Colchicine for Primary Prevention of Cardiovascular Disease in Adults With Type 2 Diabetes (Col-DM)
The Role of Colchicine in Preventing Atherosclerotic Cardiovascular Disease in Type 2 Diabetes (Col-DM Study)
This study will test whether a low-cost anti-inflammatory medicine called colchicine can help protect the blood vessels of people with type 2 diabetes. Diabetes speeds up hardening of the arteries (atherosclerosis), partly because of ongoing low-grade inflammation. Colchicine has already been shown to help prevent heart attacks and strokes in people who already have heart disease; this study looks at whether it can also help prevent early blood vessel damage before heart disease develops. Around 300 adults with type 2 diabetes will be randomly assigned to take colchicine or a placebo (dummy pill) once daily for 24 weeks, in addition to their usual diabetes and heart-risk medications. Neither participants nor the study team will know who is taking colchicine or placebo. The main measurement will be the change in the thickness of the wall of the neck (carotid) artery, measured by ultrasound, which is an early sign of blood vessel disease. The study will also look at markers of inflammation in the blood, blood vessel stiffness and function, and changes in the gut bacteria.
Panoramica dello studio
Stato
Stato
Condizioni
Condizioni
Intervento / Trattamento
Intervento / Trattamento
Descrizione dettagliata
Cardiovascular disease remains the leading cause of death in T2DM, occurring earlier and at substantially higher rates than in the general population. Despite optimisation of conventional risk factors, residual cardiovascular risk remains high, with chronic low-grade inflammation driven by dysregulated neutrophil activity recognised as a key contributor. Patients with T2DM exhibit a distinct pro-inflammatory neutrophil phenotype characterised by increased neutrophil extracellular trap (NET) formation, heightened endothelial adherence, and altered rolling kinetics, which correlates with impaired vascular function and subclinical atherosclerosis.
Colchicine inhibits neutrophil activation, migration, and NET formation, and has demonstrated efficacy in secondary cardiovascular prevention in large randomised trials. Evidence in primary prevention, particularly in T2DM, remains limited. Col-DM takes a precision medicine approach, hypothesising that colchicine's benefit will be concentrated among T2DM patients with a high-risk inflamed neutrophil signature rather than being uniform across the broader population.
Col-DM is a 24-week, parallel-group, Phase 2 randomised controlled trial. Adults with T2DM and no prior atherosclerotic cardiovascular disease are randomised 1:1 to colchicine 0.5 mg daily or matched placebo, stratified by neutrophil inflammatory phenotype classified using a microfluidic organ-on-chip platform. The primary outcome is progression of carotid intima-media thickness (CIMT), estimated overall and separately within each neutrophil-signature stratum. Secondary outcomes cover vascular function, inflammatory and oxidative stress biomarkers, and thrombotic potential. Gut microbiome composition is examined as an exploratory outcome. All outcome measures are estimated overall and separately within each neutrophil-signature stratum. Safety is monitored by an independent Data and Safety Monitoring Committee.
Tipo di studio
Tipo di studio
Iscrizione (Stimato)
Iscrizione
Fase
Fase
- Fase 2
Contatti e Sedi
Contatto studio
Contatto studio
- Nome: Sanchalika Acharyya, PhD, MPH
- Numero di telefono: 96150202
- Email: sanchalika.acharyya@nhghealth.com.sg
Backup dei contatti dello studio
- Nome: Shirley Lin Shangmei
- Email: ttsh.p2p.research@nhghealth.com.sg
Luoghi di studio
-
-
Singapore
-
Singapore, Singapore, Singapore, 308433
- Reclutamento
- Tan Tock Seng Hospital
-
Contatto:
- Rinkoo Dalan, MD, PhD
- Numero di telefono: 65-6357100
- Email: rinkoo.dalan@nhghealth.com.sg
-
Investigatore principale:
- Rinkoo Dalan, MD, PhD
-
Sub-investigatore:
- Ying Jie Chee, MD
-
Sub-investigatore:
- Rupesh Agrawal, M Med (Ophth), MD (Research)
-
Sub-investigatore:
- Huiling Liew, MD
-
Sub-investigatore:
- Ying Shan Lee, MBBS
-
Sub-investigatore:
- Eugene Fan, MD
-
-
Criteri di partecipazione
Criteri di ammissibilità
Criteri di ammissibilità
Età idonea allo studio
Accetta volontari sani
Sessi ammissibili allo studio
Descrizione
Inclusion Criteria:
- T2DM on stable diabetes medications (no change in last 3 months)
- At least one other comorbidity of hypertension, dyslipidaemia and/or obesity (BMI ≥27), with no previous history of ASCVD
- Able to provide informed consent
Exclusion Criteria:
- Recent hospitalization or acute infections within last 2 weeks.
