Colchicine and Spironolactone in Patients with MI / SYNERGY Stent Registry (CLEAR SYNERGY)
A 2x2 Factorial Randomized Controlled Trial of Colchicine and Spironolactone in Patients with Myocardial Infarction / SYNERGY Stent Registry - Organization to Assess Strategies for Ischemic Syndromes 9
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 3
Contacts and Locations
Study Contact
Study Contact
- Name: Jessica Tyrwhitt
- Phone Number: 9055274322
- Email: clear@phri.ca
Study Locations
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New South Wales
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Bankstown, New South Wales, Australia, 2200
- Bankstown-Lidcombe Hospital
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Campbelltown, New South Wales, Australia, 2560
- SWSLHD - Campbelltown
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Liverpool, New South Wales, Australia, 2170
- SWSLHD - Liverpool Hospital
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St Leonards, New South Wales, Australia, 2065
- Royal North Shore Hospital
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Victoria
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Frankston, Victoria, Australia, 3199
- Peninsula Health
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Parkville, Victoria, Australia, 3050
- Royal Melbourne Hospital
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Quebec, Canada, G1V 4G5
- Institut Universitaire de Cardiologie et de Pneumologie - ULAVAL
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Alberta
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Edmonton, Alberta, Canada
- University of Alberta Hospital
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British Columbia
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Kelowna, British Columbia, Canada
- Kelowna General Hospital
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New Westminster, British Columbia, Canada
- Fraser Clinical Trials
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Victoria, British Columbia, Canada
- Victoria Heart Institute Foundation
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Ontario
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Brampton, Ontario, Canada
- William Osler Health
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Hamilton, Ontario, Canada, L8L2X2
- Hamilton General Hospital
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Kingston, Ontario, Canada
- Kingston Health Science Centre
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Kitchener, Ontario, Canada
- St. Mary's General Hospital
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London, Ontario, Canada
- London Health Sciences Centre
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Newmarket, Ontario, Canada
- York PCI Group INC
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Ottawa, Ontario, Canada
- University of Ottawa Heart Institute
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Saint Catharines, Ontario, Canada
- Niagara Health System
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Scarborough, Ontario, Canada
- Scarborough Cardiology Research Associates Inc.
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Toronto, Ontario, Canada
- St. Michael's Hospital
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Toronto, Ontario, Canada
- Sunnybrook Health Sciences Centre
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Toronto, Ontario, Canada
- Toronto General Hospital, University Health Network
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Windsor, Ontario, Canada
- Windsor Regional Hospital
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Quebec
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Montreal, Quebec, Canada
- Jewish General Hospital
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Sherbrooke, Quebec, Canada
- CIUSSS de l'Estrie - CHUS - Hôpital Fleurimont
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Saskatchewan
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Regina, Saskatchewan, Canada
- PVRI - Regina General Hospital
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Saskatoon, Saskatchewan, Canada
- Royal University Hospital
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Brno, Czechia, 625 00
- Czech Center University Hospital Brno
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Brno, Czechia, 656 91
- St. Anne´s University Hospital
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Karlovy Vary, Czechia, 36225
- Karlovarska krajska nemocnice a.s.
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Prague, Czechia, 10000
- University Hospital Královské Vinohrady
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Alexandria, Egypt, 21568
- Alexandria University Hospital
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Banī Suwayf, Egypt, 62511
- Beni suef University hospital
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Cairo, Egypt, 11576
- Nasser Institute for Research and Treatment
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Fayoum, Egypt, 63511
- Fayoum General Hospital
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Fayoum, Egypt, 63711
- Tamia Central Hospital
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Giza, Egypt, 12651
- National Heart Institute
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Ismailia, Egypt, 41522
- Suez Canal University Hospital
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Dakahlia
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Mansoura, Dakahlia, Egypt, 35516
- Mansoura University Hospital
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Kharga
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New Cairo, Kharga, Egypt, 72738
- Kharga Specialized Hospital
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Nimes, France, 30 000
- Centre Hospitalier Universitaire de Nīmes
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Paris, France, 75013
- Institut de Cardiologie de la Pitié-Salpêtrière
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Calvados
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Caen, Calvados, France, 14000
- Centre Hospitalier Universitaire de Caen
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Debrecen, Hungary, 4032
- University of Debrecen
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Kecskemét, Hungary, 6000
- Bacs-Kiskun County Hospital
