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    Clinical Trial Results:
    Effect of colchicine on cardiovascular target organ damage in patients with type 2 diabetes - A randomized placebo-controlled trial

    Summary
    EudraCT number
    2021-003525-30
    Trial protocol
    DK  
    Global end of trial date
    11 Dec 2023

    Results information
    Results version number
    v1(current)
    This version publication date
    02 Oct 2024
    First version publication date
    02 Oct 2024
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    COLCAD
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    -
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Aarhus University Hospital, Steno Diabetes Center Aarhus
    Sponsor organisation address
    Palle Juul-Jensens Blvd. 11, Aarhus N, Denmark, 8200
    Public contact
    Medical/Steno Aarhus Research Lab, Aarhus University Hospital, Steno Diabetes Center Aarhus, baier@clin.au.dk
    Scientific contact
    Medical/Steno Aarhus Research Lab, Aarhus University Hospital, Steno Diabetes Center Aarhus, baier@clin.au.dk
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    28 Aug 2024
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    11 Dec 2023
    Global end of trial reached?
    Yes
    Global end of trial date
    11 Dec 2023
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The primary objective is to evaluate the effect of colchicine on arterial stiffness assessed as carotid-femoral pulse wave velocity compared to placebo in patients with type 2 diabetes.
    Protection of trial subjects
    Ethical Approval: The trial was conducted in accordance with the Declaration of Helsinki and the International Conference on Harmonisation (ICH) Good Clinical Practice (GCP) guidelines. The study protocol, informed consent forms, and all other study-related documents were reviewed and approved by an independent ethics committee (IEC) or institutional review board (IRB) before the initiation of the trial. Informed Consent: Prior to participation, all subjects were provided with comprehensive information regarding the study’s purpose, procedures, potential risks, and benefits. Written informed consent was obtained from each participant before any study-related procedures were conducted. Participants were informed of their right to withdraw from the study at any time without penalty or loss of benefits to which they were otherwise entitled. Confidentiality: The confidentiality of participants' data was strictly maintained throughout the study. Personal identifiers were replaced with unique codes to protect participants’ identities. Access to the data was restricted to authorized personnel only, and all data handling complied with applicable data protection regulations, including the General Data Protection Regulation (GDPR). Monitoring: The trial was conducted in accordance with Good Clinical practice and was monitored by a local independent GCP-monitoring unit. Any unexpected risks or adverse effects were promptly reported to the IEC/IRB, regulatory authorities, and study participants as necessary. Risk Minimization: The study was designed to minimize risks to participants. Measures included regular monitoring of participants' health, provision of rescue medication or interventions as needed, and pre-specified stopping rules for individual participants or the entire trial in case of significant safety concerns.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    01 Mar 2022
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Denmark: 100
    Worldwide total number of subjects
    100
    EEA total number of subjects
    100
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    19
    From 65 to 84 years
    81
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    The screening process involved identifying potential participants, obtaining informed consent, and assessing eligibility based on inclusion/exclusion criteria through medical history, physical exams, and necessary tests. Ineligible individuals were excluded, and their data were handled confidentially. Only eligible participants proceeded to randomi

    Period 1
    Period 1 title
    Overall trial (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator, Monitor, Data analyst
    Blinding implementation details
    Blinding was implemented by assigning participants to study groups using a computer-generated randomization code, kept confidential by an independent third party. Investigators, participants, and outcome assessors were blinded to group assignments. Colchicine/placeboe were identical in appearance, packaging, and labeling, ensuring that neither participants nor staff could distinguish between them, maintaining blinding integrity throughout the trial.

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Active
    Arm description
    Colchicine 0.5 mg once daily
    Arm type
    Active comparator

    Investigational medicinal product name
    Colchicine
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Coated tablet
    Routes of administration
    Oral use
    Dosage and administration details
    1 tablet (0.5 mg) once daily

    Arm title
    Placebo
    Arm description
    Placebo
    Arm type
    Placebo

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Coated tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Placebo, one tablet once daily

    Number of subjects in period 1
    Active Placebo
    Started
    50
    50
    Completed
    48
    47
    Not completed
    2
    3
         Consent withdrawn by subject
    1
    2
         Adverse event, non-fatal
    1
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Active
    Reporting group description
    Colchicine 0.5 mg once daily

