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Effekt av kolchicin på progresjon av koronar aterosklerose hos pasienter med TET2-CHIP-variant

30. september 2026 oppdatert av: Han Yaling, Shenyang Northern Hospital

Effekten av kolchicin på progresjon av koronar aterosklerose hos pasienter med TET2-CHIP-variant: en pilot klinisk studie (COLCHIP-Pilot)

This study aims to investigate whether TET2-associated clonal hematopoiesis of indeterminate potential (TET2-CHIP) can serve as a biomarker to guide precision use of colchicine in a population of clinically stable post-ACS patients receiving standard of care (SoC) therapy. Specifically, we will evaluate whether TET2-CHIP status predicts a differential response to colchicine. As a pilot study, it also aims to provide detailed data supporting design of further trial, such as sample size calculating, endpoint optimizing, etc.

Studieoversikt

Detaljert beskrivelse

This is a single-center, prospective, randomized, open-label, assessor-blinded pilot trial. A total of 120 patients will be enrolled and stratified by CHIP variant status into a TET2-CHIP group or a non-CHIP group. TET2-CHIP group (N = 60): Participants will be randomized (1:1) to colchicine 0.5 mg once daily plus SoC therapy (n = 30) or SoC therapy alone (control; n = 30). Non-CHIP group (N = 60): Participants will be randomized (1:1) to colchicine 0.5 mg once daily plus SoC therapy (n = 30) or SoC therapy alone (control; n = 30). SoC therapy includes but is not limited to appropriate lipid lowering, anti-platelet therapy, anti-hypertensive and beta blockers as defined by local guidelines. Patients should also be instructed to follow heart healthy (low fat) diet and regular exercise program. The index qualifying ACS must have occurred at least 30 days and no more than 90 days prior to randomization.

Baseline assessment for all participants will include coronary CT angiography (CCTA) using photon-counting detector CT (PCD-CT), inflammatory biomarkers testing and CHIP variant sequencing. After randomization, participants will have visits at Month 0, 1, 3, 6, 9, and 12. Repeat CCTA for the assessment of coronary plaque will occur during the Month 12 visit. The primary endpoint is the percent change in total plaque volume in non-culprit coronary lesion from baseline to Month 12, measured by CCTA. Secondary endpoints include the percent change in other plaques (calcified plaque, noncalcified plaque, low attenuation plaque, and fibrotic plaque) volume of coronary artery plaque from baseline to Month 12; change in levels of inflammatory biomarkers (IL-6, IL-1β, IL-18, hs-CRP, and S100A12); change in the TET2-CHIP variant allele fraction; and major adverse cardiovascular events (MACE), defined as a composite of all-cause death, nonfatal myocardial infarction, nonfatal stroke, and ischemia-driven revascularization. Participants will be followed for 12 months.

Studietype

Intervensjonell

Registrering (Antatt)

120

Fase

  • Fase 4

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

  • Navn: Zaixin Jiang, MD, PhD
  • Telefonnummer: +8618646330195
  • E-post: jzxdr2013@163.com

Studiesteder

    • Liaoning
      • Shenyang, Liaoning, Kina
        • Rekruttering
        • General Hospital of Northern Theater Command
        • Hovedetterforsker:
          • Yaling Han, MD, PhD
        • Ta kontakt med:

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

40 år til 85 år (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

Inclusion Criteria:

  1. Age 40-85 years;

  2. Patients with recent hospitalization for documented ACS (the index event occurring 30-90 days before randomization) and meeting all of the following:

    1. During the index hospitalization, patients underwent either PCI or diagnostic coronary angiography alone,
    2. At least one non-culprit coronary lesion with 30%-70% diameter stenosis by visual estimation on coronary angiography,
    3. Clinically stable throughout the screening period,
    4. Receiving standard of care therapy for ACS in accordance with national guidelines,
    5. Peripheral blood DNA available for targeted sequencing, with results demonstrating either TET2-CHIP or no CHIP-associated variants;
  3. Written informed consent.