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Szeged, Hungary, 6725
- University of Szeged
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Kathmandu, Nepal, 44600
- Manmohan Cardiothoracic Vascular and Transplant Center
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Bagmati Province/ State 3
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Bharatpur, Bagmati Province/ State 3, Nepal, 44200
- Chitwan Medical College Teaching Hospital
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Maharajgung
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Kathmandu, Maharajgung, Nepal, 44600
- Shahid Gangalal National Heart Centre
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's-Hertogenbosch, Netherlands, 5223 GV
- Bernhoven Ziekenhuis
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Arnhem, Netherlands, 6815 AD
- Rijnstate Ziekenhuis
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Den Haag, Netherlands, 2545AA
- Haga hospital
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Doetinchem, Netherlands, 7009 BL
- Slingeland Ziekenhuis
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Dordrecht, Netherlands, 3318 AT
- Albert Schweitzer Ziekenhuis
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Ede, Netherlands, 6716 RP
- Gelderse Vallei Ziekenhuis
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Goes, Netherlands, 4462 RA
- Admiraal de Ruyter Hospital
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Gouda, Netherlands, 2803HH
- Groene Hart Ziekenhuis Gouda
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Nijmegen, Netherlands, 6525 GA
- Radboud UMC
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Flevoland
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Almere, Flevoland, Netherlands, 1315 RA
- Flevoziekenhuis
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Gelderland
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Apeldoorn, Gelderland, Netherlands, 7334DZ
- Gelre Ziekenhuizen
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Harderwijk, Gelderland, Netherlands, 3844 DG
- St. Jansdal Ziekenhuis
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Noord Holland
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Hilversum, Noord Holland, Netherlands, 1212VG
- Tergooi Hospital
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Overijssel
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Almelo, Overijssel, Netherlands, 7609PP
- ZiekenhuisGroepTwente (ZGT)
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Zuid Holland
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Gorinchem, Zuid Holland, Netherlands, 4204 AA
- Beatrixziekenhuis
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Rotterdam, Zuid Holland, Netherlands, 3045PM
- Franciscus Gasthuis
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Bitola, North Macedonia, 7000
- PHI Clinical Hospital "Dr. Trifun Panovski"
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Skopje, North Macedonia, 1000
- University Clinic of Cardiology
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Tetovo, North Macedonia, 1200
- Clinical Hospital Tetovo
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Belgrade, Serbia, 11000
- Clinical Center of Serbia
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Belgrade, Serbia, 11000
- University Medical Center Zvezdara
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Belgrade, Serbia, 11000
- Institute for Cardiovascular diseases Dedinje
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Sremska Kamenica, Serbia, 21208
- Institute of Cardiovascular Disease Vojvodina
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Badalona, Spain, 08916
- Germans Trias i Pujol University Hospital
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Barcelona, Spain, 08003
- Hospital Del Mar
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Barcelona, Spain, 08036
- Clínic Barcelona Hospital Universitario
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Granada, Spain, 18014
- Hospital Universitario Virgen de las Nieves
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Madrid, Spain, 28046
- Hospital Universitario La Paz
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Vigo, Spain, 36312
- Hospital Alvaro Cunqueiro
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Asturias
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Gijon, Asturias, Spain, 33394
- Hospital de Cabuenes
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Oviedo, Asturias, Spain, 33011
- Hospital Universitario Central de Asturias (HUCA)
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Baleares
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Palma, Baleares, Spain, 07120
- Hospital Son Espases
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Barcelona
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l'Hospitalet de Llobregat, Barcelona, Spain, 08907
- Hospital Universitario de Bellvitge
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Geneva, Switzerland, 1205
- Hôpitaux Universitaires de Genève
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Luzern, Switzerland, 6000
- Luzerner Kantonsspital
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London, United Kingdom, SW17OQT
- St. George's Hospital NHS Foundation Trust
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Middlesbrough, United Kingdom, TS4 3BW
- The James Cook University Hospital
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Sheffield, United Kingdom, S57AU
- Sheffield Teaching Hospitals NHS Foundation Trust
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Dorset (county)
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Bournemouth, Dorset (county), United Kingdom, BH7 7DW
- University Hospitals Dorset NHS Foundation Trust
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East Riding of Yorkshire (unitary authority)
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Cottingham, East Riding of Yorkshire (unitary authority), United Kingdom, HU16 5JQ
- Castle Hill Hospital
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East Sussex (county)
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Brighton, East Sussex (county), United Kingdom, BN2 1ES
- Brighton & Sussex University Hospital NHS Trust
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Hertfordshire (county)
