WSC 2025 | Anti-inflammatory therapy for ischemic stroke prevention: the CHANCE-3 and CONVINCE trials

Two major big trials on ischemic stroke. So one is CHANCE-3 done out of China. So people, they were randomized to get colchicine or no colchicine and the duration was for 90 days. So it was a completely neutral trial. We didn’t see any reduction in the risk of stroke or cardiovascular events. Reassuringly enough, we didn’t see any increase in the side effects. So there were no more side effects for colchicine. So the most interesting study is the CONVINCE trial. So the CONVINCE trial randomized people to colchicine or no colchicine, but actually people were followed for almost three years. So although the trial didn’t meet the endpoint of efficacy, and the reason for that is first it was prematurely discontinued so they weren’t able to accrue the number of events that they were hoping for. And second there was a high discontinuation rate of the colchicine so overall as a community we believe that the trial probably was underpowered for meeting this target. However in pre-specified analysis, there is hope. We did see a signal for possible reduction in the risk of strokes by giving colchicine. You know, and again, this is like a hypothesis that needs to be proven, but definitely requires more research. And it’s a great opportunity because colchicine is a very inexpensive medication, is widely available and again comes with minimal risks.

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