Key result
Colchicine fails to significantly reduce MACE over usual care in stroke patients with atherosclerosis.
Why the study?
Does colchicine added to usual care reduce MACE in stroke patients stratified by the presence of atherosclerosis?
RCT (n=3,144)
Does colchicine added to usual care reduce MACE in stroke patients stratified by the presence of atherosclerosis?
Hazard Ratio: 0.83 (95% CI 0.64–1.07)
Absolute Event Rate: 11.1% vs 14.2%
In a secondary analysis of the CONVINCE trial, colchicine did not significantly reduce MACE in stroke patients with atherosclerosis on intention-to-treat analysis, though on-treatment analysis suggested a potential benefit.
Background and aims It is uncertain whether benefit from anti-inflammatory therapies after stroke is confined to patients with atherosclerosis. Methods We performed a post-hoc analysis of the CONVINCE trial (comparing colchicine+usual care vs. usual care) in patients stratified according to the presence/absence of atherosclerosis (cervico-cranial artery plaque, coronary disease, peripheral arterial disease, or carotid revascularisation). The primary outcome was MACE (composite of fatal/non-fatal recurrent ischemic stroke or coronary event). Results The trial included 3,144 participants (1,875 with atherosclerosis, median follow-up 33.6 months, 338 MACE events). On intention-to-treat analysis, there were numerically fewer MACE events in the atherosclerosis group assigned to colchicine (105 [11.1%], 3.88 [95% CI 3.21-4.70] per 100 person-years) vs.usual care (132 [14.2%], 4.83 [4.07-5.73]/100 person-years), which was not statistically significant (HR 0.83, 0.64-1.07). There was no difference in the rate of the primary outcome according to treatment allocation in the non-atherosclerosis subgroup (HR 0.94, 0.64-1.39) (Pinteraction 0.60). There was a non-significant reduced risk of recurrent ischemic stroke in the colchicine arm (HR 0.76, 0.56-1.05) in the atherosclerosis group only. In the pre-specified on-treatment analysis, colchicine reduced the risk of MACE in patients with atherosclerosis (HR 0.76, 0.58-0.99), but not without (HR 0.95, 0.63-1.42). Conclusions There was no significant between-group interactions for colchicine and atherosclerosis for MACE. However, outcome events were numerically fewer in patients with atherosclerosis assigned to colchicine and significant benefit was observed in the on-treatment analysis in this group. Data suggest the presence of atherosclerosis should be an inclusion criteria in future trials of anti-inflammatory therapies. Conflict of interest Figure 1 - belongs to Conclusions
No takes yet. Share an insight, caveat, or question.
McCabe et al. (2026) conducted an RCT in Stroke (n=3,144). Colchicine vs. Usual care was evaluated on MACE (composite of fatal/non-fatal recurrent ischemic stroke or coronary event) (HR 0.83, 95% CI 0.64-1.07). In patients with prior stroke and atherosclerosis, colchicine did not significantly reduce MACE compared to usual care (HR 0.83; 95% CI 0.64-1.07), though on-treatment analysis suggested benefit.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: