AzTrials
AzTrials

Myocardium; InjuryPhase 2NCT04218786

Effect of Colchicine in Patients With Myocardial Infarction

A Phase 2 study testing Colchicine in people with Myocardium; Injury and Myocardial Infarction, run by Shifa Tameer-e-Millat University at 1 site in Pakistan.

Withdrawn

Withdrawn. The study stopped before anyone enrolled.

Official record
Search all trials

Trial summary

Over the past years, a substantial volume of evidence has accumulated identifying inflammatory processes as key mediators of the deleterious effects of ischemia/reperfusion-related phenomena in patients presenting with ST-segment-elevation myocardial infarction (STEMI). Read more about this study

Who is it for?
Ages 18 to 80 years
What is being tested?
Colchicine
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
0 participants
Where
1 sitePakistan
Study dates
Dec 2025to Jun 2026
Phase
Phase 2
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • All patients 18 years or above presenting in emergency department with acute myocardial infarction. These patients will be requested to take the medication at the time of discharge after stabilization and management

Who cannot join

  • Patients with prior myocardial infarction 30 days before
  • Patients with ischemic cardiomyopathy
  • Age <18 or > 80 years
  • Active inflammatory or infectious disease or known malignancy
  • Known hypersensitivity to colchicine,
  • renal failure (eGFR <30ml.min.1.73m)
Show all 9Show fewer
  • hepatic failure
  • Stent thrombosis
  • Cardiac arrest or cardiogenic shock as presenting symptoms

Trial locations and contacts

1 site in 1 country.

Pakistan1 site
  • Rawalpindi Institute of Cardiology

    Rawalpindi, 46000

Other trials in Pakistan

About this study

Official title: Outcomes of Low-dose Colchicine in Patients With Myocardial Infarction: A Randomized Controlled Trial

Over the past years, a substantial volume of evidence has accumulated identifying inflammatory processes as key mediators of the deleterious effects of ischemia/reperfusion-related phenomena in patients presenting with ST-segment-elevation myocardial infarction (STEMI). Nevertheless, equally impressive is the lack of clinically applicable therapeutic strategies that could mitigate these processes, thus providing significant cardioprotection. Despite the well-known fact that inflammation plays an important role in coronary artery disease development and progression, there have been few attempts to systematically examine the potential role of anti-inflammatory treatment in this setting, possibly because of a lack in anti-inflammatory agents without the adverse cardiovascular safety profile of corticosteroids and nonsteroidal anti-inflammatory drugs. Colchicine is a substance with potent anti-inflammatory properties, having a unique mechanism of action, which allows for safe use in patients with cardiovascular disease.

The purpose of the present clinical study is to test the hypothesis that a short course of treatment with colchicine could lead to reduced major adverse cardiovascular events (MACE) in acute MI.

Read the detailed description

Over the past years, a substantial volume of evidence has accumulated identifying inflammatory processes as key mediators of the deleterious effects of ischemia/reperfusion-related phenomena in patients presenting with ST-segment-elevation myocardial infarction (STEMI). Nevertheless, equally impressive is the lack of clinically applicable therapeutic strategies that could mitigate these processes, thus providing significant cardioprotection.

Despite the well-known fact that inflammation plays an important role in coronary artery disease development and progression, there have been few attempts to systematically examine the potential role of anti-inflammatory treatment in this setting, possibly because of a lack in anti-inflammatory agents without the adverse cardiovascular safety profile of corticosteroids and nonsteroidal anti-inflammatory drugs. Some anti-inflammatory agents, like pexelizumab, are focused on complement cascade.Another agent is Varespladib, which targets sPLA2 that causes oxidative stress and inflammation. There are other therapeutic targets that have been widely investigated. Colchicine is a substance with potent anti-inflammatory properties, having a unique mechanism of action, which allows for safe use in patients with cardiovascular disease.

Colchicine binds to non-polymerized tubulin, forming a stable complex that effectively inhibits the dynamic of microtubules, depolymerizing them. Thus, any process requiring changes in the cell cytoskeleton, such as cellular mitosis, exocytosis and neutrophil motility, is affected. Colchicine has an important effect on atrial myocytes, changing the atrial response to autonomic effects (reducing the sympathetic activity and increasing the parasympathetic one). Due to this particular mode of action, colchicine has been indicated in atrial fibrillation post-cardiac surgery. A similar trial is being conducted to investigate any effusions or syndromes that occur after myocardial infarction.