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Stevenage, Hertfordshire (county), United Kingdom, SG14AB
- Lister Hospital
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Kent (county)
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Ashford, Kent (county), United Kingdom, TN24 0LZ
- William Harvey Hospital -East Kent Hospitals University NHS Foundation Trust
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Norfolk (county)
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Norwich, Norfolk (county), United Kingdom, NR4 7UY
- Norfolk and Norwich University Hospital
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Northamptonshire (county)
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Kettering, Northamptonshire (county), United Kingdom, NN16 8UZ
- Kettering General Hospital
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Nottinghamshire (county)
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Nottingham, Nottinghamshire (county), United Kingdom, NG5 1PB
- Nottingham University Hospitals NHS Trust
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Surrey (county)
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Chertsey, Surrey (county), United Kingdom, KT16 0PZ
- Ashford & St Peter's Hospitals NHS Foundation Trust
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Wiltshire (county)
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Salisbury, Wiltshire (county), United Kingdom, SP2 8BJ
- Salisbury Nhs Foundation Trust
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California
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Bakersfield, California, United States, 93308
- Central Cardiology
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District of Columbia
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Washington, District of Columbia, United States, 20010
- Medstar Washington Hospital Center
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Illinois
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Chicago, Illinois, United States, 60612
- University of Illinois
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Springfield, Illinois, United States, 62769
- Prairie Education & Research Cooperative
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Indiana
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Munster, Indiana, United States, 46321
- Community Hospital
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Massachusetts
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Burlington, Massachusetts, United States, 01805
- Lahey Hospital and Medical Center
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New Mexico
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Albuquerque, New Mexico, United States, 87102
- New Mexico Heart Institute
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New York
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New York, New York, United States, 10016
- NYU Langone Medical Center
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Ohio
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Cincinnati, Ohio, United States, 45219
- The Christ Hospital Lindner Research Center
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Pennsylvania
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Hershey, Pennsylvania, United States, 17033
- Penn State Health Milton S. Hershey Medical Center
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Rhode Island
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Providence, Rhode Island, United States, 02903
- Rhode Island Hospital
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
a) Patients with STEMI referred for PCI within 12 hours of symptom onset, have a culprit lesion amenable to stenting, and with planned SYNERGY stent implantation for SYNERGY registry
OR
b) Patients with STEMI referred for PCI within 48 hours of symptom onset, not prospectively enrolled in SYNERGY stent registry
OR
c) Patients with diagnosis of Non STEMI with ischemic symptoms and either Hs Troponin > or = 300x ULN or Troponin > or = 200x ULN who have undergone PCI with one of the following:
i. LVEF< or =45% ii. Diabetes iii. Multivessel CAD defined as 50% stenosis in 2nd major epicardial vessel iv. Prior MI v. Age >60 years
- Able to be enrolled/randomized within 72 hours of index PCI (however patients should be randomized as soon as possible after PCI)
- Written informed consent
Exclusion Criteria:
- Age ≤18 years
- Pregnancy, breastfeeding, or women of childbearing potential who are not using an effective method of contraception
- Any medical, geographic, or social factor making study participation impractical or precluding required follow-up
- Systolic blood pressure <90 mm Hg
- Active diarrhea
- Known allergy or contraindication to everolimus, the SYNERGY stent or any of its components
- Unable to receive dual antiplatelet therapy
- Any contraindication or known intolerance to colchicine or spironolactone
- Requirement for colchicine or mineralocorticoid antagonist for another indication
- History of cirrhosis or current severe hepatic disease
- Current or planned use of any of: cyclosporine, verapamil, HIV protease inhibitors, azole antifungals, or macrolide antibiotics
- Creatinine clearance <30 mL/min/1.73 m2
- Serum Potassium >5.0 meq/L
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Factorial Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Placebo Comparator: Placebo +/- SYNERGY Stent
Colchicine-placebo tablet + Spironolactone-placebo tablet. Trial participants who receive a SYNERGY Bioabsorbable Polymer Drug-Eluting Stent during their index PCI for STEMI will be included in the embedded SYNERGY Stent Registry. |
Trial participants who receive a SYNERGY™ Bioabsorbable Polymer Drug-Eluting (everolimus) Stent during their index PCI for STEMI will be included in the SYNERGY Stent Registry.
Matching Spironolactone-Placebo once daily
Matching Colchicine-placebo once daily
|
|
Active Comparator: Colchicine + Spironolactone +/- SYNERGY Stent
Colchicine 0.5 mg tablet + Spironolactone 25 mg tablet. Trial participants who receive a SYNERGY Bioabsorbable Polymer Drug-Eluting Stent during their index PCI for STEMI will be included in the embedded SYNERGY Stent Registry. |
Spironolactone 25 mg once daily
Trial participants who receive a SYNERGY™ Bioabsorbable Polymer Drug-Eluting (everolimus) Stent during their index PCI for STEMI will be included in the SYNERGY Stent Registry.
