Colchicine for Prevention of Vascular Inflammation in Non-cardio Embolic Stroke

Prior treatment

• Concurrent treatment with moderate or strong CYP3A4 inhibitors (clarithromycin, erythromycin, telithromycin, other macrolide antibiotics, ketoconazole, itraconazole, voriconazole, ritonavir, atazanavir, indinavir, other HIV protease inhibitors, verapamil, diltiazem, quinidine, digoxin, disulfiram) or P-gp inhibitors (cyclosporine) at randomisation.
• Inflammatory bowel disease (Crohn's or ulcerative colitis) or chronic diarrhoea.
  • 9\. Dementia, sufficient to impair independence in basic activities of daily living.
  • 10\. Active malignancy, known hepatitis B or C, or HIV infection prior to qualifying stroke/TIA.
  • 11\. Impaired swallow preventing oral administration of study medication. 12. History of poor medication compliance. 13. Unlikely to comply with study procedures and follow-up visits due to severe or fatal comorbid illness or other factor (eg. inability to travel for follow up visits), in opinion of randomising physician.
  • 14\. Pregnancy, breast-feeding, or pre-menopausal women 15. Patient concurrently participating in another clinical trial with an investigational drug or device, or use of investigational drug within 30 days or 5 half-lives before the Screening visit (whichever is longer) 16. Known allergy or sensitivity to colchicine.

Other illness

• Cardio-embolic stroke/TIA, probably caused by identified atrial fibrillation (permanent or paroxysmal), in the opinion of the treating physician.
• Stroke/TIA caused by dissection, endocarditis, paradoxical embolism, drug use, venous thrombosis, within 48 hours aftercarotid or cardiac surgery, hypercoagulability states, migraine, or inherited cerebrovascular disorders (eg. Fabry's disease, CADASIL), in the opinion of the treating physician.
• History of myopathy or myalgias with raised creatine kinase (CK) on statin therapy.
• Symptomatic peripheral neuropathy and pre-existing progressive neuromuscular disease

Lab values

• Cardio-embolic stroke/TIA probably caused by other identified cardiac source (intra-cardiac thrombus, endocarditis, metallic heart valve, low ejection fraction \<30%), in the opinion of the treating physician.
• Blood dyscrasia defined as anaemia (haemoglobin \<10g/dL), thrombocytopenia (platelet count \<150 x109/L) or leucopenia (white cell count \<4 x109/L) at randomisation.
• Impaired hepatic function (transaminases greater than twice upper limit of normal) at randomisation.

• Written informed consent consistent with ICH-GCP guidelines and local laws signed prior to all trial-related procedures.
• Age 40 years or greater
• Either,
  • ischaemic stroke without major disability (modified Rankin score 3 or less)
  • or high-risk TIA
• Qualifying stroke/TIA probably caused by large artery stenosis, small artery occlusion (lacunar stroke), or cryptogenic embolism, with cardiac embolism or other defined stroke mechanism deemed unlikely in the opinion of the treating physician.
• GFRgreater than or equal to 50 ml/min.
• In the opinion of the treating physician, patient is medically-stable, capable of participating in a randomised trial, and willing to attend follow-up.