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RecruitingPhase 4

Colchicine in Acutely Decompensated HFREF

Colchicine in Acutely Decompensated Heart Failure With Reduced Ejection Fraction: a Pilot Study

Who can join

As published by the study on ClinicalTrials.gov. "Not stated" means the study hasn't said — ask the study team.

Age
18 Years and older
Sex
All sexes
Healthy volunteers
Not accepted
Compensation
Mentioned in the study description

Other requirements are listed under Eligibility below. Only the study team can confirm whether you can join.

What to expect

No one can promise a trial will help you personally — that is what the research is trying to find out.

What participation involves

  • Time periods mentioned: 14 days, 76 days, 7 days
  • Procedures mentioned: Pills, Blood draws

Only what the study's summary and detailed description on ClinicalTrials.gov say. Time periods may describe the whole study or a part of it — ask the study team what applies to you.

Show the study's own words
  • "Placebo regimen will be analogous, with one pill bid for 14 days followed by one pill once per day for 76 days."
  • "Blood samples will be collected at baseline, 24±6h, 48±6h and 72±6h after treatment initiation, and subsequently at 14±7 days and at study closure."
  • "The first four blood samples will be obtained while the subject is still admitted to the hospital."
  • "The blood sample at 14±7 days will be obtained during an outpatient encounter."
  • "A study closure visit with clinical assessment and experimental drug collection for capsule counting to assess compliance will be conducted at 90±14; the final blood sample will be collected at that time."
  • "Of note, the effect was most pronounced among patients with baseline high-sensitivity C-reactive protein (hs-CRP) ≥3.0 mg/l and for treatment duration over 7 days, and was higher for doses of 1.0 mg daily than lower colchicine doses."
Compensation
Mentioned in the study description
  • Study-related exams and procedures are typically provided at no cost. This is how many trials work in general — confirm the details for this study with the study team.
  • Participants are monitored closely by the research team throughout the study.
  • Some participants may receive access to an investigational treatment, which is still being studied.
  • Your participation helps researchers learn whether this approach could help future patients.

About this study

This is a double blind, placebo-controlled pilot trial randomizing patients admitted to the hospital with acutely decompensated heart failure (ADHF) and inflammation to receive either colchicine or matching placebo. Upon enrollment, patients will be randomized 1:1 to receive either the experimental drug (Colchicine) or matching placebo. The regimen in the active arm will consist of 14 days of Colchicine 0.6 mg bid followed by 76±14 days of Colchicine 0.6 mg once per day. Placebo regimen will be analogous, with one pill bid for 14 days followed by one pill once per day for 76 days. Dose reduction for patients with Stage III chronic kidney disease is allowed as detailed in the protocol. At the same time, dose reduction can also be elected in case of GI symptoms. The study team will transiently stop the experimental medication in case of acute kidney injury (AKI), defined per Kidney Disease Improving Global Outcomes (KDIGO) Stage I, as specified in the protocol. These patients will continue with their standard of care for the management of heart failure which consists of a combination of medications that relieve congestion, normalize blood pressure and heart rate, and block the effects of hormones on the heart. The proposed treatment will be in addition to standard of care. No standard of care medications will be withheld. While inflammation is a known risk factor in heart failure, there are no standard anti-inflammatory drugs used in patients with heart failure, as the benefit is not established. The study team will study colchicine, an anti-inflammatory drug, as compares with placebo. Blood will be obtained from the patients in order to measure hsCRP and IL-6. Blood samples will be collected at baseline, 24±6h, 48±6h and 72±6h after treatment initiation, and subsequently at 14±7 days and at study closure. The first four blood samples will be obtained while the subject is still admitted to the hospital. The blood sample at 14±7 days will be obtained during an outpatient encounter. A study closure visit with clinical assessment and experimental drug collection for capsule counting to assess compliance will be conducted at 90±14; the final blood sample will be collected at that time.

Compensation is read from the study's own description and may be missing — always confirm with the study team.

Eligibility

Official eligibility criteria

Inclusion Criteria: 1. Primary admission diagnosis of acute decompensated heart failure as evidenced by: * Heart failure symptoms and at least one of the following: * Pulmonary congestion/edema at physical exam (or chest radiography) * E/e' \> 13 on transthoracic echocardiography * Left heart catheterization showing elevated left ventricular (LV) end-diastolic pressure \>18 mmHg or right heart catheterization showing pulmonary artery occluding pressure (wedge) \>16 mmHg * Elevated plasma B-type natriuretic peptide (\>100 pg/ml) or N-terminal B-type natriuretic peptide (\>300 pg/ml) 2. LV systolic dysfunction (left ventricular ejection fraction \[LVEF\] \<40%) during the index hospitalization or prior 12 months; 3. Expected duration of heart failure at least three months 4. Age 18 years or older 5. Willing and able to provide written informed consent 6. Screening plasma CRP \>0.3 mg/dL (3 mg/L) or high-sensitivity CRP \>2 mg/L Exclusion Criteria: 1. Concomitant clinically significant comorbidities that would interfere with the execution or interpretation of the study, including but not limited to acute coronary syndromes, uncontrolled hypertension or orthostatic hypotension, tachy- or brady-arrhythmias, acute or chronic pulmonary disease or neuromuscular disorders affecting respiration 2. Cardiac resynchronization therapy (CRT), coronary artery revascularization procedures, or heart valve surgeries performed within 3 months or planned during the admission 3. Previous or planned implantation of left ventricular assist devices or heart transplantation 4. Chronic use of intravenous inotropes 5. Current or recent (i.e. within 4 half-lives) use of immunosuppressive or anti-inflammatory drugs (not including NSAIDs). 6. Current treatment with colchicine or planned initiation of colchicine therapy in the next three months for gout 7. Chronic inflammatory disorder, including but not limited to rheumatoid arthritis and systemic lupus erythematosus 8. Active infection (of any type) 9. Chronic or recurrent infectious disease, including hepatitis B virus, hepatitis C virus, and HIV/AIDS 10. Prior (within the past 5 years) or current malignancy, with the exclusion of in situ lesion with low potential for progression 11. Any comorbidity leading to expected survival less than three months or inability to complete the study 12. End-stage kidney disease requiring renal replacement therapy 13. Neutropenia (\<2,000/mm3) or Thrombocytopenia (\<50,000/mm3) 14. Pregnancy * For all biological females with child bearing potential a pregnancy test will be performed as part of standard of care. 15. Presence of specific contraindications to colchicine treatment, which may include * Previous adverse reaction to colchicine * Biliary obstruction * Renal impairment with estimated glomerular filtration rate (eGFR) \<30 ml/min * Liver cirrhosis from stage Child-Pugh A to more advanced 16. Prisoners 17. Treatment with medication contraindicated for concomitant use with colchicine per Food and Drugs Administration labeling, including: * Protease inhibitors * Macrolides antibiotic * Ketoconazole, Fluconazole and Itraconazole * Nefazodone * Non-dihydropiridine calcium channel blockers * Aprepitant * Ranolazine * Cyclosporine

Study sites (1)

VA