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Chronic Limb-Threatening IschemiaPhase 3CIRCLE-AsiaNCT07536373

Colchicine in Chronic Limb-Threatening Ischemia

A Phase 3 study testing Colchicine 0.5 MG Oral Tablet Once Daily in people with Chronic Limb-Threatening Ischemia, run by Shin Kong Wu Ho-Su Memorial Hospital at 5 sites in Taiwan.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

Chronic limb-threatening ischemia (CLTI) is the most severe form of peripheral artery disease, a condition in which narrowed or blocked arteries reduce blood flow to the legs. People with CLTI may have severe leg pain at rest, non-healing wounds, or gangrene, and face a high risk of leg amputation and death. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Chronic Limb-Threatening Ischemia
What is being tested?
Colchicine 0.5 MG Oral Tablet Once Daily
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
200 participants
Where
5 sitesTaiwan
Study dates
2 Jun 2026to Apr 2030
Phase
Phase 3
Are there results?
Not yet: the study is under way

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 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age ≥18 years.
  • Documented chronic limb-threatening ischemia, meeting the following:
  • Presence of ischemic symptoms compatible with CLTI, defined as arterial insufficiency with gangrene, non-healing ischemic ulcer, or rest pain consistent with Rutherford classes 4-5 AND
  • Imaging evidence within the past 12 months showing atherosclerotic PAD, including CTA, MRA, angiography or duplex ultrasound AND
  • Ankle-Brachial Index (ABI) ≤0.80 or Toe-Brachial Index (TBI) ≤0.60 for patients without prior revascularization; ABI ≤0.85 or TBI ≤0.65 for those with prior revascularization OR
  • Ischemic rest pain alone (Rutherford class 4) defined as ankle systolic pressure <50 mmHg, toe pressure of <30 mmHg, transcutaneous PO2 of <30 mmHg, or flat-line transtarsal pulse volume recording OR
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  • Tissue loss with or without ischemic rest pain (Rutherford class 5) defined as ankle systolic pressure <70 mmHg, toe pressure of <50 mmHg, transcutaneous PO2 of <30 mmHg, or flatline transtarsal pulse volume recording
  • Recent successful revascularization:
  • Underwent technically successful endovascular therapy (EVT) or surgical bypass within the last 7 days prior to randomization
  • For individuals requiring multiple revascularization attempts on the same index leg, the procedure considered for eligibility (in other words, the qualifying or index procedure) must be the final planned or anticipated revascularization attempt
  • There must be demonstrated graft or vascular patency after the qualifying revascularization procedure with one in-line blood flow to the foot, either by angiography, duplex ultrasound, CTA or MRA
  • There must be no immediate plan for reintervention
  • Informed Consent:
  • Demonstrated ability and willingness to adhere to the study protocol, attend scheduled follow-up visits, complete all required assessments, and provide written informed consent

Who cannot join

  • Age <18 years
  • Asymptomatic or mild disease: Patients who underwent revascularization for disease graded Rutherford classes 0-3
  • Patients with major tissue loss (Rutherford 6) in whom major amputation was planned at the time of screening
  • Failure to establish at least one tibial artery outflow after revascularization
  • Recent acute limb ischemia events within 2 weeks of screening
  • Clinical signs of active, uncontrolled, severe limb infection or septicemia, such as fever exceeding 38.5°C, a white blood cell count above 15,000 cells/µL, or hypotension, at the time of screening (this does not include osteomyelitis confined to the phalanges or metatarsal heads or foot cellulitis treatable with IV antibiotics at the time of revascularization)
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  • Unstable hemodynamics after the index revascularization procedure
  • Unable to tolerate any antiplatelet agent or with severe bleeding diathesis
  • Acute coronary syndrome, acute stroke, or hospitalization for heart failure within 30 days of screening
  • Any contraindication or known intolerance to colchicine
  • Requirement for colchicine for another indication
  • Need for use of medications known to have drug-drug interactions with colchicine, particularly drugs known to inhibit CYP3A4 or P-glycoprotein
  • Active hepatitis or severe liver cirrhosis (Child Pugh C)
  • Pregnancy, breastfeeding, or women of childbearing potential who are not using an effective method of contraception
  • Previous (within 30 days) or concomitant participation in another clinical study with investigational medicinal product(s)
  • Life expectancy <1 year

Trial locations and contacts

5 sites in 1 country. Contact the study team or a site near you to ask about taking part.

5 sites in 1 country

Taiwan5 sites, 5 recruiting
  • Chi Mei Medical Center

    Tainan, 710

    Chon-Seng Hong, MD, +886-6-281-2811, Ahsingsing@gmail.com

    Not yet recruiting
  • Shin Kong Wu Ho-Su Memorial Hospital

    Taipei, Taipei, 111

    Donna SH Lin, MD, +886-2-2833-2211, donna.lin24@gmail.com

    Recruiting
  • National Taiwan University Hospital

    Taipei, 100

    Jen-Kuang Lee, MD, PhD, +886-2-2312-3456, b85401104@gmail.com

    Recruiting
  • Taipei Veterans General Hospital

    Taipei, 112

    Tai-Wei Chen, MD, +886-2-2871-2121, radiant107@gmail.com

    Not yet recruiting
  • Linkou Chang Gung Memorial Hospital

    Taoyuan, 333

    Chun-Chi Chen, MD, +886-3-328-1200, mr3228@gmail.com

    Not yet recruiting

Other trials in Taiwan

About this study

Official title: Colchicine in Chronic Limb-Threatening Ischemia for Reduction of Complications and Limb Events in Asia

Chronic limb-threatening ischemia (CLTI) is the most severe form of peripheral artery disease, a condition in which narrowed or blocked arteries reduce blood flow to the legs. People with CLTI may have severe leg pain at rest, non-healing wounds, or gangrene, and face a high risk of leg amputation and death. Even after successful procedures to restore blood flow to the leg (called revascularization), many patients still experience serious complications. Inflammation in the blood vessels is believed to play an important role in these poor outcomes.

Colchicine is an anti-inflammatory medication that has been used safely for decades to treat gout and other inflammatory conditions. Recent large clinical trials have shown that a low dose of colchicine (0.5 mg per day) can reduce heart attacks and strokes in patients with coronary artery disease. However, it has not been studied in patients with CLTI.

Read more

The CIRCLE-Asia trial (Colchicine in Chronic Limb-Threatening Ischemia for Reduction of Complications and Limb Events in Asia) is a pilot study designed to evaluate whether colchicine can improve outcomes in patients with CLTI who have recently undergone a successful procedure to restore blood flow to their leg. Treatment begins within 7 days of the procedure.

This is a randomized, double-blind, placebo-controlled, multicenter trial conducted at five hospitals in Taiwan. A total of 200 adult patients with CLTI who have undergone successful revascularization will be randomly assigned in a 1:1 ratio to receive either colchicine 0.5 mg once daily or a matching placebo pill, in addition to their usual medications, for 12 months. Neither the patients nor the study doctors will know which treatment each patient receives.

The main outcome of interest is amputation-free survival, defined as the time until major amputation of the affected leg (above the ankle) or death from any cause, over 12 months of follow-up. The study will also assess other important outcomes including major limb complications, heart attacks, strokes, wound healing, changes in blood flow measurements, inflammatory blood markers, quality of life, and medication safety.

This pilot trial will provide the first randomized evidence on the potential benefits and safety of colchicine in CLTI patients and will help inform the design of a larger definitive trial.

Being tested
Colchicine 0.5 MG Oral Tablet Once Daily, Placebo
Keywords
CIRCLE-Asia, Chronic limb-threatening ischemia, Peripheral artery disease, Colchicine, Amputation-free survival
Medical subject headings
Chronic Limb-Threatening Ischemia, Peripheral Arterial Disease

What participants receive

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

  • Colchicine 0.5 MG Oral Tablet Once DailyDrug

    Colchicine 0.5 mg oral tablet (Colchicine Tablets 0.5mg, Synmosa), taken once daily in addition to standard of care, for 12 months. Treatment is initiated within 7 days of successful lower-extremity revascularization. For patients experiencing intolerance such as diarrhea or gastrointestinal discomfort, the dose may be reduced to 0.25 mg daily (half tablet). If the medication is considered harmful, treatment is interrupted and resumed when safe.

  • PlaceboDrug

    Matching placebo tablet, identical in appearance to the colchicine 0.5 mg tablet (supplied by Synmosa Biopharma Corporation), taken orally once daily in addition to standard of care, for 12 months. Treatment is initiated within 7 days of successful lower-extremity revascularization. The same dose adjustment and discontinuation rules apply as for the active treatment arm.

Study groups in NCT07536373
Study groupRoleWhat they receive
ColchicineExperimentalColchicine 0.5 mg per tab, taken 1 tab daily
Receives: Drug: Colchicine 0.5 MG Oral Tablet Once Daily
PlaceboPlacebo comparatorPlacebo tablets matching in appearance with study drug, taken 1 tab per day
Receives: Drug: Placebo

What is being measured

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

  1. Amputation-free survival

    Defined as the time to major (above the ankle) amputation of the study limb or death from any cause

    Measured: 12 months

Secondary outcomes (19)
  1. Number of Participants with Major (Above the Ankle) Non-Traumatic Amputation of the Study Limb

    Number of participants who underwent major (above the ankle) non-traumatic amputation of the study limb during the 12-month follow-up period.

    Measured: 12 months

  2. Major adverse limb event (MALE, including non-traumatic above-ankle amputation and major lower limb artery reintervention) and its components

    Measured: 12 months

  3. Major adverse cardiovascular event (MACE, including non-fatal myocardial infarction, non-fatal stroke, and cardiovascular death) and its components

    Measured: 12 months

  4. Wound healing rates at 3, 6, 9 and 12 months for Rutherford 5 patients (or time to wound healing)

    Measured: 12 months

  5. Number of Participants with Acute Limb Ischemia

    Number of participants experiencing acute limb ischemia of the study limb during the 12-month follow-up period, adjudicated by a blinded clinical events committee.

