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Colchicine for the Reduction of Dependency and Vascular Events After an Acute Intracerebral Hemorrhage

Phase 3
Not yet recruiting
Conditions
Colchicine
ICH - Intracerebral Hemorrhage
Stroke
Dependence
Interventions
Registration Number
NCT06587737
Lead Sponsor
Population Health Research Institute
Brief Summary

Data indicate that patients with intracerebral hemorrhage (ICH) are at high risk for thromboembolic events and disability that is not being sufficiently mitigated by current treatment strategies. This is aggravated by the cessation of antithrombotic medications for significant periods after hemorrhage. These findings highlight the need for novel treatments that modify the high risk for major vascular events and functional outcomes in ICH survivors.

The objective of CoVasc-ICH 2 is to demonstrate that oral colchicine 0.5 mg daily is superior to placebo for improving the outcomes of ICH survivors with evidence or risk factors for atherosclerosis, when started within 72 hours from ICH onset.

Detailed Description

Not available

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
1125
Inclusion Criteria

Adult patients presenting with spontaneous intraparenchymal hemorrhage within 72 hours of symptom onset and qualifying for at least one of the following categories:

i. history of symptomatic coronary, peripheral and/or carotid artery disease (severe atherosclerotic vascular disease), or ii. visualized extracranial cervical/intracranial atherosclerotic disease causing any degree of stenosis/occlusion or presence of aortic arch plaque with maximum thickness ≥1 mm (moderate atherosclerotic vascular disease), or iii. two or more risk factors including: age 60 years or older, hypertension, dyslipidemia, diabetes mellitus, chronic kidney disease (eGFR: 15-50mL/min), history of ischemic stroke or current smoking (mild atherosclerotic vascular disease).

Exclusion Criteria
  • secondary causes of ICH (such as trauma, macrovascular anomalies, neoplasms or bleeding diathesis)
  • ICH volume more than 60ml in the last imaging scan prior to consent
  • Glasgow Coma Scale (GCS) score less than 7 or being intubated at the time of consent
  • inflammatory bowel disease or chronic diarrhea
  • cirrhosis or severe hepatic dysfunction
  • renal insufficiency (eGFR<15mL/min)
  • concurrent or planned treatment with strong CYP3A4 inhibitors (atazanavir, clarithromycin, darunavir/ritonavir, indinavir, itraconazole, ketoconazole, lopinavir/ritonavir, nefazodone, nelfinavir, ritonavir, saquinavir, telithromycin, tipranavir/ritonavir) or P-gp inhibitors (cyclosporine, ranolazine)
  • pregnancy or breast-feeding
  • known allergy or sensitivity to colchicine
  • a strong indication for colchicine where assignment to placebo is deemed unacceptable
  • estimated life expectancy less than 6 months at the time of enrollment, and
  • inability to adhere to study procedures

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
colchicine 0.5mg ODColchicine 0.5 MG-
placeboPlacebo-
Primary Outcome Measures
NameTimeMethod
Efficacy: MACE and Dependencythrough study completion, an average of 36 months

Treatment with colchicine will reduce the risk for major adverse cardiovascular events (MACE) and dependency

Safety: Symptomatic hematoma expansion, major gastrointestinal adverse reactions or infection ratesthrough study completion, an average of 36 months

There will be no clinically-important change in symptomatic hematoma expansion, major gastrointestinal adverse reactions or infection rates with oral colchicine 0.5mg OD compared with matching placebo

Secondary Outcome Measures
NameTimeMethod
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