criteria:
- Unscheduled visit for symptoms and / or congestive signs of HF that require treatment with intravenous diuretics (at least 40 mg intravenous furosemide)
- Clinical evidence, by symptoms or signs, and / or radiological of congestion.
- NT-proBNP concentration greater than 900 pg / ml at screening visit.
- Age over 18 years.
- Patients who have given their informed consent in writing.
Exclusion Criteria:
- Severe valve disease with indication for surgical repair.
- Extracardiac disease with estimated vital prognosis of less than 1 year.
- Inflammatory bowel disease (Crohn's disease or ulcerative colitis), diarrhea chronic or malabsorption.
- Rheumatic inflammatory disease.
- Serious gastrointestinal disorders
- Stomach ulcer
- Hematological disorders, such as blood dyscrasias
- Previous neuromuscular disease
- Severe renal failure (glomerular filtration rate <30 ml / kg / min / 1.73m2)
- History of cirrhosis, chronic active hepatitis or severe liver disease, defined by GOT (AST) or GPT (ALT) values that exceed 3 x upper limit of normality
- Patient who is taking colchicine for other indications (mainly chronic prescriptions for familial Mediterranean fever or gout). No washout period will be required for patients who have been treated with colchicine and have stopped treatment prior to randomization.
- Patient with a history of allergic reactions or significant sensitivity to colchicine.
- Chronic treatment with immunosuppressants, corticosteroids, interleukin-1 antagonists in the 6 months prior to inclusion.
- Pregnant or lactating women, where pregnancy is defined as the state of a woman after conception and until the end of gestation, confirmed by a positive test result for human chorionic gonadotropin (hCG), or planned become pregnant or plan to breastfeed during study treatment or within 30 days of the end of study drug treatment.
- Woman of childbearing potential who is unwilling to inform her partner of her participation in this clinical study or to use 2 effective contraceptive methods that are acceptable or to practice strict sexual abstinence (the investigator must assess the reliability of sexual abstinence and make it the preferred and usual lifestyle of the subject) during treatment with study drug (colchicine or placebo) and for an additional 30 days after the last dose of study drug.rmal.
Sites / Locations
- Hospital Clínico Universitario Virgen de la ArrixacaRecruiting
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
Experimental
Placebo
Arm Description
Colchicine 0.5 mg
Placebo
Outcomes
Primary Outcome Measures
Decreased NT-proBNP levels
Decreased (N-terminal prohormone of brain natriuretic peptide) levels
Secondary Outcome Measures
Improvement of clinical stability
dose of intravenous diuretics
Improvement of clinical stability
NYHA (New York Heart Association) Scale . Level 1 to 4. Level 1 is the one with the least limitation or symptoms.
Improvement of clinical stability
EVA scale . Level 1 to 10 . Level 1 is the one with the least pain, limitation or symptoms.
Improvement of clinical stability
LIKERT scale. Level 1 to 5 . Level 1 expresses the patient's agreement with a specific aspect.
Improvement of clinical stability
Number of Acute Decompensation Episodes
Improvement of clinical stability
Number of Congestion Episodes
Improvement of clinical stability
biomarkers (hsTnT, IL-1 beta, IL-6, sST2 y CA125.)
Mortality rate reduction
Total days of hospitalization
Full Information
NCT ID
NCT04705987
First Posted
January 11, 2021
Last Updated
September 17, 2023
Sponsor
Fundacion para la Formacion e Investigacion Sanitarias de la Region de Murcia
1. Study Identification
Unique Protocol Identification Number
NCT04705987
Brief Title
Randomized Double-blind Trial to Study the Benefit of Colchicine in Patients With Acutely Decompensated Heart Failure
Acronym
COLICA
Official Title
Randomized Double-blind Trial to Study the Benefit of Colchicine in Patients With Acutely Decompensated Heart Failure
Study Type
Interventional
2. Study Status
Record Verification Date
September 2023
Overall Recruitment Status
Recruiting
Study Start Date
February 8, 2021 (Actual)
Primary Completion Date
November 16, 2023 (Anticipated)
Study Completion Date
December 16, 2023 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Fundacion para la Formacion e Investigacion Sanitarias de la Region de Murcia
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
Heart failure (HF) is a chronic disease associated with multiple acute decompensations, which are the main cause of hospital admission above 65 years and two thirds of the high costs associated with the disease. Furthermore, in the patient they reflect a phase of clinical instability, with a higher risk of early readmission (20-30% at 30 days) and higher mortality (10-15% at 30 days and 30-40% at 1year).
However, the investigators do not have treatments specifically aimed at this unstable phase, known as acute or decompensated (HF). It is known that, in this acute and unstable state, there is an increase in inflammatory parameters. Indeed, our group has recently demonstrated the relevance of the interleukin-1 axis, in particular IL-1beta and sST2 concentrations identified a worse prognosis regardless of HF phenotype. Colchicine, a widely available drug, has proven to be a powerful cardiovascular anti-inflammatory, acting on inflammasome and therefore inhibiting the production of IL1-beta.The study hypothesis is that colchicine administered early during the acute phase can promote stability in terms of biomarkers of cardiac function and new decompensations. For this it is designed a randomized, double-blind clinical study with two arms (colchicine 0.5 mg vs. placebo) initiated within the first 24 hours of hospitalisation and administered for 60 days, in patients with acute decompensated HF with either reduced or preserved LV ejection fraction.