The purpose of the present clinical study is to test the hypothesis that a short course of treatment with colchicine could lead to reduced major adverse cardiovascular events (MACE) in acute MI.

Being tested
Colchicine, Placebo oral tablet
Keywords
colchicine; outcome: myocardial infarction
Medical subject headings
Wounds and Injuries, Myocardial Infarction, Myocardial Ischemia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • ColchicineDrug

    The tablet will be given once daily for the span of the study

  • Placebo oral tabletDrug

    The tablet will be given once daily for the span of the study

Study groups in NCT04218786
Study groupRoleWhat they receive
Colchicine GroupActive comparatorThis group will receive low dose colchicine, 0.5 mg.
Receives: Drug: Colchicine
Placebo groupPlacebo comparatorThis group will receive a placebo drug with a similar shape and mass as that to experimental drug
Receives: Drug: Placebo oral tablet

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Major cardiovascular adverse events (number of events)

    This outcome will be assessed using a questionnaire. The following headings will be used:

    • Cardiovascular death (number of events)
    • Non-fatal myocardial infarction (number of events)
    • Resuscitated cardiac arrest (number of events)
    • Hospitalization for unstable angina (number of events) For each heading, the total number of events will be recorded and the numbers will all be added to calculate 'Major Adverse Cardiovascular Events' in form of number of events. This outcome has no specific values of measure but a discrete numerical value

    Measured: 3 months

Secondary outcomes (3)
  1. Troponin I (ng/ml)

    This workup will be recorded on the same questionnaire as a numerical value with its specific unit of measure upon followup of patient.

    Measured: 3 months

  2. Creatine Kinase-Myocardial Band (IU/L)

    This workup will be recorded on the same questionnaire as a numerical value with its specific unit of measure upon followup of patient.

    Measured: 3 months

  3. C-reactive protein (mg/L)

    This workup will be recorded on the same questionnaire as a numerical value with its specific unit of measure upon followup of patient.

    Measured: 3 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted6 Jan 2020
  2. Study startDec 2025 (estimated)
  3. Primary completionMar 2026 (estimated)
  4. Study completionJun 2026 (estimated)

Why it stopped: Due to the pandemic, there were logistical issues in continuing the study.

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Care provider, Outcomes assessor
Enrolment
0 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04218786
Sponsor's protocol ID
STMU2020
Status last verified
Apr 2023
First submitted
1 Jan 2020
Last updated
12 Apr 2023
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Turer AT, Hill JA. Pathogenesis of myocardial ischemia-reperfusion injury and rationale for therapy. Am J Cardiol. 2010 Aug 1;106(3):360-8. doi: 10.1016/j.amjcard.2010.03.032.

    PubMed 20643246
  • Christia P, Frangogiannis NG. Targeting inflammatory pathways in myocardial infarction. Eur J Clin Invest. 2013 Sep;43(9):986-95. doi: 10.1111/eci.12118. Epub 2013 Jun 17.

    PubMed 23772948
  • Adlbrecht C, Wurm R, Humenberger M, Andreas M, Redwan B, Distelmaier K, Klappacher G, Lang IM. Peri-interventional endothelin--a receptor blockade improves long-term outcome in patients with ST-elevation acute myocardial infarction. Thromb Haemost. 2014 Jul 3;112(1):176-82. doi: 10.1160/TH13-10-0832. Epub 2014 Apr 3.

    PubMed 24695986
  • He J, Li J, Wang Y, Hao P, Hua Q. Neutrophil-to-lymphocyte ratio (NLR) predicts mortality and adverse-outcomes after ST-segment elevation myocardial infarction in Chinese people. Int J Clin Exp Pathol. 2014 Jun 15;7(7):4045-56. eCollection 2014.

    PubMed 25120783
  • Kawaguchi M, Takahashi M, Hata T, Kashima Y, Usui F, Morimoto H, Izawa A, Takahashi Y, Masumoto J, Koyama J, Hongo M, Noda T, Nakayama J, Sagara J, Taniguchi S, Ikeda U. Inflammasome activation of cardiac fibroblasts is essential for myocardial ischemia/reperfusion injury. Circulation. 2011 Feb 15;123(6):594-604. doi: 10.1161/CIRCULATIONAHA.110.982777. Epub 2011 Jan 31.

    PubMed 21282498
  • Chen K, Schenone AL, Borges N, Militello M, Menon V. Teaching an Old Dog New Tricks: Colchicine in Cardiovascular Medicine. Am J Cardiovasc Drugs. 2017 Oct;17(5):347-360. doi: 10.1007/s40256-017-0226-3.

