- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05418686
Study of Colchicine Resistance in Familial Mediterranean Fever (COLCHI-RESIST)
Study Of Colchicine Resistance In Familial Mediterranean Fever
Five to 10% of familial mediterranean patients are considered colchicine-resistant (i.e. patients with a persistent inflammatory syndrome, despite taking the maximum tolerated dose of colchicine daily). The recommended treatment in this case is a subcutaneous anti-interleukin 1 biotherapy (anakinra or canakinumab). These treatments are expensive (1,000 to 12,000 euros/month).
However, for a patient to be considered colchicine-resistant, compliance with the treatment must be verified. Furthermore specific activation of the pyrin inflammasome by Clostrioides difficile toxin and the overrepresentation of these bacteria in the stools of our patients led us to systematically search for them in our resistant patients. The demonstration of the involvement of C. difficile in the imbalance of the disease has not yet been published.
The colchiresist study aim to better characterize colchicine-resistance by confirming good compliance to treatment with colchicine hair measurement and by looking for clostrioides infection or intestinal dysbiosis.
Study Overview
Status
Conditions
Detailed Description
Patients meeting the criteria for colchicine resistance will be included in a follow-up visit.
- Adherence to colchicine therapy will be assessed by the Girerd questionnaire completed by the patient at the inclusion visit.
- A blood test is performed including a haemogram, CRP and SAA, creatinine and proteinuria.
- a standard stool analysis on site to look for C. difficile toxin.
For research purposes, samples of:
- Stool.
- A strand of hair with the diameter of a pencil and a minimum length of 2 cm, in the region of the posterior vertex, where the growth and integration are relatively constant to avoid variability.
- In patients with baldness or bleached hair only: pubic and/or axillary hair will be taken, The samples will then be processed without segmentation.
- Additional blood (5ml) and urine (2ml) samples for colchicine dosage. The patient's participation ends after this visit
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Léa SAVEY, MD
- Phone Number: 0033156017431
- Email: lea.savey@aphp.fr
Study Contact Backup
- Name: Sophie Georgin-Lavialle, PD, PhD
- Phone Number: 0033156017431
- Email: sophie.georgin-lavialle@aphp.fr
Study Locations
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Paris, France, 75020
- Service de Médecine Interne. Hôpital Tenon, 4 Rue de la Chine
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Contact:
- Léa SAVEY, MD
- Phone Number: 0033156016791
- Email: lea.savey@aphp.fr
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Contact:
- Sophie Georgin-Lavialle, MD, PhD
- Phone Number: 0033156017431
- Email: sophie.georgin-lavialle@aphp.fr
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
Inclusion Criteria Age ≥ 12 years with no upper age limit -Patients with familial Mediterranean fever (FMF) meeting international criteria for the disease (Livneh criteria) and carrying 2 pathogenic mutations in the MEFV gene.
Patients considered colchicine-resistant according to EULAR criteria reviewed by an expert consensus:
- Persistence of signs of activity (at least one attack per month for at least 3 months) despite taking the maximum tolerated dosage of colchicine.
- Persistence of a biological inflammatory syndrome after exclusion of other causes and despite taking a maximum tolerated dosage of colchicine.
- Signature of an informed consent by the patient (or his parents if under 18 years of age)
- Patients affiliated to a social security system
Exclusion Criteria:
- Patients participating in another interventional trial
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Colchicine-resistant Familial Mediterranean Fever patients
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For research purposes, samples of:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Amount of colchicine measured in the first 2 cm of hair from the scalp of an FMF patient considered colchicine resistant or from pubic hair in patients with bald or colored hair, which corresponds to the average compliance of the last 2 months of intake
Time Frame: Through study completion, an average of 18 months
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To assess 2-month compliance with colchicine in patients with FMF considered resistant via capillary drug dosage
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Through study completion, an average of 18 months
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Correlation between the amount of colchicine measured in the hair and the blood and urine levels of colchicine attesting to the last days' intake.
Time Frame: Through study completion, an average of 18 months
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To study blood and urine colchicine dosage in FMF patients considered resistant to colchicine
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Through study completion, an average of 18 months
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Correlation between capillary colchicine dosage and colchicine compliance assessed with the 6-item GIRERD
Time Frame: Through study completion, an average of 18 months
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Compare hair dosing to self-reported compliance
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Through study completion, an average of 18 months
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Composition of the fecal microbiota (search for an overrepresentation of clostridiae) in colchicine-resistant patients patients with colchicine resistance
Time Frame: Through study completion, an average of 18 months
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Studying the composition of the fecal microbiota in colchicine-resistant FMF patients
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Through study completion, an average of 18 months
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Testing for clostridioides difficile toxin B in colchicin-resistant patients
Time Frame: Through study completion, an average of 18 months
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Testing colchicine-resistant FMF patients for clostridioides difficile toxin to rule out chronic asymptomatic carriage
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Through study completion, an average of 18 months
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Dosage of proinflammatory cytokines IL1, IL6, IL18, TNFa and il1Ra.
Time Frame: Through study completion, an average of 18 months
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Study blood levels of proinflammatory cytokines in colchicine-resistant patients, in particular IL1 and il1RA
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Through study completion, an average of 18 months
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Percentage of patients for whom a prescription of anti-IL-1 biotherapy could have been avoided (i.e. poor compliance with Colchicine and/or Clostrioides Difficile infection)
Time Frame: Through study completion, an average of 18 months
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Determine the percentage of patients labeled colchicine resistant who were actually noncompliant or chronically infected with pyrin-activating bacteria like clostridioides difficile
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Through study completion, an average of 18 months
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Collaborators and Investigators
Investigators
- Principal Investigator: Léa SAVEY, MD, Assistance Publique - Hôpitaux de Paris
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Skin Diseases
- Infections
- Genetic Diseases, Inborn
- Gram-Negative Bacterial Infections
- Bacterial Infections
- Bacterial Infections and Mycoses
- Skin Diseases, Genetic
- Body Temperature Changes
- Fever
- Brucellosis
- Familial Mediterranean Fever
- Hereditary Autoinflammatory Diseases
- Molecular Mechanisms of Pharmacological Action
- Antirheumatic Agents
- Antineoplastic Agents
- Tubulin Modulators
- Antimitotic Agents
- Mitosis Modulators
- Gout Suppressants
- Colchicine
Other Study ID Numbers
- APHP211442
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
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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