- Current Treatment with corticosteroids or immunosuppressive agents
- Pre-existing malignancies or other terminal conditions with limited prognosis
- Pregnancy
- Breastfeeding
- Inability to provide written consent
- Renal impairment (eGFR< 60ml/min)
- Liver cirrhosis or ALT/AST >3x ULN
- Pharmacogenomics indicative of adverse effects
- Hypersensitivity to the active substance or to the following excipients: Lactose, Maize starch, Sodium laurilsulfate, Magnesium stearate
- Known blood dyscrasia
- Women of childbearing age who are keen to conceive in the next 1 year
- Taking a strong P-glycoprotein inhibitor (e.g. cyclosporine, ranolazine) or a strong CYP3A4 inhibitor
- Known myositis with raised creatine kinase with statins (statin myopathy).
- Gout attack within the last 1 year
- Currently taking Aspirin
- Taking any oral contraceptives
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Prevenzione
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Quadruplicare
Numero di armi
Armi e interventi
Gruppo di partecipanti / ArmGruppo di partecipanti / Arm |
Intervento / TrattamentoIntervento / Trattamento |
|---|---|
|
Sperimentale: Colchicine
Colchicine 0.5 mg orally once daily for 24 weeks, in addition to usual risk-factor-based therapy |
For 24 weeks |
|
Comparatore placebo: Placebo
Matched placebo orally once daily for 24 weeks, in addition to usual risk-factor-based therapy |
Matched placebo tablets (identical in size, shape, taste, and packaging to colchicine), once daily, for 24 weeks |
Cosa sta misurando lo studio?
Misure di risultato primarie
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Change from Baseline in Mean-Maximum Carotid Intima-Media Thickness (Mean-Maximum CIMT)
Lasso di tempo: Baseline and 24 weeks
|
Mean-maximum CIMT is defined as the average of the maximum CIMT values obtained from the far wall of the left and right common carotid arteries, each derived from six measurements taken across three projections (lateral, anterior, and posterior) at 1 cm proximal to the carotid bifurcation, measured by high-resolution B-mode carotid ultrasonography. |
Baseline and 24 weeks
|
Misure di risultato secondarie
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Change from Baseline in Mean Carotid Intima-Media Thickness (avgCIMT)
Lasso di tempo: Baseline and 24 weeks
|
Mean CIMT (avgCIMT) is defined as the average of all twelve individual IMT measurements obtained from the far wall of the left and right common carotid arteries (six measurements per side), measured by high-resolution B-mode carotid ultrasonography. |
Baseline and 24 weeks
|
|
Change from Baseline in Carotid Plaque Volume
Lasso di tempo: Baseline and 24 weeks
|
Carotid plaque volume is measured using 3D plaque volume software following standard acquisition protocol in participants with identified carotid plaque on ultrasonography. |
Baseline and 24 weeks
|
|
Change from Baseline in Endothelial Function (Flow-Mediated Dilation)
Lasso di tempo: Baseline and 24 weeks
|
Endothelial function is assessed by flow-mediated dilation (FMD) of the brachial artery using high-resolution ultrasound, expressed as the percentage change in brachial artery diameter following reactive hyperaemia. |
Baseline and 24 weeks
|
|
Change from Baseline in Microvascular Reactivity (Reactive Hyperaemia Index)
Lasso di tempo: Baseline and 24 weeks
|
Microvascular reactivity is assessed by the reactive hyperaemia index (RHI) measured using EndoPAT, a non-invasive device that quantifies peripheral arterial tone response to forearm occlusion. |
Baseline and 24 weeks
|
|
Change from Baseline in Arterial Stiffness (Pulse Wave Velocity)
Lasso di tempo: Baseline and 24 weeks
|
Arterial stiffness is assessed by carotid-femoral pulse wave velocity (PWV) measured using SphygmoCor XCEL, a validated applanation tonometry-based device. |
Baseline and 24 weeks
|
|
Change from Baseline in Arterial Stiffness (Cardio-Ankle Vascular Index)
Lasso di tempo: Baseline and 24 weeks
|