Detailed Description
The primary objective of the study is the reduction of NT-proBNP at two months of treatment. A secondary objective is to attain a greater clinical stability, in terms of reduction of new HF decompensations and need for diuretics, and symptoms improvement. The calculated population size is 278 patients. Follow-up visits will be carried out at discharge, 7 days, 4 weeks and 8 weeks after the hospital discharge. The potential of the study is very high given the high prevalence and clinical impact of HF hospitalizations, together with the absence of specific treatment for this phase of the disease. Therefore, in case of a positive result, this would mean a huge clinical, social and health benefits, as well as being an important therapeutic progress.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HEART FAILURE
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
278 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Experimental
Arm Type
Experimental
Arm Description
Colchicine 0.5 mg
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo
Intervention Type
Drug
Intervention Name(s)
Colchicine 0.5 MG
Intervention Description
Colchicine 0.5 mg/24h Treatment 8 weeks
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo 1c/24h Treatment 8 weeks
Primary Outcome Measure Information:
Title
Decreased NT-proBNP levels
Description
Decreased (N-terminal prohormone of brain natriuretic peptide) levels
Time Frame
Up to 8 weeks
Secondary Outcome Measure Information:
Title
Improvement of clinical stability
Description
dose of intravenous diuretics
Time Frame
Up to 8 weeks
Title
Improvement of clinical stability
Description
NYHA (New York Heart Association) Scale . Level 1 to 4. Level 1 is the one with the least limitation or symptoms.
Time Frame
Up to 8 weeks
Title
Improvement of clinical stability
Description
EVA scale . Level 1 to 10 . Level 1 is the one with the least pain, limitation or symptoms.
Time Frame
Up to 8 weeks
Title
Improvement of clinical stability
Description
LIKERT scale. Level 1 to 5 . Level 1 expresses the patient's agreement with a specific aspect.
Time Frame
Up to 8 weeks
Title
Improvement of clinical stability
Description
Number of Acute Decompensation Episodes
Time Frame
Up to 8 weeks
Title
Improvement of clinical stability
Description
Number of Congestion Episodes
Time Frame
Up to 8 weeks
Title
Improvement of clinical stability
Description
biomarkers (hsTnT, IL-1 beta, IL-6, sST2 y CA125.)
Time Frame
Up to 8 weeks
Title
Mortality rate reduction
Time Frame
Up to 8 weeks
Title
Total days of hospitalization
Time Frame
Up to 8 weeks
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Unscheduled visit for symptoms and / or congestive signs of HF that require treatment with intravenous diuretics (at least 40 mg intravenous furosemide)
Clinical evidence, by symptoms or signs, and / or radiological of congestion.
NT-proBNP concentration greater than 900 pg / ml at screening visit.
Age over 18 years.
Patients who have given their informed consent in writing.
Exclusion Criteria:
Severe valve disease with indication for surgical repair.
Extracardiac disease with estimated vital prognosis of less than 1 year.
Inflammatory bowel disease (Crohn's disease or ulcerative colitis), diarrhea chronic or malabsorption.
Rheumatic inflammatory disease.
Serious gastrointestinal disorders
Stomach ulcer
Hematological disorders, such as blood dyscrasias
Previous neuromuscular disease
Severe renal failure (glomerular filtration rate <30 ml / kg / min / 1.73m2)
History of cirrhosis, chronic active hepatitis or severe liver disease, defined by GOT (AST) or GPT (ALT) values that exceed 3 x upper limit of normality
Patient who is taking colchicine for other indications (mainly chronic prescriptions for familial Mediterranean fever or gout). No washout period will be required for patients who have been treated with colchicine and have stopped treatment prior to randomization.
Patient with a history of allergic reactions or significant sensitivity to colchicine.
Chronic treatment with immunosuppressants, corticosteroids, interleukin-1 antagonists in the 6 months prior to inclusion.
Pregnant or lactating women, where pregnancy is defined as the state of a woman after conception and until the end of gestation, confirmed by a positive test result for human chorionic gonadotropin (hCG), or planned become pregnant or plan to breastfeed during study treatment or within 30 days of the end of study drug treatment.
Woman of childbearing potential who is unwilling to inform her partner of her participation in this clinical study or to use 2 effective contraceptive methods that are acceptable or to practice strict sexual abstinence (the investigator must assess the reliability of sexual abstinence and make it the preferred and usual lifestyle of the subject) during treatment with study drug (colchicine or placebo) and for an additional 30 days after the last dose of study drug.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Domingo A Pascual Figal, MD
Phone
968-381027
Email
dpascual@um.es
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Domingo Pascual Figal, MD
Organizational Affiliation
Hospital Clínico Universitario Virgen de la Arrixaca
Official's Role
Principal Investigator
Facility Information:
Facility Name
Hospital Clínico Universitario Virgen de la Arrixaca
City
Murcia
ZIP/Postal Code
30120
Country
Spain
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Domingo Pascual Figal, MD
12. IPD Sharing Statement
Learn more about this trial
Randomized Double-blind Trial to Study the Benefit of Colchicine in Patients With Acutely Decompensated Heart Failure
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