Colchicine Use in Intracranial Atherosclerotic Disease

Inclusion Criteria 1. Chinese patients aged 40-80 years old 2. Patients with symptomatic ICAD of ≥ 50% stenosis in middle cerebral arteries, basilar artery. Degree of stenosis will be quantified by computer tomographic angiography (CTA), magnetic resonance imaging (MRI) or digital subtraction angiography (DSA) by the WASID method (13). Symptomatic ICAD is defined as ischemic stroke or transient ischemic attack with clinical or radiological signs correspond to the vascular territory supplied by the disease vessel. 3. Patients with first-ever ischaemic stroke within 8 weeks of recruitment Exclusion Criteria 1. Patients who are unable to provide an informed consent 2. Patients who are contraindicated to contrast MRI scans, e.g. non-MRI compatible pacemaker, claustrophobia, known gadolinium-based contrast allergy, estimated glomerular filtration rate \< 30mL/min/1.73m2, etc. 3. Patients who have absolute or relative contraindications to colchicine therapy, e.g. colchicine allergy, neuromuscular disorders, haematological diseases, chronic diarrhea, estimated glomerular filtration rate \< 30mL/min/1.73m2, chronic liver disease, etc. 4. Patients with intracranial stenosis not due to atherosclerosis, e.g. vasculitis, vasospasm, Moyamoya disease, etc. 5. Pregnancy 6. Patients with elevated creatine kinase level at randomisation stage of study. 7. Recurrent gouty arthritis that requires colchicine for \> 3 months per year; 8. Inflammatory bowel disease or chronic diarrhea; 9. Neuromuscular disease or a nontransient creatine kinase level that was greater than three times the upper limit of the normal range (unless due to infarction) for \> 3 months; 10. Clinically significant nontransient hematologic abnormalities with hemoglobin \<10g/dL, white blood cell \< 4x10\^9, or platelet \< 100x10\^9/L for \> 3 months; 11. Alcoholism; 12. Long term systemic glucocorticoid therapy