Arterial stiffness is additionally assessed by the cardio-ankle vascular index (CAVI), a measure of arterial stiffness from the origin of the aorta to the ankle that is less dependent on blood pressure at the time of measurement. |
Baseline and 24 weeks
|
|
Change from Baseline in Skin Advanced Glycation End Products (Skin Autofluorescence)
Lasso di tempo: Baseline and 24 weeks
|
Tissue advanced glycation end product (AGE) accumulation is measured non-invasively using the AGE Reader, which quantifies skin autofluorescence using ultraviolet light excitation. |
Baseline and 24 weeks
|
|
Change from Baseline in Retinal Layer Thickness (Optical Coherence Tomography)
Lasso di tempo: Baseline and 24 weeks
|
Retinal layer thickness is measured by optical coherence tomography (OCT) as a surrogate of retinal and systemic microvascular health. |
Baseline and 24 weeks
|
|
Change from Baseline in Retinal Microvascular Density (Optical Coherence Tomography Angiography)
Lasso di tempo: Baseline and 24 weeks
|
Retinal microvascular density is measured by optical coherence tomography angiography (OCTA) as a surrogate of systemic microvascular health. |
Baseline and 24 weeks
|
|
Change from Baseline in High-Sensitivity C-Reactive Protein (hsCRP)
Lasso di tempo: Baseline and 24 weeks
|
Serum high-sensitivity C-reactive protein (hsCRP) is measured as a marker of systemic inflammation. |
Baseline and 24 weeks
|
|
Change from Baseline in Interleukin-6 (IL-6)
Lasso di tempo: Baseline and 24 weeks
|
Plasma interleukin-6 (IL-6) is measured as a marker of systemic inflammation and cytokine activity. |
Baseline and 24 weeks
|
|
Change from Baseline in Plasminogen Activator Inhibitor-1 (PAI-1)
Lasso di tempo: Baseline and 24 weeks
|
Plasma plasminogen activator inhibitor-1 (PAI-1) is measured as a marker of impaired fibrinolysis and endothelial dysfunction. |
Baseline and 24 weeks
|
|
Change from Baseline in Cell-Free DNA (NETosis Marker)
Lasso di tempo: Baseline and 24 weeks
|
Plasma cell-free DNA is measured as a marker of neutrophil extracellular trap (NET) formation and neutrophil-mediated inflammatory activity. |
Baseline and 24 weeks
|
|
Change from Baseline in Citrullinated Histone H3 (NETosis Marker)
Lasso di tempo: Baseline and 24 weeks
|
Plasma citrullinated histone H3 is measured as a specific marker of neutrophil extracellular trap (NET) formation and NETosis. |
Baseline and 24 weeks
|
|
Change from Baseline in E-selectin
Lasso di tempo: Baseline and 24 weeks
|
Plasma E-selectin is measured as a marker of endothelial activation and inflammation. |
Baseline and 24 weeks
|
|
Change from Baseline in Intercellular Adhesion Molecule-1 (ICAM-1)
Lasso di tempo: Baseline and 24 weeks
|
Plasma ICAM-1 is measured as a marker of endothelial activation and leucocyte adhesion. |
Baseline and 24 weeks
|
|
Change from Baseline in Vascular Cell Adhesion Molecule-1 (VCAM-1)
Lasso di tempo: Baseline and 24 weeks
|
Plasma VCAM-1 is measured as a marker of endothelial activation and vascular inflammation. |
Baseline and 24 weeks
|
|
Change from Baseline in Oxidative Stress Index
Lasso di tempo: Baseline and 24 weeks
|
An integrated oxidative stress index is derived from nuclear magnetic resonance (NMR)-based redox profiling of plasma and erythrocytes, providing a composite measure of systemic oxidative stress. |
Baseline and 24 weeks
|
|
Change from Baseline in Thrombotic Potential (Clot Waveform Analysis)
Lasso di tempo: Baseline and 24 weeks
|
Clot waveform analysis is performed to characterise the kinetics of clot formation and fibrinolysis in plasma as a measure of overall thrombotic potential. |
Baseline and 24 weeks
|
|
Change from Baseline in Von Willebrand Factor Antigen (VWF:Ag)
Lasso di tempo: Baseline and 24 weeks
|
Plasma von Willebrand factor antigen (VWF:Ag) is measured as a marker of endothelial activation and thrombotic risk. |
Baseline and 24 weeks
|
|
Change from Baseline in Von Willebrand Factor Activity (VWF:Act)
Lasso di tempo: Baseline and 24 weeks
|
Plasma von Willebrand factor activity (VWF:Act) is measured as a functional marker of thrombotic risk and platelet adhesion capacity. |
Baseline and 24 weeks
|
|
Change from Baseline in Factor VIII
