Role of Colchicine As Anti-Inflammatory Therapy in HFpEF (CO-HFpEF)

The Role of Colchicine As Anti-Inflammatory Treatment in Patients with HFpEF: a Prospective Study

Heart failure with preserved ejection fraction (HFpEF) is a condition associated with high morbidity and mortality. Chronic low-grade inflammation plays a key role in its progression, yet few treatments specifically target this pathway.

This clinical trial aims to evaluate the effectiveness of colchicine, a well-tolerated anti-inflammatory drug, in reducing inflammation in HFpEF patients. The study will assess whether colchicine lowers levels of soluble ST2 (sST2), a biomarker linked to inflammation and cardiac stress in HFpEF.

Participants will take colchicine daily for three months, with blood samples collected at baseline and at the end of the study to measure changes in sST2 levels. The findings could provide new insights into the potential role of colchicine as a treatment for HFpEF.

Study Overview

• Status: Active, not recruiting
• Conditions: HFpEF - Heart Failure with Preserved Ejection Fraction
• Intervention / Treatment: Drug: Colchicine Tablets

Detailed Description

Heart failure with preserved ejection fraction (HFpEF) is a complex condition associated with high morbidity and mortality. While its exact causes remain unclear, low-grade systemic inflammation plays a key role by promoting myocardial fibrosis and increasing heart muscle stiffness. Despite this, anti-inflammatory treatments for HFpEF remain largely unexplored.

Colchicine is a well-established anti-inflammatory drug that blocks key inflammatory pathways, including inflammasome activation and the release of interleukin-1 (IL-1). It has demonstrated cardiovascular benefits in trials such as COLCOT and LoDoCo2, significantly reducing the risk of heart-related events in coronary artery disease. However, its effects in HFpEF patients are not yet known.

Two important biomarkers-soluble suppression of tumorigenicity 2 (sST2) and high-sensitivity C-reactive protein (hsCRP)-are strongly linked to worse outcomes in HFpEF. Elevated sST2 reflects increased fibrosis and cardiac stress, while high hsCRP indicates systemic inflammation. Both markers are associated with more severe symptoms and a higher risk of complications. Additionally, the 6-minute walk test (6MWT) is a widely used measure of physical function and exercise capacity in heart failure patients.

This single-center, prospective clinical trial aims to evaluate the effects of colchicine in HFpEF patients with elevated inflammation. Participants will receive colchicine for three months, with assessments of sST2, hsCRP, and 6MWT performance before and after treatment. Findings from this study may provide valuable insights into whether colchicine can reduce inflammation and improve functional capacity in HFpEF patients.

• Study Type: Interventional
• Enrollment (Estimated): 75
• Phase: Phase 3

Contacts and Locations

Study Locations

• Egypt
  • Cairo, Egypt, 11562
    • Cairo University - Kasr Al-Ainy

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Adult ≥ 18 years of age, males and females.
• Left Ventricular Ejection Fraction (LVEF) ≥ 50%.
• Symptoms and/or signs of heart failure.
• H2FPEF score ≥ 6 points or HFA-PEFF score ≥ 5 points.
• N-terminal pro-B-type natriuretic peptide (NT-proBNP) ≥125 pg/mL at baseline (patients with atrial fibrillation at baseline NT-proBNP ≥365 pg/mL), or objective evidence of systemic or pulmonary congestion.
• Stable medical therapy within the last 1 month.

Exclusion Criteria:

• Patients requiring colchicine for other conditions or with a history of colchicine intolerance or hypersensitivity.
• Active or chronic inflammatory diseases or infection.
• Presence of active solid tumors or hematological malignancies.
• Estimated glomerular filtration rate (eGFR) <35 mL/min/1.73 m².
• Severe liver disease includes Child-Pugh class B or C, cirrhosis, or chronic active hepatitis.
• Concurrent use of strong CYP3A4 or P-glycoprotein inhibitors.
• Presence of blood dyscrasias.
• Recent major cardiovascular events or procedures within the last 3 months.
• Established diagnosis of pericardial disease, myocarditis, hypertrophic cardiomyopathy, and cardiac amyloidosis
• Significant valvular heart disease.
• Lack of informed consent.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Participant Group/Arm; Eligible HFpEF patients with a body weight of ≥70 kg will receive colchicine 0.5 mg twice daily, while those weighing <70 kg will receive 0.5 mg once daily, in addition to usual care for 12 weeks.	Drug: Colchicine Tablets; Oral colchicine tablets. The dosing regimen is as follows: Patients weighing >70 kg: 0.5 mg twice daily (BID); Patients weighing ≤70 kg: 0.5 mg once daily (OD) Administered for 3 months; Other Names: Colchicine

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Soluble Suppression of Tumourigenicity 2 (sST2,ng/ml)	Delta_circulating sST2	From baseline to 12 weeks post-treatment initiation

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in high-sensitivity C-reactive protein (hsCRP, mg/L)	Delta_circulating_hsCRP	From baseline to 12 weeks post-treatment initiation
Change in 6 Minute Walk Test (6MWT,meters)	Change in 6MWT distance	From baseline to 12 weeks post-treatment initiation

Collaborators and Investigators

• Sponsor: Cairo University
• Investigators: Study Chair: Magdy Abdelhamid Abdel Aziz, Professor of Cardivascular M, Cairo university; Principal Investigator: Shaima M Zeyad, Cardiology Resident, Cairo university; Principal Investigator: Ahmed Kamal, MD in Cardiology, Cairo university; Principal Investigator: Nesrine M El Gharbawi, Prof of clin. & Chem Patho, Cairo university

Study record dates

Study Major Dates

• Study Start (Actual): July 1, 2024
• Primary Completion (Estimated): February 22, 2025
• Study Completion (Estimated): March 1, 2025

Study Registration Dates

• First Submitted: February 15, 2025
• First Submitted That Met QC Criteria: February 15, 2025
• First Posted (Actual): March 25, 2025

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: February 23, 2025
• Last Verified: February 1, 2025

More Information

Terms related to this study

• Keywords: Colchicine; HFpEF
• Additional Relevant MeSH Terms: Cardiovascular Diseases; Heart Diseases; Heart Failure; Antineoplastic Agents; Molecular Mechanisms of Pharmacological Action; Gout Suppressants; Antirheumatic Agents; Tubulin Modulators; Antimitotic Agents; Mitosis Modulators; Colchicine
• Other Study ID Numbers: ms-220-2024

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED
• IPD Plan Description: Data will be available upon reasonable request with a corresponding offer.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No