Colchicine 0.5 mg once daily
|
|
Active Comparator: Spironolactone +/- SYNERGY Stent
Colchicine-placebo tablet + Spironolactone 25 mg tablet. Trial participants who receive a SYNERGY Bioabsorbable Polymer Drug-Eluting Stent during their index PCI for STEMI will be included in the embedded SYNERGY Stent Registry. |
Spironolactone 25 mg once daily
Trial participants who receive a SYNERGY™ Bioabsorbable Polymer Drug-Eluting (everolimus) Stent during their index PCI for STEMI will be included in the SYNERGY Stent Registry.
Matching Colchicine-placebo once daily
|
|
Active Comparator: Colchicine +/- SYNERGY Stent
Colchicine 0.5 mg tablet + Spironolactone-placebo tablet. Trial participants who receive a SYNERGY Bioabsorbable Polymer Drug-Eluting Stent during their index PCI for STEMI will be included in the embedded SYNERGY Stent Registry. |
Trial participants who receive a SYNERGY™ Bioabsorbable Polymer Drug-Eluting (everolimus) Stent during their index PCI for STEMI will be included in the SYNERGY Stent Registry.
Matching Spironolactone-Placebo once daily
Colchicine 0.5 mg once daily
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Major Adverse Cardiac Events (MACE)
Time Frame: up to 1 year
|
Major Adverse Cardiac Events (MACE) for SYNERGY Stent (defined as the composite of death, recurrent target vessel MI, stroke, or ischemia driven target vessel revascularization) compared to performance goal
|
up to 1 year
|
|
Composite of cardiovascular death, recurrent myocardial infarction, stroke, or unplanned ischemia driven revascularization
Time Frame: through study completion, an estimated average of 3 years
|
The first occurrence of cardiovascular death, recurrent myocardial infarction, stroke, or unplanned ischemia driven revascularization in the colchicine comparison
|
through study completion, an estimated average of 3 years
|
|
Total composite events of cardiovascular death or new or worsening heart failure (co-primary 1)
Time Frame: through study completion, an estimated average of 3 years
|
Total composite of cardiovascular death or new or worsening heart failure in the spironolactone comparison (co-primary 1)
|
through study completion, an estimated average of 3 years
|
|
Composite of cardiovascular death, new or worsening heart failure, recurrent myocardial infarction, or stroke (co-primary 2)
Time Frame: through study completion, an estimated average of 3 years
|
The first occurence of cardiovascular death, new or worsening heart failure, recurrent myocardial infarction, or stroke in the spironolactone comparison (co-primary 2)
|
through study completion, an estimated average of 3 years
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Sanjit S Jolly, MD, Population Health Research Institute
Publications and helpful links
General Publications
- Silvis MJM, Demkes EJ, Fiolet ATL, Dekker M, Bosch L, van Hout GPJ, Timmers L, de Kleijn DPV. Immunomodulation of the NLRP3 Inflammasome in Atherosclerosis, Coronary Artery Disease, and Acute Myocardial Infarction. J Cardiovasc Transl Res. 2021 Feb;14(1):23-34. doi: 10.1007/s12265-020-10049-w. Epub 2020 Jul 9.
- Bouabdallaoui N, Tardif JC. Colchicine in the Management of Acute and Chronic Coronary Artery Disease. Curr Cardiol Rep. 2021 Jul 16;23(9):120. doi: 10.1007/s11886-021-01560-w.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimated)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Ischemia
- Pathologic Processes
- Necrosis
- Myocardial Ischemia
- Heart Diseases
- Cardiovascular Diseases
- Vascular Diseases
- Myocardial Infarction
- Infarction
- ST Elevation Myocardial Infarction
- Non-ST Elevated Myocardial Infarction
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Antirheumatic Agents
- Antineoplastic Agents
- Tubulin Modulators
- Antimitotic Agents
- Mitosis Modulators
- Hormones, Hormone Substitutes, and Hormone Antagonists
- Natriuretic Agents
- Diuretics
- Hormone Antagonists
- Gout Suppressants
- Mineralocorticoid Receptor Antagonists
- Diuretics, Potassium Sparing
- Colchicine
- Spironolactone
Other Study ID Numbers
Other Study ID Numbers
- CLSYN.1702
- OASIS-9 (Other Identifier: Population Health Research Institute)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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