A randomized, double-blind, placebo-controlled trial (CHANCE-3) evaluated the efficacy and safety of low-dose colchicine (0.5 mg twice daily for the first three days, followed by 0.5 mg daily) compared to placebo in patients with acute non-cardioembolic minor-to-moderate ischaemic stroke or transient ischaemic attack (TIA) and high-sensitivity C-reactive protein (hs-CRP) ≥2 mg/L. A total of 8343 patients were enrolled, with 4176 assigned to colchicine and 4167 to placebo. The primary outcome was any new stroke within 90 days, and the primary safety outcome was any serious adverse event. No significant difference was found in stroke risk between the two groups, with 6.3% and 6.5% of patients experiencing a new stroke, respectively (hazard ratio 0.98, 95% CI 0.83–1.16, P=0.79). Similarly, no significant difference was observed in serious adverse events (2.2% vs 2.1%, P=0.83). The study found no evidence that low-dose colchicine reduced the risk of subsequent stroke within 90 days compared to placebo. The results suggest that colchicine does not provide a significant benefit in this population. The trial was well-conducted, with similar baseline characteristics between groups and no major safety concerns. However, the study had limitations, including the short duration of treatment and lack of follow-up data on hs-CRP levels. The findings indicate that low-dose colchicine may not be effective for secondary prevention of stroke in this population.A randomized, double-blind, placebo-controlled trial (CHANCE-3) evaluated the efficacy and safety of low-dose colchicine (0.5 mg twice daily for the first three days, followed by 0.5 mg daily) compared to placebo in patients with acute non-cardioembolic minor-to-moderate ischaemic stroke or transient ischaemic attack (TIA) and high-sensitivity C-reactive protein (hs-CRP) ≥2 mg/L. A total of 8343 patients were enrolled, with 4176 assigned to colchicine and 4167 to placebo. The primary outcome was any new stroke within 90 days, and the primary safety outcome was any serious adverse event. No significant difference was found in stroke risk between the two groups, with 6.3% and 6.5% of patients experiencing a new stroke, respectively (hazard ratio 0.98, 95% CI 0.83–1.16, P=0.79). Similarly, no significant difference was observed in serious adverse events (2.2% vs 2.1%, P=0.83). The study found no evidence that low-dose colchicine reduced the risk of subsequent stroke within 90 days compared to placebo. The results suggest that colchicine does not provide a significant benefit in this population. The trial was well-conducted, with similar baseline characteristics between groups and no major safety concerns. However, the study had limitations, including the short duration of treatment and lack of follow-up data on hs-CRP levels. The findings indicate that low-dose colchicine may not be effective for secondary prevention of stroke in this population.