Gordon Moran © Gordon Moran |
Oral 5-ASA agents have proven effective for inducing and maintaining remission in mild-to-moderate Ulcerative Colitis (UC) and thus are commonly used as first-line agents. However, in contrast to UC, there is uncertainty regarding their effectiveness in Crohn’s Disease (CD). For induction of remission in CD, a Cochrane review of randomised controlled trials (RCTs) and meta-analysis found no evidence that low/high dose 5-ASA was superior to placebo. Several studies originating from North America and Europe indicate that 5-ASA agents are the most commonly prescribed drug class for patients with CD. Therefore, there is discordance between clinical prescribing practice and evidence from RCTs.
To investigate whether 5-ASA withdrawal is non-inferior to continuation of 5-ASA in CD in remission.
STATIC is parallel-group, open-label, randomised, non-inferiority study in the UK and Canada. In total, 1580 CD patients in remission and receiving oral 5-ASA maintenance therapy will be enrolled into this study. Eligible patients will be randomly assigned in a 1:1 ratio to either continue or discontinue their oral 5-ASA therapy. The primary objective is to determine the effect of 5-ASA withdrawal on CD-related complications within 24 months of enrolment.
The secondary objectives are to determine the effect of 5-ASA withdrawal on:
These objectives will be assessed at 6, 12 and 24 months unless otherwise specified. We hope that STATIC will provide the definitive answer needed to inform gastroenterologists world-wide regarding the role of 5-ASA in CD.
STATIC was initiated in April 2019 and a minimum of 24 months will be required to complete recruitment. We aim to be able to present the results within 50 months.