Colchicine in High-risk Patients with Acute Minor-to-moderate Ischemic Stroke or Transient Ischemic Attack...

Area of Science:

• Cardiovascular Medicine
• Neurology
• Pharmacology

Background:

• Anti-inflammatory therapy with colchicine has demonstrated efficacy in mitigating recurrent vascular events among patients with coronary heart disease.
• Inflammation plays a significant role in the pathophysiology of ischemic stroke and transient ischemic attack (TIA).

Purpose of the Study:

• To evaluate the efficacy of colchicine in reducing the incidence of recurrent stroke within three months in patients with acute minor-to-moderate ischemic stroke or high-risk TIA.
• To assess the safety and tolerability of colchicine in this patient population.

Main Methods:

• The CHANCE-3 trial is a randomized, double-blind, placebo-controlled, multicenter study involving 8,238 patients.
• Participants with acute minor-to-moderate ischemic stroke (NIHSS ≤ 5) or high-risk TIA (ABCD² score ≥ 4) and hsCRP ≥ 2 mg/L were randomized within 24 hours of symptom onset.
• Patients received either colchicine (1 mg daily for 3 days, then 0.5 mg daily for 90 days) or placebo, alongside optimal medical therapy. The primary analysis employed an intention-to-treat approach.

Main Results:

• The study was powered to detect a 25% reduction in the primary efficacy outcome (any stroke within 3 months).
• Adverse events associated with colchicine use were systematically analyzed.

Conclusions:

• The findings from the CHANCE-3 trial will provide crucial insights into the role of colchicine as an anti-inflammatory agent for secondary stroke prevention.
• This research aims to establish a new therapeutic option for high-risk patients following acute ischemic stroke or TIA.