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Colchicine for Primary Prevention of Cardiovascular Disease in Adults With Type 2 Diabetes (Col-DM)

20 de setembro de 2026 atualizado por: Tan Tock Seng Hospital

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.

Visão geral do estudo

Status

Recrutamento

Condições

Intervenção / Tratamento

Descrição detalhada

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 de estudo

Intervencional

Inscrição (Estimado)

300

Estágio

  • Fase 2

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Contato de estudo

Estude backup de contato

Locais de estudo

  • Cingapura
    • Singapore
      • Singapore, Singapore, Cingapura, 308433
        • Recrutamento
        • Tan Tock Seng Hospital
        • Contato:
        • Investigador principal:
          • Rinkoo Dalan, MD, PhD
        • Subinvestigador:
          • Ying Jie Chee, MD
        • Subinvestigador:
          • Rupesh Agrawal, M Med (Ophth), MD (Research)
        • Subinvestigador:
          • Huiling Liew, MD
        • Subinvestigador:
          • Ying Shan Lee, MBBS
        • Subinvestigador:
          • Eugene Fan, MD

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

21 anos a 80 anos (Adulto, Adulto mais velho)

Aceita Voluntários Saudáveis

Não

Gêneros Elegíveis para o Estudo

Tudo

Descrição

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:

  1. Recent hospitalization or acute infections within last 2 weeks.
  2. Current Treatment with corticosteroids or immunosuppressive agents
  3. Pre-existing malignancies or other terminal conditions with limited prognosis
  4. Pregnancy
  5. Breastfeeding
  6. Inability to provide written consent
  7. Renal impairment (eGFR< 60ml/min)
  8. Liver cirrhosis or ALT/AST >3x ULN
  9. Pharmacogenomics indicative of adverse effects
  10. Hypersensitivity to the active substance or to the following excipients: Lactose, Maize starch, Sodium laurilsulfate, Magnesium stearate
  11. Known blood dyscrasia
  12. Women of childbearing age who are keen to conceive in the next 1 year
  13. Taking a strong P-glycoprotein inhibitor (e.g. cyclosporine, ranolazine) or a strong CYP3A4 inhibitor
  14. Known myositis with raised creatine kinase with statins (statin myopathy).
  15. Gout attack within the last 1 year
  16. Currently taking Aspirin
  17. Taking any oral contraceptives

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

  • Finalidade Principal: Prevenção
  • Alocação: Randomizado
  • Modelo Intervencional: Atribuição Paralela
  • Mascaramento: Quadruplicar

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Experimental: Colchicine

Colchicine 0.5 mg orally once daily for 24 weeks, in addition to usual risk-factor-based therapy
Medicamento: Colchicine 0.5 MG Oral Tablet Once Daily

For 24 weeks
Comparador de Placebo: Placebo

Matched placebo orally once daily for 24 weeks, in addition to usual risk-factor-based therapy
Medicamento: Placebo

Matched placebo tablets (identical in size, shape, taste, and packaging to colchicine), once daily, for 24 weeks

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
Change from Baseline in Mean-Maximum Carotid Intima-Media Thickness (Mean-Maximum CIMT)
Prazo: 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

Medidas de resultados secundários

Medida de resultado
Descrição da medida
Prazo
Change from Baseline in Mean Carotid Intima-Media Thickness (avgCIMT)
Prazo: 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
Prazo: 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)
Prazo: 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)
Prazo: 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)
Prazo: 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)
Prazo: 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)
Prazo: 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)
Prazo: 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)
Prazo: 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)
Prazo: 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)
Prazo: 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)
Prazo: 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)
Prazo: 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)
Prazo: 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
Prazo: 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)
Prazo: 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)
Prazo: 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
Prazo: 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)
Prazo: 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)
Prazo: 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)
Prazo: 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
Prazo: 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
Prazo: 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)
Prazo: 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
Prazo: 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

Outras medidas de resultado

Medida de resultado
Descrição da medida
Prazo
Change from Baseline in Gut Microbiome Composition
Prazo: 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)
Prazo: 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
Prazo: 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

Colaboradores e Investigadores

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Patrocinador

Tan Tock Seng Hospital

Colaboradores

Nanyang Technological University

Investigadores

  • Investigador principal: Rinkoo Dalan, MD, PhD, Tan Tock Seng Hospital

Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo (Real)

24 de julho de 2025

Conclusão Primária (Estimado)

31 de julho de 2027

Conclusão do estudo (Estimado)

31 de julho de 2027

Datas de inscrição no estudo

Enviado pela primeira vez

6 de setembro de 2026

Enviado pela primeira vez que atendeu aos critérios de CQ

20 de setembro de 2026

Primeira postagem (Real)

24 de setembro de 2026

Atualizações de registro de estudo

Última Atualização Postada (Real)

24 de setembro de 2026

Última atualização enviada que atendeu aos critérios de controle de qualidade

20 de setembro de 2026

Última verificação

1 de agosto de 2026

Mais Informações

Termos relacionados a este estudo

Palavras-chave

Termos MeSH relevantes adicionais

Outros números de identificação do estudo

  • NHG Health DSRB Ref: 2024-3120

Plano para dados de participantes individuais (IPD)

Planeja compartilhar dados de participantes individuais (IPD)?

NÃO

Descrição do plano 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.

Informações sobre medicamentos e dispositivos, documentos de estudo

Estuda um medicamento regulamentado pela FDA dos EUA

Não

Estuda um produto de dispositivo regulamentado pela FDA dos EUA

Não

produto fabricado e exportado dos EUA

Não

Essas informações foram obtidas diretamente do site clinicaltrials.gov sem nenhuma alteração. Se você tiver alguma solicitação para alterar, remover ou atualizar os detalhes do seu estudo, entre em contato com register@clinicaltrials.gov. Assim que uma alteração for implementada em clinicaltrials.gov, ela também será atualizada automaticamente em nosso site .

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