Effect of colchicine for secondary prevention according to
stroke subtype: A secondary analysis of the CONVINCE randomized
trial

J 2026

Effect of colchicine for secondary prevention according to stroke subtype: A secondary analysis of the CONVINCE randomized trial

MAES, Louise; Cathal WALSH; Christian WEIMAR; Francisco PURROY; Christopher PRICE et al.

Základní údaje

Originální název

Effect of colchicine for secondary prevention according to stroke subtype: A secondary analysis of the CONVINCE randomized trial

Autoři

Vydání

International Journal of Stroke, London, SAGE Publications, 2026, 1747-4930

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30210 Clinical neurology

Stát vydavatele

Velká Británie a Severní Irsko

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 8.700 v roce 2024

Označené pro přenos do RIV

Organizační jednotka

Lékařská fakulta

Klíčová slova anglicky

Colchicine; stroke; transient ischemic attack; stroke subtype; secondary prevention

Štítky

14110127, 14110132

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 2. 3. 2026 13:57, Mgr. Tereza Miškechová

Anotace

V originále

Background: The Colchicine for prevention of vascular inflammation in Non-CardioEmbolic stroke (CONVINCE) trial evaluated long-term treatment with colchicine for the prevention of major adverse cardiovascular events (MACE) in a stroke population. Although the intention-to-treat analysis did not demonstrate a significant reduction in the primary endpoint, fewer outcome events were observed in the colchicine-treated group. It is unknown if a potential treatment effect is modified by ischemic stroke etiology.Aims: In this pre-specified secondary analysis, we aimed to evaluate the efficacy of colchicine for prevention of MACE in patients with minor stroke or high-risk transient ischemic attack (TIA) according to index event stroke etiology.Methods: A total of 3154 patients with recent non-cardioembolic stroke or TIA were randomly assigned to receive colchicine, 0.5 mg daily in addition to guideline-based usual care or usual care alone. The primary endpoint was a composite of first fatal or non-fatal recurrent ischemic stroke, myocardial infarction, cardiac arrest, or hospitalization for unstable angina. Subgroups of patients with large-artery atherosclerosis, small-vessel disease, and cryptogenic stroke were evaluated.Results: A total of 3100 patients were included in the current analysis. The treatment effect did not vary across stroke subtype subgroups (p = 0.64 for interaction). In patients allocated to colchicine versus usual care alone, the primary endpoint occurred in 32 of 260 (12.3%) versus 42 of 263 (16%) patients with large-artery atherosclerosis (hazard ratio (HR), 0.77 (95% CI, 0.48-1.22)); 39 of 419 (9.3%) versus 47 of 435 (10.8%) patients with small-vessel occlusion (HR, 0.87 (95% CI, 0.57-1.34)); and 82 of 877 (9.4%) versus 92 of 846 (10.5%) patients with cryptogenic stroke (HR, 0.89 (95% CI, 0.66-1.12)).Conclusions: The direction of effect for prevention of recurrent MACE favored colchicine, consistent with randomized trials in coronary disease, regardless of stroke subtype. Future stroke trials should consider selecting patients with evidence of atherosclerosis irrespective of stroke subtype.Trial Registration: ClinicalTrials.gov Identifier: NCT02898610

Citovat

MAES, Louise; Cathal WALSH; Christian WEIMAR; Francisco PURROY; Christopher PRICE; Brian CLARKE; Pedro CASTRO; Anna CZLONKOWSKA; Elisa CUADRADO-GODIA; Urs FISCHER; Ana Catarina FONSECA; Michael D HILL; Dalius JATUZIS; Janika KORV; Christina KRUUSE; Robert MIKULÍK; Paul J NEDERKOORN; Laszlo SZTRIHA; Marcus THIEME; Peter KELLY a Robin LEMMENS. Effect of colchicine for secondary prevention according to stroke subtype: A secondary analysis of the CONVINCE randomized trial. International Journal of Stroke. London: SAGE Publications, 2026, 10 s. ISSN 1747-4930. Dostupné z: https://doi.org/10.1177/17474930251406818.

@article{2557841,
   author = {Maes, Louise and Walsh, Cathal and Weimar, Christian and Purroy, Francisco and Price, Christopher and Clarke, Brian and Castro, Pedro and Czlonkowska, Anna and CuadradoandGodia, Elisa and Fischer, Urs and Fonseca, Ana Catarina and Hill, Michael D and Jatuzis, Dalius and Korv, Janika and Kruuse, Christina and Mikulík, Robert and Nederkoorn, Paul J and Sztriha, Laszlo and Thieme, Marcus and Kelly, Peter and Lemmens, Robin},
   article_location = {London},
   doi = {https://doi.org/10.1177/17474930251406818},
   keywords = {Colchicine; stroke; transient ischemic attack; stroke subtype; secondary prevention},
   language = {eng},
   issn = {1747-4930},
   journal = {International Journal of Stroke},
   title = {Effect of colchicine for secondary prevention according to stroke subtype: A secondary analysis of the CONVINCE randomized trial},
   url = {https://journals.sagepub.com/doi/10.1177/17474930251406818},
   year = {2026}
}

TY  - JOUR
ID  - 2557841
AU  - Maes, Louise - Walsh, Cathal - Weimar, Christian - Purroy, Francisco - Price, Christopher - Clarke, Brian - Castro, Pedro - Czlonkowska, Anna - Cuadrado-Godia, Elisa - Fischer, Urs - Fonseca, Ana Catarina - Hill, Michael D - Jatuzis, Dalius - Korv, Janika - Kruuse, Christina - Mikulík, Robert - Nederkoorn, Paul J - Sztriha, Laszlo - Thieme, Marcus - Kelly, Peter - Lemmens, Robin
PY  - 2026
TI  - Effect of colchicine for secondary prevention according to stroke subtype: A secondary analysis of the CONVINCE randomized trial
JF  - International Journal of Stroke
PB  - SAGE Publications
SN  - 17474930
KW  - Colchicine
KW  - stroke
KW  - transient ischemic attack
KW  - stroke subtype
KW  - secondary prevention
UR  - https://journals.sagepub.com/doi/10.1177/17474930251406818
N2  - Background: The Colchicine for prevention of vascular inflammation in Non-CardioEmbolic stroke (CONVINCE) trial evaluated long-term treatment with colchicine for the prevention of major adverse cardiovascular events (MACE) in a stroke population. Although the intention-to-treat analysis did not demonstrate a significant reduction in the primary endpoint, fewer outcome events were observed in the colchicine-treated group. It is unknown if a potential treatment effect is modified by ischemic stroke etiology.Aims: In this pre-specified secondary analysis, we aimed to evaluate the efficacy of colchicine for prevention of MACE in patients with minor stroke or high-risk transient ischemic attack (TIA) according to index event stroke etiology.Methods: A total of 3154 patients with recent non-cardioembolic stroke or TIA were randomly assigned to receive colchicine, 0.5 mg daily in addition to guideline-based usual care or usual care alone. The primary endpoint was a composite of first fatal or non-fatal recurrent ischemic stroke, myocardial infarction, cardiac arrest, or hospitalization for unstable angina. Subgroups of patients with large-artery atherosclerosis, small-vessel disease, and cryptogenic stroke were evaluated.Results: A total of 3100 patients were included in the current analysis. The treatment effect did not vary across stroke subtype subgroups (p = 0.64 for interaction). In patients allocated to colchicine versus usual care alone, the primary endpoint occurred in 32 of 260 (12.3%) versus 42 of 263 (16%) patients with large-artery atherosclerosis (hazard ratio (HR), 0.77 (95% CI, 0.48-1.22)); 39 of 419 (9.3%) versus 47 of 435 (10.8%) patients with small-vessel occlusion (HR, 0.87 (95% CI, 0.57-1.34)); and 82 of 877 (9.4%) versus 92 of 846 (10.5%) patients with cryptogenic stroke (HR, 0.89 (95% CI, 0.66-1.12)).Conclusions: The direction of effect for prevention of recurrent MACE favored colchicine, consistent with randomized trials in coronary disease, regardless of stroke subtype. Future stroke trials should consider selecting patients with evidence of atherosclerosis irrespective of stroke subtype.Trial Registration: ClinicalTrials.gov Identifier: NCT02898610
ER  -

MAES, Louise; Cathal WALSH; Christian WEIMAR; Francisco PURROY; Christopher PRICE; Brian CLARKE; Pedro CASTRO; Anna CZLONKOWSKA; Elisa CUADRADO-GODIA; Urs FISCHER; Ana Catarina FONSECA; Michael D HILL; Dalius JATUZIS; Janika KORV; Christina KRUUSE; Robert MIKULÍK; Paul J NEDERKOORN; Laszlo SZTRIHA; Marcus THIEME; Peter KELLY a Robin LEMMENS. Effect of colchicine for secondary prevention according to stroke subtype: A secondary analysis of the CONVINCE randomized trial. \textit{International Journal of Stroke}. London: SAGE Publications, 2026, 10 s. ISSN~1747-4930. Dostupné z: https://doi.org/10.1177/17474930251406818.

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