    Reporting group title
    Placebo
    Reporting group description
    Placebo

    Reporting group values
    Active Placebo Total
    Number of subjects
    50 50 100
    Age categorical
    Units: Subjects
        Adults (18-64 years)
    10 9 19
        From 65-84 years
    40 41 81
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    70 ( 6 ) 72 ( 7 ) -
    Gender categorical
    Units: Subjects
        Female
    10 7 17
        Male
    40 43 83
    History of cardiovascular disease
    Units: Subjects
        Yes
    28 35 63
        No
    22 15 37
    Current smoking
    Units: Subjects
        Yes
    7 5 12
        No
    43 45 88
    Renal function stage 1 or 2
    Units: Subjects
        Yes
    45 44 89
        No
    5 6 11
    Renal function stage 3a
    Units: Subjects
        Yes
    5 6 11
        No
    45 44 89
    Metformin use
    Units: Subjects
        Yes
    44 44 88
        No
    6 6 12
    SGLT2i use
    Units: Subjects
        Yes
    23 26 49
        No
    27 24 51
    GLP-1 RA use
    Units: Subjects
        Yes
    22 22 44
        No
    28 28 56
    Insulin use
    Units: Subjects
        Yes
    13 20 33
        No
    37 30 67
    Any lipid lowering agent
    Units: Subjects
        Yes
    46 48 94
        No
    4 2 6
    Antiplatelet therapy
    Units: Subjects
        Yes
    29 33 62
        No
    21 17 38
    Anticoagulant
    Units: Subjects
        Yes
    7 13 20
        No
    43 37 80
    Single antihypertensive agent
    Units: Subjects
        Yes
    12 7 19
        No
    38 43 81
    Two or more antihypertensive agents
    Units: Subjects
        Yes
    38 39 77
        No
    12 11 23
    Body mass index
    Units: kg/m2
        arithmetic mean (standard deviation)
    29.7 ( 4.8 ) 30.8 ( 4.9 ) -
    Diabetes duration
    Units: years
        median (inter-quartile range (Q1-Q3))
    15 (10 to 18) 15 (10 to 20) -
    24 h systolic blood pressure
    Units: mmHg
        arithmetic mean (standard deviation)
    127 ( 13 ) 126 ( 12 ) -
    24 h diastolic blood pressure
    Units: mmHg
        arithmetic mean (standard deviation)
    76 ( 8 ) 76 ( 7 ) -
    Heart rate
    Units: Beats per minute
        arithmetic mean (standard deviation)
    73 ( 14 ) 75 ( 12 ) -
    HbA1c
    Units: mmol/mol
        arithmetic mean (standard deviation)
    56 ( 7 ) 56 ( 8 ) -
    LDL Cholesterol
    Units: mmol/l
        median (inter-quartile range (Q1-Q3))
    1.5 (1.2 to 1.8) 1.6 (1.2 to 1.9) -
    UACR
    Units: mg/g
        median (inter-quartile range (Q1-Q3))
    12 (3 to 90) 16 (5 to 93) -
    hsCRP
    Units: mg/l
        median (inter-quartile range (Q1-Q3))
    1.0 (0.4 to 2.3) 0.9 (0.5 to 2.1) -

    End points

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    End points reporting groups
    Reporting group title
    Active
    Reporting group description
    Colchicine 0.5 mg once daily

    Reporting group title
    Placebo
    Reporting group description
    Placebo

    Primary: Change in MAP-adjusted cfPWV

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    End point title
    Change in MAP-adjusted cfPWV
    End point description
    End point type
    Primary
    End point timeframe
    26 weeks
    End point values
    Active Placebo
    Number of subjects analysed
    46
    47
    Units: m/s
        arithmetic mean (confidence interval 95%)
    -0.2 (-0.7 to 0.2)
    0.5 (0.0 to 0.9)
    Statistical analysis title
    Change in MAP-adjusted cfPWV
    Comparison groups
    Active v Placebo
    Number of subjects included in analysis
    93
    Analysis specification
    Pre-specified
    Analysis type
    equivalence
    P-value
    = 0.03
    Method
    Mixed models analysis
    Parameter type
    Mean difference (final values)
    Point estimate
    -0.7
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -1.3
         upper limit
    -0.1

    Secondary: Change in 24h systolic blood pressure

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    End point title
    Change in 24h systolic blood pressure
    End point description
    End point type
    Secondary
    End point timeframe
    26 weeks
    End point values
    Active Placebo
    Number of subjects analysed
    41
    45
    Units: mmHg
        arithmetic mean (confidence interval 95%)
    -1 (-3 to 2)
    -4 (-6 to -1)
    Statistical analysis title
    Change in 24 h systolic blood pressure
    Comparison groups
    Active v Placebo
    Number of subjects included in analysis
    86
    Analysis specification
    Pre-specified
    Analysis type
    equivalence
    P-value
    = 0.1
    Method
    Mixed models analysis
    Parameter type
    Mean difference (final values)
    Point estimate
    3
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -1
         upper limit
    6

    Secondary: Change in 24 h diastolic blood pressure

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    End point title
    Change in 24 h diastolic blood pressure
    End point description
    End point type
    Secondary
    End point timeframe
    26 weeks
    End point values
    Active Placebo
    Number of subjects analysed
    41
    45
    Units: mmHg
        arithmetic mean (confidence interval 95%)
    -1 (-2 to 1)
    -2 (-4 to -1)
    Statistical analysis title
    Change in 24h diastolic blood pressure
    Comparison groups
    Active v Placebo
    Number of subjects included in analysis
    86
    Analysis specification
    Pre-specified
    Analysis type
    equivalence
    P-value
    = 0.17
    Method
    Mixed models analysis
    Parameter type
    Mean difference (final values)
    Point estimate
    1
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -1
         upper limit
    3

    Secondary: Change in office systolic BP

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    End point title
    Change in office systolic BP
    End point description
    End point type
    Secondary
    End point timeframe
    26 weeks
    End point values
    Active Placebo
    Number of subjects analysed
    48
    47
    Units: mmHg
        arithmetic mean (confidence interval 95%)
    -1 (-5 to 2)
    -9 (-12 to -5)
    Statistical analysis title
    Change in systolic office BP
    Comparison groups
    Placebo v Active
    Number of subjects included in analysis
    95
    Analysis specification
    Pre-specified
    Analysis type
    equivalence
    P-value
    = 0.005
    Method
    Mixed models analysis
    Parameter type
    Mean difference (final values)
    Point estimate
    7
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    2
         upper limit
    12

    Secondary: Change in office diastolic BP

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    End point title
    Change in office diastolic BP
    End point description
    End point type
    Secondary
    End point timeframe
    26 weeks
    End point values
    Active Placebo
    Number of subjects analysed
    48
    47
    Units: mmHg
        arithmetic mean (confidence interval 95%)
    -1 (-3 to 1)
    -4 (-6 to -2)
    Statistical analysis title
    change in office diastolic BP
    Comparison groups
    Active v Placebo
    Number of subjects included in analysis
    95
    Analysis specification
    Pre-specified
    Analysis type
    equivalence
    P-value
    = 0.05
    Method
    Mixed models analysis
    Parameter type
    Mean difference (final values)
    Point estimate
    3
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0
         upper limit
    5

    Secondary: Percent change in UACR

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    End point title
    Percent change in UACR
    End point description
    End point type
    Secondary
    End point timeframe
    26 weeks
    End point values
    Active Placebo
    Number of subjects analysed
    48
    46
    Units: mg/g
        median (inter-quartile range (Q1-Q3))
    17 (10 to 28)
    19 (11 to 31)
    Statistical analysis title
    Percent change in UACR
    Comparison groups
    Active v Placebo
    Number of subjects included in analysis
    94
    Analysis specification
    Pre-specified
    Analysis type
    equivalence
    P-value
    = 0.98
    Method
    Mixed models analysis
    Parameter type
    Median difference (final values)
    Point estimate
    0.5
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -29.5
         upper limit
    40.4

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    May 12 2022 - Jan 29 2024
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    25
    Reporting groups
    Reporting group title
    Active
    Reporting group description
    -

    Reporting group title
    Placebo
    Reporting group description
    -

    Serious adverse events
    Active Placebo
    Total subjects affected by serious adverse events
         subjects affected / exposed
    3 / 50 (6.00%)
    2 / 50 (4.00%)
         number of deaths (all causes)
    0
    0
         number of deaths resulting from adverse events
    0
    0
    Cardiac disorders
    Chest pain
    Additional description: Admitted with chest pain - spontaneously resolved
         subjects affected / exposed
    1 / 50 (2.00%)
    2 / 50 (4.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nervous system disorders
    Headache
    Additional description: Admitted with headache and vomiting
         subjects affected / exposed
    1 / 50 (2.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    Septic arthritis staphylococcalis
         subjects affected / exposed
    1 / 50 (2.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 0%
    Non-serious adverse events
    Active Placebo
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    10 / 50 (20.00%)
    11 / 50 (22.00%)
    Nervous system disorders
    Headache
         subjects affected / exposed
    1 / 50 (2.00%)
    0 / 50 (0.00%)
         occurrences all number
    1
    1
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    1 / 50 (2.00%)
    1 / 50 (2.00%)
         occurrences all number
    2
    2
    Nausea
         subjects affected / exposed
    4 / 50 (8.00%)
    3 / 50 (6.00%)
         occurrences all number
    7
    7
    Vomiting
         subjects affected / exposed
    1 / 50 (2.00%)
    1 / 50 (2.00%)
         occurrences all number
    2
    2
    Diarrhoea
         subjects affected / exposed
    1 / 50 (2.00%)
    3 / 50 (6.00%)
         occurrences all number
    4
    4
    Flatulence
         subjects affected / exposed
    1 / 50 (2.00%)
    1 / 50 (2.00%)
         occurrences all number
    2
    2
    Constipation
         subjects affected / exposed
    0 / 50 (0.00%)
    1 / 50 (2.00%)
         occurrences all number
    1
    1
    Musculoskeletal and connective tissue disorders
    Myopathy
         subjects affected / exposed
    1 / 50 (2.00%)
    1 / 50 (2.00%)
         occurrences all number
    2
    2
    Infections and infestations
    Pneumonia
         subjects affected / exposed
    1 / 50 (2.00%)
    0 / 50 (0.00%)
         occurrences all number
    1
    1
    Metabolism and nutrition disorders
    Hyperkalaemia
         subjects affected / exposed
    0 / 50 (0.00%)
    1 / 50 (2.00%)
         occurrences all number
    1
    1
    Hypokalaemia
         subjects affected / exposed
    0 / 50 (0.00%)
    1 / 50 (2.00%)
         occurrences all number
    1
    1

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    03 May 2022
    A high-sensitivity C-reactive protein > 2 mg/l was removed as inclusion criterion as of May 2022 due to delayed recruitment. Only one participant had been included prior to this change.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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