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ESOC 2023 | Colchicine for the prevention of vascular events after ICH

Interest is growing in the potential of neuroinflammation as a valuable target for recovery after stroke. Aristeidis Katsanos, MD, McMaster University, Hamilton, Ontario, Canada, discusses the progress of the COVASC-ICH trial (NCT05159219): a Phase II randomized, placebo-controlled trial to determine the feasibility and efficacy of colchicine for the prevention of vascular events in patients with intracerebral hemorrhage (ICH). There is currently a major unmet need for the prevention of ischemic vascular events in patients with ICH, with hesitancy to prescribe antithrombotics stemming from concerns about further bleeding. Recent cardiology studies have demonstrated that targeting inflammation can reduce the risk of major adverse cardiovascular events, which lead Dr Katsanos and colleagues to wonder if targeting inflammation in patients with ICH can stop cardiovascular events without increasing the risk of bleeding. Previous studies have suggested that inflammation in the brain is associated with worse patient outcomes and by targeting inflammation, the risk of major cardiovascular events and secondary brain injuries are improved. COVASC-ICH has initiated in 10 centers in Canada, where patients with established or risk factors for atherosclerotic disease are being randomized to low dose colchicine or placebo within 48 hours of ICH onset. Final outcomes of the study include cardiovascular events and cognitive changes over 12 months. An embedded MRI sub-study is also being conducted to determine if colchicine has an effect on inflammation after a bleed. This interview took place during the European Stroke Organisation Conference (ESOC) in Munich, Germany.

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