Efficacy of Colchicine in Preventing Recurrent Stroke in the Patients With Acute Atherothrombotic Ischemic Stroke During Hospitalization

Overview

This study is two-center, prospective, randomized, open-label, controlled, investigator-sponsored study that aims to investigate the efficacy of low-dose colchicine in preventing recurrent stroke in the patients with acute atherothrombotic minor-to-moderate ischemic stroke during hospitalization.

Description

This study is two-center, prospective, randomized, open-label, controlled, investigator-sponsored study that aims to investigate the efficacy of low-dose colchicine in preventing recurrent stroke in the patients with acute atherothrombotic minor-to-moderate ischemic stroke during hospitalization. Patients who were eligible to the inclusion criteria and ineligible to the exclusion criteria will be randomly assigned into two groups by a 1:1 ratio. Patients in one arm will receive colchicine initiated with a dose of 0.5 mg per day during on days 1 through 14. Study visits will be performed on the day of randomization and at discharge. The outcomes were stroke, neurological deterioration, сombined endpoint events (stroke, myocardial infarction and death), bleeding during 14 days of follow-up in an intention-to treat analysis.

Eligibility

Inclusion Criteria:

1. Signed informed consent form by patient prior to any study-specific procedure.
2. Patient age over 18 years
3. Presence of ipsilateral lesion of the extracranial artery ≥50% according to the European measurement method ECST or its occlusion, as well as stenosis < 50% with signs of morphological instability of the atherosclerotic plaque (ulceration, hemorrhage into the plaque, intimal flotation, mural thrombus, etc.).
4. Minor neurological deficit (NIHSS score ≤5).
5. The duration of development of stroke symptoms before colchicine taken is no more than 48 hours.
6. Confirmation of the presence of a focus of acute ischemia in the brain according to computed tomography or magnetic resonance imaging of the brain.

Exclusion Criteria:

1. The presence of risk factors and conditions that determine a different pathogenetic subtype of ischemic stroke (atrial fibrillation/flutter, ventricular aneurysm, ets.).
2. Hemorrhagic stroke
3. NIHSS score ≤5.
4. Hospitalization of the patient more than 48 hours from the onset of the disease.
5. Severe anemia, thrombocytopenia, leukopenia.
6. Course of an infectious/viral disease.
7. Concomitant treatment with moderate or strong CYP3A4 inhibitors (clarithromycin, erythromycin, telithromycin, other macrolide antibiotics, ketoconazole, itraconazole, voriconazole, ritonavir, atazanavir, indinavir, other HIV protease inhibitors, verapamil or pilitin disulfazole) inhibitors (cyclosporine) at randomization.
8. Concomitant severe degenerative disease of the nervous system.
9. Concomitant inflammatory or autoimmune disease.
10. Dementia, established mental illness.
11. History of malignancy, known hepatitis B or C, or HIV infection.
12. Swallowing impairment interfering with oral administration of the study drug.
13. Pregnancy or breastfeeding. Women of child-bearing potential who are not willing to use a medically accepted method of contraception that is considered reliable in the judgment of the Investigator.
14. Participation in another clinical study with an investigational product at any time during the 30 days prior to randomization
15. Previous enrolment or randomization in the present study.
16. Decrease renal function with creatinine clearance < 30 ml/min.
17. Presence of contraindications to taking colchicine, acetylsalicylic acid and clopidogrel.