Exclusion Criteria:

  1. Prior coronary artery bypass grafting (CABG) before documented ACS;
  2. Other clinically significant cardiovascular diseases, including moderate-to-severe valvular heart disease (moderate or severe), heart failure (NYHA class III-IV), or atrial fibrillation;
  3. Non-culprit coronary anatomy (e.g., marked tortuosity, bifurcation lesions, or small vessels <1.5 mm in diameter) deemed to preclude plaque assessment by CCTA;
  4. Planned PCI or CABG;
  5. Abnormal liver function (ALT >3 times the upper limit of normal range) at randomization;
  6. Abnormal renal function (serum creatinine >1.5 times the upper limit of normal range or estimated eGFR <45 mL/min/1.73 m²) at randomization;
  7. Hematologic abnormalities: anemia (hemoglobin <100g/L), thrombocytopenia (platelet count <100×109/L) or leukopenia (white blood cell <3×109/L) at randomization;
  8. Inflammatory bowel disease (Crohn's or ulcerative colitis) or active diarrhea;
  9. Symptomatic peripheral neuropathy, pre-existing progressive neuromuscular disease or creatine kinase (CK) level > 3 times the upper limit of normal range as measured within the past 30 days and determined to be non-transient through repeat testing;
  10. Pregnancy, breastfeeding, or women of childbearing potential who are not using an effective method of contraception;
  11. Any contraindication, known allergy or intolerance to colchicine;
  12. Colchicine use within 30 days prior to randomization, or planned colchicine therapy for other indications;
  13. Current or planned use of any of cyclosporine, verapamil, HIV protease inhibitors, azole antifungals, or macrolide antibiotics;
  14. Existing or planned treatment with other anti-inflammatory or immunosuppressive drugs;
  15. History of malignancy (hematologic or solid-tumor);
  16. History of transplantation (hematopoietic stem cell or solid-organ);
  17. Significant radiation exposure (≥40 mSv) within the past 12 months;
  18. Known hypersensitivity to iodinated contrast media or uncontrolled active hyperthyroidism;
  19. Current enrollment in another clinical trial;
  20. A predicted life expectancy < 1 year;
  21. Any other circumstances in which the investigator judges that the patient is not suitable to participate in the clinical trial.

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Enkelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Colchicine with SoC therapy (TET2-CHIP group)

Participants with TET2-CHIP will receive colchicine 0.5 mg orally once daily plus standard of care (SoC) therapy for 12 months.

SoC therapy includes but is not limited to appropriate lipid lowering, anti-platelet therapy, anti-hypertensive and beta blockers as defined by local guidelines.

SoC therapy

Ingen inngripen: SoC therapy alone (TET2-CHIP group)

Participants with TET2-CHIP will receive SoC therapy alone (no colchicine) for 12 months.

Eksperimentell: Colchicine with SoC therapy (non-CHIP group)

Participants without CHIP-associated variants will receive colchicine 0.5 mg orally once daily plus standard of care (SoC) therapy for 12 months.

SoC therapy includes but is not limited to appropriate lipid lowering, anti-platelet therapy, anti-hypertensive and beta blockers as defined by local guidelines.

SoC therapy

Ingen inngripen: SoC therapy alone (non-CHIP group)

Participants without CHIP-associated variants will receive SoC therapy alone (no colchicine) for 12 months.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Percent change in total plaque volume of coronary artery plaque
Tidsramme: Up to 12 months

Percent change in total plaque volume of coronary artery plaque measured by CCTA

Up to 12 months

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Percent change in other plaques (calcified plaque, noncalcified plaque, low attenuation plaque, and fibrotic plaque) volume of coronary artery plaque
Tidsramme: Up to 12 months

Percent change in other plaques (calcified plaque, noncalcified plaque, low attenuation plaque, and fibrotic plaque) volume of coronary artery plaque measured by CCTA.

Up to 12 months
Change in levels of inflammatory biomarkers
Tidsramme: Up to 12 months

Change in levels of circulating IL-6, IL-1β, IL-18, hs-CRP, and S100A12.

Up to 12 months
Change in TET2-CHIP variant allele fraction at 6 months
Tidsramme: Up to 6 months

Change in TET2-CHIP variant allele fraction measured by next generation sequencing.

Up to 6 months
Change in TET2-CHIP variant allele fraction at 12 months
Tidsramme: Up to 12months

Change in TET2-CHIP variant allele fraction measured by next generation sequencing.

Up to 12months
Major adverse cardiovascular events (MACE)
Tidsramme: Up to 12 months

A composite of all-cause death, nonfatal myocardial infarction, nonfatal stroke, and ischemia-driven revascularization.

Up to 12 months

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Etterforskere

  • Studiestol: Yaling Han, MD, PhD, The General Hospital of Northern Theater Command

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

8. juni 2026

Primær fullføring (Antatt)

1. desember 2027

Studiet fullført (Antatt)

1. desember 2027

Datoer for studieregistrering

Først innsendt

15. januar 2026

Først innsendt som oppfylte QC-kriteriene

22. januar 2026

Først lagt ut (Faktiske)

23. januar 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

1. oktober 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

30. september 2026

Sist bekreftet

1. januar 2026

Mer informasjon

Begreper knyttet til denne studien

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • PRECISE

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

NEI

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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