Controlled Assessment of Salicylate and Azathioprine

ISRCTN ISRCTN99666810
DOI https://doi.org/10.1186/ISRCTN99666810
Secondary identifying numbers N/A
Submission date
08/01/2008
Registration date
30/01/2008
Last edited
17/10/2012
Recruitment status
Stopped
Overall study status
Stopped
Condition category
Digestive System
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English summary of protocol

Not provided at time of registration

Contact information

Prof Richard Logan
Scientific

Division of Epidemiology and Public Health
Queens Medical Centre
Nottingham
NG7 2UH
United Kingdom

Phone +44 (0)115 823 0452
Email Richard.Logan@nottingham.ac.uk

Study information

Study designThis will be a randomised, open, multi-centre, withdrawal study. There will be two phases: phase 1, the primary outcome measure over one year, and phase 2, ongoing follow-up out to 3 years.
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Scientific titleA randomised, open study of aminosalicylate withdrawal in patients with ulcerative colitis in established remission on combination treatment of azathioprine (or 6-mercaptopurine) and an aminosalicylate
Study acronymCASA
Study objectivesTo investigate whether azathioprine alone is as effective as azathioprine and a 5-aminosalicylic acid (5-ASA) compound in maintaining recently established remission in patients on both drugs.
Ethics approval(s)Ethics approval received from the Cambridgeshire 4 Research Ethics Committee (REC) (formerly Eastern MREC) on the 15th September 2005.
Health condition(s) or problem(s) studiedUlcerative colitis
InterventionPlease note that this study was stopped in 2008 due to poor recruitment.

At enrolment patients (already taking azathioprine and a 5-ASA) will have bloods taken and have a sigmoidoscopy to confirm remission. They will then be randomised to:
1. Mono-therapy (i.e. withdraw their existing 5-ASA and take azathioprine only)
2. Dual-therapy (i.e. continue as normal on azathioprine and their existing 5-ASA)

They will remain on their randomised therapy for 12 months, after which the clinician will review their treatment. Patients will be followed up every 3 months by either telephone contact or clinic visit. Their blood results, which are done every 2 - 3 months by routine NHS azathioprine blood monitoring, will be recorded as part of the study. They will also be followed up after 24 months and 36 months by clinic visit.
Intervention typeDrug
Pharmaceutical study type(s)
PhaseNot Specified
Drug / device / biological / vaccine name(s)Azathioprine (or 6-mercaptopurine), 5-aminosalicylic acid
Primary outcome measureRelapse rates of azathioprine mono-therapy compared to azathioprine and salicylate dual therapy over the first 12 months.
Secondary outcome measuresFactors predictive of success of the different treatment regimes.
Overall study start date01/02/2006
Completion date31/12/2009
Reason abandoned (if study stopped)Participant recruitment issue

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participants410 (less than 40 were recruited by the time the trial was stopped)
Key inclusion criteria1. Male and female patients aged between 18 and 75 years with ulcerative colitis
2. Patients whose ulcerative colitis has been in clinical remission, defined as being off steroids for 3 months or longer
3. Patients taking both azathioprine (or 6-mercaptopurine) and an aminosalicylate
4. Patients taking azathioprine (greater than 50 mg/day) or 6-mercaptopurine (greater than 25 mg/day) at a stable dose for at least 8 weeks
5. Patients taking an aminosalicylate at a stable dose (specified below) for at least 4 weeks:
5.1. Sulphasalazine greater than 1.5 g/day
5.2. Pentasa (slow release mesalazine) greater than 750 mg/day
5.3. Asacol (mesalazine) or generic equivalents greater than 800 mg/day
5.4. Colazide (balsalazide) greater than 2.25 g/day
5.5. Dipentum (olsalazine) greater than 750 mg/day
6. Patients on combined treatment with azathioprine (or 6-MP) and an aminosalicylate for a minimum of 6 months but no more than 4 years without relapse. Patients may enter if they have briefly been off either treatment during this time (e.g., because of abnormal blood test results) but prescription of each drug should cover at least 85% of the period of time for continuous drug treatment to be declared. N.B. Duration of aminosalicylate may be longer.
7. Patients who have given written informed consent
Key exclusion criteria1. Patients with Crohn’s disease
2. Patients with a baseline Walmsley Simple Activity Index greater than 2
3. Patients with a baseline sigmoidoscopy grade of greater than 2 (Baron Scale)
4. Patients requiring long term treatment with oral steroids for any medical condition
5. Women who are pregnant or lactating
6. Patients with known human immunodeficiency virus (HIV) infection
7. Other serious medical or psychiatric illness currently ongoing, or experienced within the past three months, that in the opinion of the investigator would compromise the study
8. Patients unable to comply with the protocol requirements, including severe alcohol and drug use
Date of first enrolment01/02/2006
Date of final enrolment31/12/2009

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centre

Division of Epidemiology and Public Health
Nottingham
NG7 2UH
United Kingdom

Sponsor information

University of Nottingham (UK)
University/education

Research Innovation Services
King's Meadow Campus
Lenton Lane
Nottingham
NG7 2NR
England
United Kingdom

Phone +44 (0)115 951 5679
Email paul.cartledge@nottingham.ac.uk
Website http://www.nottingham.ac.uk/
ROR logo "ROR" https://ror.org/01ee9ar58

Funders

Funder type

Charity

Moulton Charitable Foundation (UK)

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan