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COVID-19Phase 3COLCOVIDNCT04328480

The ECLA PHRI COLCOVID Trial. Effects of Colchicine on Moderate/High-risk Hospitalized COVID-19 Patients.

A Phase 3 study testing Colchicine in people with COVID-19, run by Estudios Clínicos Latino América at 1 site in Argentina.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The ECLA PHRI COLCOVID Trial is a simple, pragmatic randomized open controlled trial to test the effects of colchicine on moderate/high-risk hospitalized COVID-19 patients with the aim of reducing mortality and/or new requirement for mechanical ventilation. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
COVID-19
What is being tested?
Colchicine
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
1,279 participants
Where
1 siteArgentina
Study dates
17 Apr 2020to 26 Apr 2021
Phase
Phase 3
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Consented adults (age ≥18 years) and
  • COVID-19 suspicious and
  • Admitted to hospital or already in hospital and
  • COVID-19 suggestive symptoms (fever or febrile equivalent, loss of smell and taste, fatigue, etc.) that may be present or absent at randomization time and
  • SARS (severe acute respiratory syndrome)
  • shortness of breath (dyspnea) or
  • image of typical or atypical pneumonia or
  • oxygen desaturation (SpO2 ≤ 93)

Who cannot join

  • Clear indication or contraindication for the use of colchicine
  • Pregnant or breastfeeding female.
  • Chronic renal disease with creatinine clearance <15 ml/min/m2
  • Negative PCR test for SARS-COV2

Trial locations and contacts

1 site in 1 country.

Argentina1 site
  • Sanatorio Parque

    Rosario, Santa Fe Province, 2000

Other trials in Argentina

About this study

Official title: The ECLA PHRI COLCOVID Trial

The ECLA PHRI COLCOVID Trial is a simple, pragmatic randomized open controlled trial to test the effects of colchicine on moderate/high-risk hospitalized COVID-19 patients with the aim of reducing mortality and/or new requirement for mechanical ventilation.

Read the detailed description

Various anti-viral treatments are being tested in clinical trials worldwide. The World Health Organization (WHO) launched a simple,pragmatic worldwide open-label trial to test Remdesivir, Lopinavir/Ritonavir, Interferon and Hydroxychloroquine or Chloroquine.The most important complication of COVID-19 severe cases is respiratory failure from severe acute respiratory syndrome (SARS), the leading cause of mortality. Accumulating evidence suggests that patients with severe COVID-19 might have a cytokine storm syndrome, a hyperinflammatory syndrome characterized by a fulminant and fatal hypercytokinemia and multiorgan failure.

The proposed pathophysiological mechanism of cytokine storm and inflammatory cascade activation is based on evidence collected primarily during the SARS-CoV and MERS-CoV epidemics (with a significant increase in IL1B, IL6, IL12, IFNγ, IP10, TNFα, IL15, and IL17 among others). The data collected during the pandemic with COVID-19 also shows a significant increase in inflammatory cytokines (GCSF, IP10, MCP1, MIP1A, and TNFα, among others) in sicker patients admitted to intensive care. In the absence of effective treatments for the management of patients with COVID-19 and respiratory failure, the immunomodulatory and anti-inflammatory effect of colchicine on cytokines involved in the hyper-inflammatory state is postulated. Several lines of research worldwide are testing powerful anti-inflammatory drugs for the pandemic, with different options including steroids, cytokine blockers, and other potent anti-inflammatory agents. Steroids are partially contraindicated in viral infections.

Colchicine is a powerful anti-inflammatory drug approved for the treatment or prevention of gout and Familial Mediterranean Fever at doses ranging between 0.3 mg and 2.4 mg/day. Its mechanism of action is through the inhibition of tubulin polymerization, as well as through potential effects on cellular adhesion molecules and inflammatory chemokines. It might also have direct anti-inflammatory effects by inhibiting key inflammatory signalling networks known as inflammasome and pro-inflammatory cytokines. Additionally, evidence suggests that colchicine exerts a direct anti-inflammatory effect by inhibiting the synthesis of tumor necrosis factor alpha and IL-6, monocyte migration, and the secretion of matrix metalloproteinase-9. Through the disruption of the cytoskeleton, colchicine is believed to suppress secretion of cytokines and chemokines as well as in vitro platelet aggregation. All these are potentially beneficial effects that might diminish or ameliorate the COVID-19 inflammatory storm associated with severe forms of the disease. Importantly, in one contemporary trial low-dose colchicine administered to patients who survived from acute coronary syndrome shows a statistically significantly reduction of cardiovascular complications.

We have therefore designed in a simple, pragmatic randomized controlled trial to test the effects of colchicine on severe hospitalized COVID-19 cases with the aim of reducing mortality.

Sample size calculation:

A minimum sample size of 1200 patients will provide 80% power to detect a relative risk reduction of approximately 30% in the treated group if the assumed composite rate (new requirement of intubation and / or death) in the control group is about 24%.

The ECLA PHRI COLCOVID Trial allows randomization to another trial, specifically patients included in the trial might be (or not) randomized to an antithrombotic strategy.

Conditions
COVID-19
Being tested
Colchicine, Local standard of care
Medical subject headings
COVID-19

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • ColchicineDrug

    Also called Colchicina

    The colchicine dosage schedule will vary according to the following scenarios:

    1. In patients not receiving Lopinavir/Ritonavir
    • Loading dose of 1.5 mg followed by 0.5 mg after two hours (day 1)
    • The next day 0.5 mg bid for 14 days or until discharge.
    1. In patients receiving Lopinavir/Ritonavir
    • Loading dose of 0.5 mg (day 1)
    • After 72 hours from the loading dose, 0.5 mg every 72 hours for 14 days or until discharge.
    1. Patients under treatment with Colchicine that are starting with Lopinavir/Ritonavir
    • Dose of 0.5 mg 72 hours after starting Lopinavir/Ritonavir.
    • Continue with 0.5 mg every 72 hours for 14 days or until discharge.

    Only the oral route will be used except in the case of patients associated with mechanical ventilation or with contraindications to the oral route, in whom it will be administered by nasogastric tube.

  • Local standard of careOther

    Local standard of care for COVID-19 SARS moderate /high-risk patients

Study groups in NCT04328480
Study groupRoleWhat they receive
Local standard of care plus colchicineActive comparatorLocal standard of care plus colchicine (specific dosage schedule)
Receives: Drug: Colchicine; Other: Local standard of care
Local standard of careOtherLocal standard of care for COVID-19 SARS moderate / high-risk patients
Receives: Other: Local standard of care

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Composite outcome: New requirement for mechanical ventilation or death

    Number of participants who require new intubation for mechanical ventilation or die

    Measured: 28 days post randomization

  2. Mortality

    Number of participants who die

    Measured: 28 days post randomization

Secondary outcomes (10)
  1. New requirement for mechanical ventilation or death from respiratory failure

    Number of participants who require new intubation for mechanical ventilation or die from respiratory failure

    Measured: 28 days post randomization

  2. New requirement for mechanical ventilation or death from non-respiratory failure

    Number of participants who require new intubation for mechanical ventilation or die from non-respiratory failure

    Measured: 28 days post randomization

  3. Mortality due to respiratory failure

    Number of participants who die from respiratory failure

    Measured: 28 days post randomization

  4. Mortality due to non-respiratory failure

    Number of participants who die from non-respiratory failure

    Measured: 28 days post randomization

  5. In hospital - Composite outcome

    Number of participants who require intubation for mechanical ventilation or die

    Measured: During hospitalization or until death, whichever comes first, assessed up to 28 days

  6. In hospital - Mortality

    Number of participants who die

    Measured: During hospitalization or until death, whichever comes first, assessed up to 28 days

  7. Composite outcome (New requirement for mechanical ventilation or death) evaluated in Non-intubated population

    Number of participants who were not intubated at randomization and require new intubation for mechanical ventilation or die

    Measured: 28 days post randomization

  8. Mortality evaluated in Non-intubated population

    Number of participants who were not intubated at randomization and die

    Measured: 28 days post randomization

  9. Mean WHO descriptive score of COVID-19 during hospitalization

    Mean WHO descriptive score of COVID-19 in the active treatment group compared to the placebo group

    Measured: During hospitalization or until death, whichever comes first, assessed up to 28 days

  10. Highest WHO descriptive score of COVID-19 during hospitalization

    Mean highest WHO descriptive score of COVID-19 in the active treatment group compared to the placebo group

    Measured: During hospitalization or until death, whichever comes first, assessed up to 28 days

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted31 Mar 2020
  2. Study start17 Apr 2020
  3. Primary completion25 Apr 2021
  4. Study completion26 Apr 2021

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Simple pragmatic randomized open controlled trial
Masking
None (open label)
Enrolment
1,279 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04328480
Sponsor's protocol ID
COLCOVID version 2.0
Acronym
COLCOVID
Status last verified
Apr 2021
First submitted
30 Mar 2020
Last updated
27 Apr 2021
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Slobodnick A, Shah B, Krasnokutsky S, Pillinger MH. Update on colchicine, 2017. Rheumatology (Oxford). 2018 Jan 1;57(suppl_1):i4-i11. doi: 10.1093/rheumatology/kex453.

    PubMed 29272515
  • Tardif JC, Kouz S, Waters DD, Bertrand OF, Diaz R, Maggioni AP, Pinto FJ, Ibrahim R, Gamra H, Kiwan GS, Berry C, Lopez-Sendon J, Ostadal P, Koenig W, Angoulvant D, Gregoire JC, Lavoie MA, Dube MP, Rhainds D, Provencher M, Blondeau L, Orfanos A, L'Allier PL, Guertin MC, Roubille F. Efficacy and Safety of Low-Dose Colchicine after Myocardial Infarction. N Engl J Med. 2019 Dec 26;381(26):2497-2505. doi: 10.1056/NEJMoa1912388. Epub 2019 Nov 16.

    PubMed 31733140
  • Yusuf S, Collins R, Peto R. Why do we need some large, simple randomized trials? Stat Med. 1984 Oct-Dec;3(4):409-22. doi: 10.1002/sim.4780030421. No abstract available.

    PubMed 6528136
  • McDermott MM, Newman AB. Preserving Clinical Trial Integrity During the Coronavirus Pandemic. JAMA. 2020 Jun 2;323(21):2135-2136. doi: 10.1001/jama.2020.4689. No abstract available.

    PubMed 32211830
  • Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, Manson JJ; HLH Across Speciality Collaboration, UK. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet. 2020 Mar 28;395(10229):1033-1034. doi: 10.1016/S0140-6736(20)30628-0. Epub 2020 Mar 16. No abstract available.

    PubMed 32192578
  • Diaz R, Orlandini A, Castellana N, Caccavo A, Corral P, Corral G, Chacon C, Lamelas P, Botto F, Diaz ML, Dominguez JM, Pascual A, Rovito C, Galatte A, Scarafia F, Sued O, Gutierrez O, Jolly SS, Miro JM, Eikelboom J, Loeb M, Maggioni AP, Bhatt DL, Yusuf S; ECLA PHRI COLCOVID Trial Investigators. Effect of Colchicine vs Usual Care Alone on Intubation and 28-Day Mortality in Patients Hospitalized With COVID-19: A Randomized Clinical Trial. JAMA Netw Open. 2021 Dec 1;4(12):e2141328. doi: 10.1001/jamanetworkopen.2021.41328.

    PubMed 34964849

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Colchicine in people with COVID-19, run by Estudios Clínicos Latino América at 1 site in Argentina.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 27 Apr 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Argentina. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Composite outcome: New requirement for mechanical ventilation or death (time frame: 28 days post randomization). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04328480, which also lists 6 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Apr 2021.

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