Lasso di tempo: Baseline and 24 weeks
|
Plasma factor VIII levels are measured as a marker of coagulation activation and thrombotic potential. |
Baseline and 24 weeks
|
|
Change from Baseline in Thrombin Generation
Lasso di tempo: Baseline and 24 weeks
|
Thrombin generation is measured using a calibrated automated thrombogram to assess overall coagulation potential and thrombotic risk. |
Baseline and 24 weeks
|
|
Change from Baseline in Oxidised LDL (Ox-LDL)
Lasso di tempo: Baseline and 24 weeks
|
Plasma oxidised LDL (Ox-LDL) is measured by nuclear magnetic resonance (NMR) spectroscopy as a marker of lipid oxidation and atherogenic risk. |
Baseline and 24 weeks
|
|
Change from Baseline in Atherogenic Lipid Subfractions
Lasso di tempo: Baseline and 24 weeks
|
Atherogenic lipid subfractions are characterised by nuclear magnetic resonance (NMR) spectroscopy, providing detailed lipoprotein particle profiling beyond standard lipid panels. |
Baseline and 24 weeks
|
Altre misure di risultato
Altre misure di risultato
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Change from Baseline in Gut Microbiome Composition
Lasso di tempo: Baseline and 24 weeks
|
Gut microbiome composition is characterised from stool samples by metagenomic sequencing, to examine whether colchicine-associated shifts in microbial composition relate to treatment response. |
Baseline and 24 weeks
|
|
Change from Baseline in Plasma Metabolite Profile (Metabolomics)
Lasso di tempo: Baseline and 24 weeks
|
As an exploratory analysis, plasma metabolomic profiling will be performed on stored blood samples to characterise changes in the metabolite profile over 24 weeks. |
Baseline and 24 weeks
|
|
Incidence of Adverse Events and Serious Adverse Events
Lasso di tempo: From randomisation through 24 weeks
|
Safety is assessed by the incidence of adverse events (AEs) and serious adverse events (SAEs), defined per standard regulatory criteria, ascertained at each study visit and telephone contact, and adjudicated by an independent Data and Safety Monitoring Committee. |
From randomisation through 24 weeks
|
Collaboratori e investigatori
Sponsor
Sponsor
Collaboratori
Collaboratori
Investigatori
Investigatori
- Investigatore principale: Rinkoo Dalan, MD, PhD, Tan Tock Seng Hospital
Studiare le date dei record
Studia le date principali
Inizio studio (Effettivo)
Inizio studio
Completamento primario (Stimato)
Completamento primario
Completamento dello studio (Stimato)
Completamento dello studio
Date di iscrizione allo studio
Primo inviato
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Primo Inserito
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento pubblicato
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Parole chiave
Termini MeSH pertinenti aggiuntivi
- Malattie del sistema endocrino
- Malattie vascolari
- Processi patologici
- Malattie metaboliche
- Disturbi del metabolismo del glucosio
- Diabete mellito
- Arteriosclerosi
- Malattie arteriose occlusive
- Condizioni patologiche, segni e sintomi
- Malattie nutrizionali e metaboliche
- Diabete mellito, tipo 2
- Malattia cardiovascolare
- Infiammazione
- Aterosclerosi
- Composti eterociclici
- Alcaloidi
- Colchicina
Altri numeri di identificazione dello studio
Altri numeri di identificazione dello studio
- NHG Health DSRB Ref: 2024-3120
Piano per i dati dei singoli partecipanti (IPD)
Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?
Descrizione del piano IPD
The individual participant data will not be publicly shared due to patient confidentiality restrictions and institutional data governance requirements. Researchers seeking access for secondary analyses may contact the study team to discuss feasibility, subject to a formal data sharing or research collaboration agreement with the institution.
Informazioni su farmaci e dispositivi, documenti di studio
Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti
Studia un dispositivo regolamentato dalla FDA degli Stati Uniti
prodotto fabbricato ed esportato dagli Stati Uniti
Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .