Colchicine has been researched a while, has your doctor and hospital done anything with it? Do they know about ANY of that research?
colchicine (19 posts to December 2011)
Long-term colchicine for the prevention of vascular recurrent events in non-cardioembolic stroke (CONVINCE): a randomised controlled trial
- et al.
Summary
Background
Anti-inflammatory therapy with long-term colchicine prevented vascular recurrence
in coronary disease. Unlike coronary disease, which is typically caused by atherosclerosis,
ischaemic stroke is caused by diverse mechanisms including atherosclerosis and small
vessel disease or is frequently due to an unknown cause. We aimed to investigate the
hypothesis that long-term colchicine would reduce recurrent events after ischaemic
stroke.
Methods
We did a randomised, parallel-group, open-label, blinded endpoint assessed trial comparing
long-term colchicine (0·5 mg orally per day) plus guideline-based usual care with
usual care only. Hospital-based patients with non-severe, non-cardioembolic ischaemic
stroke or high-risk transient ischaemic attack were eligible. The primary endpoint
was a composite of first fatal or non-fatal recurrent ischaemic stroke, myocardial
infarction, cardiac arrest, or hospitalisation (defined as an admission to an inpatient
unit or a visit to an emergency department that resulted in at least a 24 h stay [or
a change in calendar date if the hospital admission or discharge times were not available])
for unstable angina. The p value for significance was 0·048 to adjust for two prespecified
interim analyses conducted by the data monitoring committee, for which the steering
committee and trial investigators remained blinded. The trial was registered at ClinicalTrials.gov (NCT02898610) and is completed.
Findings
3154 patients were randomly assigned between Dec 19, 2016, and Nov 21, 2022, with
the last follow-up on Jan 31, 2024. The trial finished before the anticipated number
of outcomes was accrued (367 outcomes planned) due to budget constraints attributable
to the COVID-19 pandemic. Ten patients withdrew consent for analysis of their data,
leaving 3144 patients in the intention-to-treat analysis: 1569 (colchicine and usual
care) and 1575 (usual care alone). A primary endpoint occurred in 338 patients, 153
(9·8%) of 1569 patients allocated to colchicine and usual care and 185 (11·7%) of
1575 patients allocated to usual care alone (incidence rates 3·32 vs 3·92 per 100 person-years, hazard ratio 0·84; 95% CI 0·68–1·05, p=0·12). Although
no between-group difference in C-reactive protein (CRP) was observed at baseline,
patients treated with colchicine had lower CRP at 28 days and at 1, 2, and 3 years
(p<0·05 for all timepoints). The rates of serious adverse events were similar in both
groups.
Interpretation
Although no statistically significant benefit was observed on the primary intention-to-treat
analysis, the findings provide new evidence supporting the rationale for anti-inflammatory
therapy in further randomised trials.
Funding
Health Research Board Ireland, Deutsche Forschungsgemeinschaft (German Research Foundation),
and Fonds Wetenschappelijk Onderzoek Vlaanderen (Research Foundation Flanders), Belgium.
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