Colchicine to Reduce Coronary Artery Inflammation in People With HIV

Prior treatment

• Previous MI, stroke or coronary by-pass surgery
• History of non-cutaneus malignancy prior to enrollment
• Participant is receiving drugs that inhibit the CYP3A4 (e.g. Verapamil, Azithromycin, Clarithromycin, protease inhibitors, cobicistat), CYP2D6 or inhibitors of P-glycoprotein (see section 6.3.2 for more information)
• Participant needs treatment with colchicine for any indication
• Postmenopausal state, defined as no menses for 12 months without an alternative medical cause. A high follicle stimulating hormone (FSH) level in the postmenopausal range may be used to confirm a post-menopausal state in women not using hormonal contraception or hormonal replacement therapy. However in the absence of 12 months of amenorrhea, a single FSH measurement is insufficient.
• Known iodine contrast allergy with prior history of anaphylaxis

Other illness

• History of inflammatory bowel disease or chronic diarrhoea
• Participants with stomach ulcers or gastrointestinal bleeding
• Known hypersensitivity to the active substances or any of the excipients

Lab values

• Severe Heart failure defined as LVEF \< 35%.
• Renal dysfunctions defined as eGFR \< 50 ml/min or serum creatinine levels \> 1.7 mg/dL
• Levels of ALT over five times the upper limit of normal OR levels of ALT over three times the upper limit of normal AND bilirrubin levels over one point five times the upper limit of normal
• Participants with highly elevated hsCRP \> 10 mg/dL at screening

Other

• Severe hepatic impairments defined as a Child-Pugh category C
• Women of childbearing potential. For this trial, definitions of nonchildbearing potential includes:
• Permanent sterilisation methods including hysterectomy, bilateral salpingectomy and bilateral oophorectomy.
• Male participants are considered fertile after puberty unless permanently sterile by bilateral orchiectomy. To prevent pregnancies in female partners of male participants, they must agree to use highly effective contraceptive methods or have practiced sexual abstinence during the treatment period and until the end of relevant systemic exposure, defined as 5 half-lives of the IMP (9 days approximately).
• Patient without legal capacity who is unable to understand the nature, significance and consequences of the trial.

• PWH \> 50 years old
• High cardiovascular risk measured by SCORE-2 \> 5%
• Stable antiretroviral therapy (ART) in the previous six months
• Viral load \< 50 copies/mililiter for at least 1 year. One blip is allowed (Viral load between 20-200 copies/mililiter with a previous and after viral load determinations \< 20 copies per mililiter.
• CD4 cell count \> 350 cells/mm3
• Stable dose of an intermediate or high intensity statin in the previous year (statin dose should not be modified throghout the study unless there is a robust clinical indication). In case the participant does not receive statins, all other hypolipemiants (bempedoic acid, ezetimibe) will need to be at a stable dose as well in the previous year.
• No clinical indication for a change in treatment based on European Society of Cardiology Guidelines
• Written informed consent obtained according to international guidelines and local laws
• Ability to understand the nature of the trial and the trial related procedures and to comply with them