    PubMed 28353024
  • Robertson S, Martinez GJ, Payet CA, Barraclough JY, Celermajer DS, Bursill C, Patel S. Colchicine therapy in acute coronary syndrome patients acts on caspase-1 to suppress NLRP3 inflammasome monocyte activation. Clin Sci (Lond). 2016 Jul 1;130(14):1237-46. doi: 10.1042/CS20160090. Epub 2016 Apr 21.

    PubMed 27129183
  • Misawa T, Takahama M, Kozaki T, Lee H, Zou J, Saitoh T, Akira S. Microtubule-driven spatial arrangement of mitochondria promotes activation of the NLRP3 inflammasome. Nat Immunol. 2013 May;14(5):454-60. doi: 10.1038/ni.2550. Epub 2013 Mar 17.

    PubMed 23502856
  • Akodad M, Fauconnier J, Sicard P, Huet F, Blandel F, Bourret A, de Santa Barbara P, Aguilhon S, LeGall M, Hugon G, Lacampagne A, Roubille F. Interest of colchicine in the treatment of acute myocardial infarct responsible for heart failure in a mouse model. Int J Cardiol. 2017 Aug 1;240:347-353. doi: 10.1016/j.ijcard.2017.03.126. Epub 2017 Apr 1.

    PubMed 28395979
  • Rymer JA, Newby LK. Failure to Launch: Targeting Inflammation in Acute Coronary Syndromes. JACC Basic Transl Sci. 2017 Aug 28;2(4):484-497. doi: 10.1016/j.jacbts.2017.07.001. eCollection 2017 Aug.

    PubMed 30062164
  • Pinckard RN, Olson MS, Giclas PC, Terry R, Boyer JT, O'Rourke RA. Consumption of classical complement components by heart subcellular membranes in vitro and in patients after acute myocardial infarction. J Clin Invest. 1975 Sep;56(3):740-50. doi: 10.1172/JCI108145.

    PubMed 808560
  • Gora S, Maouche S, Atout R, Wanherdrick K, Lambeau G, Cambien F, Ninio E, Karabina SA. Phospholipolyzed LDL induces an inflammatory response in endothelial cells through endoplasmic reticulum stress signaling. FASEB J. 2010 Sep;24(9):3284-97. doi: 10.1096/fj.09-146852. Epub 2010 Apr 29.

    PubMed 20430794
  • Serruys PW, Garcia-Garcia HM, Buszman P, Erne P, Verheye S, Aschermann M, Duckers H, Bleie O, Dudek D, Botker HE, von Birgelen C, D'Amico D, Hutchinson T, Zambanini A, Mastik F, van Es GA, van der Steen AF, Vince DG, Ganz P, Hamm CW, Wijns W, Zalewski A; Integrated Biomarker and Imaging Study-2 Investigators. Effects of the direct lipoprotein-associated phospholipase A(2) inhibitor darapladib on human coronary atherosclerotic plaque. Circulation. 2008 Sep 9;118(11):1172-82. doi: 10.1161/CIRCULATIONAHA.108.771899. Epub 2008 Sep 1.

    PubMed 18765397
  • Ridker PM, Thuren T, Zalewski A, Libby P. Interleukin-1beta inhibition and the prevention of recurrent cardiovascular events: rationale and design of the Canakinumab Anti-inflammatory Thrombosis Outcomes Study (CANTOS). Am Heart J. 2011 Oct;162(4):597-605. doi: 10.1016/j.ahj.2011.06.012. Epub 2011 Sep 14.

    PubMed 21982649
  • Tanguay JF, Geoffroy P, Sirois MG, Libersan D, Kumar A, Schaub RG, Merhi Y. Prevention of in-stent restenosis via reduction of thrombo-inflammatory reactions with recombinant P-selectin glycoprotein ligand-1. Thromb Haemost. 2004 Jun;91(6):1186-93. doi: 10.1160/TH03-11-0701.

    PubMed 15175806

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Colchicine in people with Myocardium; Injury and Myocardial Infarction, run by Shifa Tameer-e-Millat University at 1 site in Pakistan.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: withdrawn, as of the sponsor's last update on 12 Apr 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study was withdrawn before enrolling participants, so there are no results.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Major cardiovascular adverse events (number of events) (time frame: 3 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04218786, which also lists 35 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Apr 2023.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in