    Measured: 12 months

  6. Number of Deaths from Any Cause

    Number of participants who died from any cause during the 12-month follow-up period.

    Measured: 12 months

  7. Number of Deaths from Cardiovascular Causes

    Number of participants who died from cardiovascular causes during the 12-month follow-up period, adjudicated by a blinded clinical events committee.

    Measured: 12 months

  8. Number of Deaths from Limb-Related Causes

    Number of participants who died from limb-related causes (e.g., fatal limb sepsis, complications of major amputation) during the 12-month follow-up period.

    Measured: 12 months

  9. Number of Participants with Adverse Gastrointestinal Events

    Number of participants experiencing adverse gastrointestinal events (including nausea, vomiting, abdominal pain, and diarrhea) during the 12-month treatment period.

    Measured: 12 months

  10. Number of Participants with Adverse Hematologic Events

    Number of participants experiencing adverse hematologic events (including leukopenia, thrombocytopenia, and anemia) during the 12-month treatment period.

    Measured: 12 months

  11. Number of Participants with Serious Infections

    Number of participants experiencing serious infections (defined as infections requiring hospitalization or intravenous antibiotics) during the 12-month follow-up period.

    Measured: 12 months

  12. Number of Participants with Diarrhea

    Number of participants experiencing diarrhea as an adverse event during the 12-month treatment period. Diarrhea is defined as the passage of three or more loose or watery stools within a 24-hour period, and severity is graded by the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. Grade 1 = increase of <4 stools/day over baseline; Grade 2 = increase of 4-6 stools/day; Grade 3 = increase of ≥7 stools/day or hospitalization indicated; Grade 4 = life-threatening consequences; Grade 5 = death.

    Measured: 12 months

  13. Number of Participants with Drug Discontinuation Due to Any Adverse Event

    Number of participants who permanently discontinued the study drug due to any adverse event during the 12-month treatment period.

    Measured: 12 months

  14. Change in Health-Related Quality of Life as Measured by the EQ-5D-5L Index Score

    Change from baseline in EQ-5D-5L index score at 12 months. The EQ-5D-5L is a generic health status questionnaire. Index scores range from -0.6 to 1.0, where higher scores indicate better health-related quality of life.

    Measured: Baseline and 12 months

  15. Change in Disease-Specific Quality of Life as Measured by the VASCUQOL-6 Score

    Change from baseline in Vascular Quality of Life Questionnaire-6 (VASCUQOL-6) summary score at 12 months. VASCUQOL-6 scores range from 6 to 24, where higher scores indicate better vascular disease-specific quality of life.

    Measured: Baseline and 12 months

  16. Change in Walking Ability as Measured by the Walking Impairment Questionnaire (WIQ) Score

    Change from baseline in Walking Impairment Questionnaire (WIQ) composite score at 12 months. The WIQ assesses walking distance, walking speed, and stair climbing. Each domain is scored from 0 to 100, where higher scores indicate better walking ability.

    Measured: Baseline and 12 months

  17. Change in Ankle-Brachial Index (ABI)

    Change from baseline in ankle-brachial index (ABI) of the study limb at 12 months. ABI is calculated as the ratio of ankle systolic blood pressure to brachial systolic blood pressure (unitless ratio). Higher values indicate better lower-extremity arterial perfusion.

    Measured: Baseline and 12 months

  18. Change in Toe-Brachial Index (TBI)

    Change from baseline in toe-brachial index (TBI) of the study limb at 12 months. TBI is calculated as the ratio of toe systolic blood pressure to brachial systolic blood pressure (unitless ratio). Higher values indicate better distal perfusion.

    Measured: Baseline and 12 months

  19. Change in Transcutaneous Oxygen Pressure (TcPO2)

    Change from baseline in transcutaneous oxygen pressure (TcPO2) of the study limb at 12 months, measured in mmHg. Higher values indicate better tissue oxygenation.

    Measured: Baseline and 12 months

Timeline

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

  1. First posted17 Apr 2026
  2. Study start2 Jun 2026
  3. Primary completionApr 2029 (estimated)
  4. Study completionApr 2030 (estimated)

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 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
200 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07536373
Sponsor's protocol ID
20250310R
Acronym
CIRCLE-Asia
Status last verified
Jul 2026
First submitted
5 Apr 2026
Last updated
14 Jul 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Colchicine 0.5 MG Oral Tablet Once Daily in people with Chronic Limb-Threatening Ischemia, run by Shin Kong Wu Ho-Su Memorial Hospital at 5 sites in Taiwan.

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 14 inclusion and 16 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: looking for participants now, as of the sponsor's last update on 14 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 5 sites in Taiwan. 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 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

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

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

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

Contact Donna SH Lin, MD (+886-2-2833-2211, donna.lin24@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Amputation-free survival (time frame: 12 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 14 Jul 2026.

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