RECRUITING

Colchicine in Acutely Decompensated HFREF

Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

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.

Official Title

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

Quick Facts

Study Start:2024-06
Study Completion:2028-06
Study Type:Not specified
Phase:Not Applicable
Enrollment:Not specified
Status:RECRUITING

Study ID

NCT06286423

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Ages Eligible for Study:18 Years
Sexes Eligible for Study:ALL
Accepts Healthy Volunteers:No
Standard Ages:ADULT, OLDER_ADULT
Inclusion CriteriaExclusion Criteria
  1. 1. Primary admission diagnosis of acute decompensated heart failure as evidenced by:
  2. * Heart failure symptoms and at least one of the following:
  3. * Pulmonary congestion/edema at physical exam (or chest radiography)
  4. * E/e' \> 13 on transthoracic echocardiography
  5. * 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
  6. * Elevated plasma B-type natriuretic peptide (\>100 pg/ml) or N-terminal B-type natriuretic peptide (\>300 pg/ml)
  7. 2. LV systolic dysfunction (left ventricular ejection fraction \[LVEF\] \<40%) during the index hospitalization or prior 12 months;
  8. 3. Expected duration of heart failure at least three months
  9. 4. Age 18 years or older
  10. 5. Willing and able to provide written informed consent
  11. 6. Screening plasma CRP \>0.3 mg/dL (3 mg/L) or high-sensitivity CRP \>2 mg/L
  1. 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. 2. Cardiac resynchronization therapy (CRT), coronary artery revascularization procedures, or heart valve surgeries performed within 3 months or planned during the admission
  3. 3. Previous or planned implantation of left ventricular assist devices or heart transplantation
  4. 4. Chronic use of intravenous inotropes
  5. 5. Current or recent (i.e. within 4 half-lives) use of immunosuppressive or anti-inflammatory drugs (not including NSAIDs).
  6. 6. Current treatment with colchicine or planned initiation of colchicine therapy in the next three months for gout
  7. 7. Chronic inflammatory disorder, including but not limited to rheumatoid arthritis and systemic lupus erythematosus
  8. 8. Active infection (of any type)
  9. 9. Chronic or recurrent infectious disease, including hepatitis B virus, hepatitis C virus, and HIV/AIDS
  10. 10. Prior (within the past 5 years) or current malignancy, with the exclusion of in situ lesion with low potential for progression
  11. 11. Any comorbidity leading to expected survival less than three months or inability to complete the study
  12. 12. End-stage kidney disease requiring renal replacement therapy
  13. 13. Neutropenia (\<2,000/mm3) or Thrombocytopenia (\<50,000/mm3)
  14. 14. Pregnancy
  15. * For all biological females with child bearing potential a pregnancy test will be performed as part of standard of care.
  16. 15. Presence of specific contraindications to colchicine treatment, which may include
  17. * Previous adverse reaction to colchicine
  18. * Biliary obstruction
  19. * Renal impairment with estimated glomerular filtration rate (eGFR) \<30 ml/min
  20. * Liver cirrhosis from stage Child-Pugh A to more advanced
  21. 16. Prisoners
  22. 17. Treatment with medication contraindicated for concomitant use with colchicine per
  23. * Protease inhibitors
  24. * Macrolides antibiotic
  25. * Ketoconazole, Fluconazole and Itraconazole
  26. * Nefazodone
  27. * Non-dihydropiridine calcium channel blockers
  28. * Aprepitant
  29. * Ranolazine
  30. * Cyclosporine

Contacts and Locations

Study Contact

Austin Hogwood
CONTACT
(804)536-7036
ach2jb@virginia.edu
Francesco Moroni, MD
CONTACT
(804)351-7089
nmf7mm@uvahealth.org

Principal Investigator

Antonio Abbate, MD
PRINCIPAL_INVESTIGATOR
UVA Health

Study Locations (Sites)

UVA Health
Charlottesville, Virginia, 22908
United States

Collaborators and Investigators

Sponsor: University of Virginia

  • Antonio Abbate, MD, PRINCIPAL_INVESTIGATOR, UVA Health

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

Study Start Date2024-06
Study Completion Date2028-06

Study Record Updates

Study Start Date2024-06
Study Completion Date2028-06

Terms related to this study

Keywords Provided by Researchers

  • Colchicine
  • Heart Failure
  • Decompensated Heart Failure
  • Heart Failure with Reduced Ejection Fraction
  • HFrEF

Additional Relevant MeSH Terms

  • Heart Failure
  • Decompensated Heart Failure
  • Heart Failure With Reduced Ejection Fraction