Ulcerative Colitis in RemissionPhase 4STOPNCT07718529
Safety and Efficacy of a STOPping Strategy Versus Classical Maintenance Dose of JAK Inhibitors in Deep Remission Patients With Ulcerative Colitis
A Phase 4 study testing treatment withdrawal in people with Ulcerative Colitis in Remission, run by Assistance Publique Hopitaux De Marseille at 22 sites in France.
Trial summary
This phase IV, multicenter, open-label randomized controlled trial will evaluate whether a JAK inhibitor discontinuation strategy is superior to standard maintenance therapy in adult patients with ulcerative colitis who are in sustained deep remission. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Ulcerative Colitis in Remission
- What is being tested?
- treatment withdrawal
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 224 participants
- Where
- 22 sitesFrance
- Study dates
- Jan 2027to Jan 2031
- Phase
- Phase 4
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Diagnosis of UC from at least 6 months according to clinical, endoscopic, histological and/or radiological criteria.
- Male or female age ≥ 18 years
- Currently treated by JAK inhibitor (tofacitinib, upadacitinib or filgotinib) for more than 12 months.
- Currently at a stable dose of tofacitinib (5mg or 10mg twice a day), upadacitinib (15mg or 30mg per day) or filgotinib (200mg per day) for 6 months.
- Clinical steroid free remission for at least 6 months, defined by a partial Mayo Score < 2, with no subscore > 1 and rectal bleeding (RB) subscore of 0 (annex 1).
- Endoscopic steroid free remission for at inclusion, defined by a Mayo endoscopic subscore = 0 (annex 1).
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- Fecal calprotectin ≤ 150μg/g.
- Without known risk factors for venous thromboembolism (VTE).
- Without known risk factors for major adverse cardiovascular events (MACE).
- Without known risk factors for malignancy.
- For women of child-bearing potential (WOCBP), and for men with partners who are WOCBP, willingness to use appropriate and efficient contraception, as recommended when using JAK inhibitor treatment (notably upadacitinib), during all the experimental treatment and until at least 4 weeks after the end of the experimental treatment, according to SmPC and CTFG (Clinical Trials Facilitation and Coordination Group) recommendations.
- Patients able to understand information provide to them and to give written informed consent for study.
- Affiliation to a social security scheme.
- Good general health according to history and clinical examination.
Who cannot join
- Steroid use ≤ 6 months prior to enrolment.
- Currently treated by steroid, immunosuppressive agents or biologics.
- Pregnancy or planned pregnancy during the study.
- Breastfeeding.
- Non-compliant subject or inability to follow study protocol.
- Intolerance of JAK inhibitors (excipients included) or severe adverse event.
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- Contraindications to using a JAK inhibitor (excipients included).
- Known risk factors for VTE.
- Known risk factors for MACE.
- Active neoplasia or history of malignant tumours less than 5 years old.
- Participation to another interventional study protocol (except for RIPH3 studies)
- Severe hepatic insufficiency.
- Severe to end-stage renal insufficiency.
- Active tuberculosis, serious infections such as septicemia or opportunistic infections.
- Absence or refusal of informed consent.
- People under guardianship, conservatorship, or judicial protection;
- People receiving psychiatric care;
- People who have been deprived of their liberty by judicial or administrative order
- People with difficulty understanding and/or cognitive disorder
Trial locations and contacts
22 sites in 1 country. Contact the study team or a site near you to ask about taking part.
22 sites in 1 country
France22 sites
CHU Amiens-Picardie
Amiens
Mathurin Fumery, +330322088849, fumery.mathurin@chu-amiens.fr
Mathurin FUMERY
Centre Hospitalier d'Avignon
Avignon
Alban Benezech, +330432753409, benezech.alban@ch-avignon.fr
Alban BENEZECH
CHRU Besançon
Besançon
Lucine Vuitton, +330381218683, lvuitton@chu-besancon.fr
Lucine VUITTON
CHU Bordeaux
Bordeaux
pauline rivière, +330557656094, pauline.riviere@chu-bordeaux.fr
Pauline RIVIERE
CHU Clermont Ferrand
Clermont-Ferrand
Anthony Buisson, +330473750598, a_buisson@chu-clermontferrand.fr
Anthony BUISSON
Chu Lille
Lille
Maria Nachury, +330320444714, maria.nachury@chru-lille.fr
Maria NACHURY
HCL
Lyon
AP-HM hopital Nord
Marseille
Lucas GUILLO, +330491968737, lucas.guillo@ap-hm.fr
Lucas GUILLO
CHU Montpellier
Montpellier
Romain Altwegg, +330467337064, r-altwegg@chu-montpellier.fr
Romain ALTWEGG
CHRU Nancy
Nancy
Bénédicte Caron, b.caron@chru-nancy.fr
Benedicte CARON
CHU Nantes
Nantes
Arnaud Bourreille, +330240083152, arnaud.bourreille@chu-nantes.fr
Arnaud BOUREILLE
CHU Nice
Nice
Adrien Nicolau, +330492036168, nicolau.a@chu-nice.fr
Adrien NICOLAU
CHU Nîmes
Nîmes
Ludovic Caillo, +330466683183, Ludovic.CAILLO@chu-nimes.fr
Ludovic CAILLO
Hôpital Beaujon
Paris
Alexandre Nuzzo, +330140875668, alexandre.nuzzo@aphp.fr
Alexandre NUZZO
Hôpital Bicêtre
Paris
Aurélien Amiot, +330145213726, aurelien.amiot@aphp.fr
Aurélien AMIOT
Hôpital Henri-Mondor
Paris
Mathieu Uzzan, +330149812362, mathieu.uzzan@aphp.fr
Mathieu UZZAN
Institut des MICI
Paris
Carmen Stefanescu, +330141430573, carmen.stefanescu@institutdesmici.fr
Carmen STEFANESCU
Chu Rennes
Rennes
Guillaume Bouguen, +330299284347, Guillaume.BOUGUEN@chu-rennes.fr
Guillaume BOUGUEN
CHU Rouen
Rouen
Nicolas Richard, +330232886634, nicolas.richard@chu-rouen.fr
Nicolas RICHARD
CHU St Etienne
Saint-Etienne
Xavier Roblin, +330477828119, xavier.roblin@chu-st-etienne.fr
Xavier ROBLIN
Chits Toulon
Toulon
Camille Silbertin Blanc, +330494144163, camille.sibertin-blanc@ch-toulon.fr
Camille SIBERTIN BLANC
CHU Toulouse
Toulouse
Cyrielle Gilletta, +330561323080, Gilletta.c@chu-Toulouse.fr
Cyrielle GILETTA
About this study
Official title: Safety and Efficacy of a STOPping Strategy Versus Classical Maintenance Dose of JAK Inhibitors in Deep Remission Patients With Ulcerative Colitis: a Randomized Controlled Trial
This phase IV, multicenter, open-label randomized controlled trial will evaluate whether a JAK inhibitor discontinuation strategy is superior to standard maintenance therapy in adult patients with ulcerative colitis who are in sustained deep remission. A total of 224 patients treated with tofacitinib, upadacitinib, or filgotinib will be randomized to either treatment withdrawal or continuation of maintenance therapy and followed for 104 weeks. The primary objective is to compare safety, efficacy, and patient satisfaction at Week 52, while secondary objectives include assessment of remission maintenance, quality of life, treatment exposure, endoscopic outcomes, and relapse rates
Read the detailed description
Background:
Janus kinase (JAK) inhibitors are effective oral therapies for moderate-to-severe ulcerative colitis (UC). Their lack of immunogenicity provides a unique opportunity to evaluate treatment withdrawal and intermittent treatment strategies. However, safety concerns raised by regulatory agencies, including increased risks of infections, venous thromboembolism, major adverse cardiovascular events, and malignancies, support the investigation of strategies aiming to reduce long-term exposure to JAK inhibitors while maintaining disease control.
Objective:
To demonstrate the superiority of a JAK inhibitor stopping strategy compared with standard maintenance therapy in terms of treatment safety, efficacy, and patient satisfaction in adults with ulcerative colitis in deep remission.
Study Design:
This is a phase IV, prospective, multicenter, open-label, randomized controlled trial. Adult patients with ulcerative colitis receiving a stable dose of tofacitinib, upadacitinib, or filgotinib for at least 12 months and achieving sustained steroid-free clinical, biological, and endoscopic remission for at least 6 months will be randomized to either treatment discontinuation or continuation of standard maintenance therapy. A total of 224 participants will be enrolled and followed for 104 weeks.
Primary Endpoint:
The primary endpoint is a composite outcome assessing treatment safety, efficacy, and patient satisfaction during the first 52 weeks after randomization. Patient satisfaction will be evaluated using the Treatment Satisfaction Questionnaire for Medication (TSQM 1.4).
Secondary Endpoints:
Secondary outcomes include adverse events and serious adverse events, maintenance of remission, treatment satisfaction, quality of life, JAK inhibitor exposure, endoscopic outcomes, relapse rates, treatment success at Weeks 52 and 104, and identification of predictors of successful treatment discontinuation.
Expected Benefits:
Reducing exposure to JAK inhibitors may improve the overall safety profile by decreasing treatment-related adverse events while reducing treatment burden for patients with ulcerative colitis. This strategy could support a more individualized and potentially safer long-term management approach for patients in sustained deep remission.
- Conditions
- Ulcerative Colitis in Remission
- Being tested
- treatment withdrawal
- Keywords
- ulcerative colitis, treatment removal
- Medical subject headings
- Colitis, Ulcerative
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
treatment withdrawalDrug
the patients will stop their treatment, as long as possible until symptom reappearance, if any
| Study group | Role | What they receive |
|---|---|---|
| standard of care | No intervention | Not described |
| STOP, treatment withdrawal | Experimental | Not described Receives: Drug: treatment withdrawal |
What is being measured
The primary outcome is the main question the study is designed to answer.
The primary endpoint of this study will be a composite criterion of treatment safety, efficacy, and patient satisfaction during the first 52 weeks of the follow-up.
treatment safety, during the first 52 weeks of the follow-up.
Measured: 1 year
The primary endpoint of this study will be a composite criterion of treatment safety, efficacy, and patient satisfaction during the first 52 weeks of the follow-up.
treatment efficacy, during the first 52 weeks of the follow-up.
Measured: 1 year
The primary endpoint of this study will be a composite criterion of treatment safety, efficacy, and patient satisfaction during the first 52 weeks of the follow-up.
patient satisfaction during the first 52 weeks of the follow-up.
Measured: 1 year
Secondary outcomes (8)
Safety: occurrence of herpes zoster, infection, cardiovascular event, biochemical parameter, malignancies, adverse event leading to discontinuation, and all adverse events (serious or not) during the whole follow-up.
Measured: 2 years
Remission rate at the end the first 52 weeks of the follow-up
Measured: 1 year
Assess the treatment success of this innovative therapeutic strategy at the end of the first 52 weeks of the follow-up and after 104 weeks of follow-up.
Measured: 2 years
Partial Mayo score at each visit of the entire follow-up
Measured: 2 years
Number of days under treatment and cumulative dose of treatment per patient between randomization and primary endpoint
Measured: 1 year
Number of days under induction dose of JAK inhibitor at the end the first 52 weeks of the follow-up.
Measured: 1 year
Mayo endoscopic subscore at week 52 and week 104
Measured: 2 years
Proportion of patients relapsing for each arm
Measured: 2 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted22 Jul 2026
- Study startJan 2027 (estimated)
- Primary completionJan 2030 (estimated)
- Study completionJan 2031 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Ulcerative Colitis in RemissionStudies of the same condition, open and under way.
- More trials run by Assistance Publique Hopitaux De MarseilleThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 4
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 224 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Assistance Publique Hopitaux De Marseille
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Lucas GUILLO, DR, Principal investigator, AP-HM
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07718529
- Sponsor's protocol ID
- RCAPHM24_0353 - STOP
- Other IDs
- 2026-525643-32-00
- Acronym
- STOP
- Status last verified
- Jul 2026
- First submitted
- 10 Jul 2026
- Last updated
- 22 Jul 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Study at a glance
From the registry record, last updated by the sponsor on 22 Jul 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Safety and Efficacy of a STOPping Strategy Versus Classical Maintenance Dose of JAK Inhibitors in Deep Remission Patients With Ulcerative Colitis: a Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT07718529
- Acronym / sponsor ID
- STOP / RCAPHM24_0353 - STOP
- Conditions
- Ulcerative Colitis in Remission
- Keywords
- ulcerative colitis, treatment removal
- Phase
- Phase 4
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 224 participants (estimated)
- Lead sponsor
- Assistance Publique Hopitaux De MarseilleUniversity, hospital or other
- Study start
- Jan 2027 (estimated)
- Primary completion
- Jan 2030 (estimated)
- Study completion
- Jan 2031 (estimated)
- First posted
- 22 Jul 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This phase IV, multicenter, open-label randomized controlled trial will evaluate whether a JAK inhibitor discontinuation strategy is superior to standard maintenance therapy in adult patients with ulcerative colitis who are in sustained deep remission. A total of 224 patients treated with tofacitinib, upadacitinib, or filgotinib will be randomized to either treatment withdrawal or continuation of maintenance therapy and followed for 104 weeks. The primary objective is to compare safety, efficacy, and patient satisfaction at Week 52, while secondary objectives include assessment of remission maintenance, quality of life, treatment exposure, endoscopic outcomes, and relapse rates
Detailed description
Background:
Janus kinase (JAK) inhibitors are effective oral therapies for moderate-to-severe ulcerative colitis (UC). Their lack of immunogenicity provides a unique opportunity to evaluate treatment withdrawal and intermittent treatment strategies. However, safety concerns raised by regulatory agencies, including increased risks of infections, venous thromboembolism, major adverse cardiovascular events, and malignancies, support the investigation of strategies aiming to reduce long-term exposure to JAK inhibitors while maintaining disease control.
Objective:
To demonstrate the superiority of a JAK inhibitor stopping strategy compared with standard maintenance therapy in terms of treatment safety, efficacy, and patient satisfaction in adults with ulcerative colitis in deep remission.
Study Design:
This is a phase IV, prospective, multicenter, open-label, randomized controlled trial. Adult patients with ulcerative colitis receiving a stable dose of tofacitinib, upadacitinib, or filgotinib for at least 12 months and achieving sustained steroid-free clinical, biological, and endoscopic remission for at least 6 months will be randomized to either treatment discontinuation or continuation of standard maintenance therapy. A total of 224 participants will be enrolled and followed for 104 weeks.
Primary Endpoint:
The primary endpoint is a composite outcome assessing treatment safety, efficacy, and patient satisfaction during the first 52 weeks after randomization. Patient satisfaction will be evaluated using the Treatment Satisfaction Questionnaire for Medication (TSQM 1.4).
Secondary Endpoints:
Secondary outcomes include adverse events and serious adverse events, maintenance of remission, treatment satisfaction, quality of life, JAK inhibitor exposure, endoscopic outcomes, relapse rates, treatment success at Weeks 52 and 104, and identification of predictors of successful treatment discontinuation.
Expected Benefits:
Reducing exposure to JAK inhibitors may improve the overall safety profile by decreasing treatment-related adverse events while reducing treatment burden for patients with ulcerative colitis. This strategy could support a more individualized and potentially safer long-term management approach for patients in sustained deep remission.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| standard of care | No intervention | – |
| STOP, treatment withdrawal | Experimental | Drug: treatment withdrawal |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (14 listed)
- Diagnosis of UC from at least 6 months according to clinical, endoscopic, histological and/or radiological criteria.
- Male or female age ≥ 18 years
- Currently treated by JAK inhibitor (tofacitinib, upadacitinib or filgotinib) for more than 12 months.
- Currently at a stable dose of tofacitinib (5mg or 10mg twice a day), upadacitinib (15mg or 30mg per day) or filgotinib (200mg per day) for 6 months.
- Clinical steroid free remission for at least 6 months, defined by a partial Mayo Score < 2, with no subscore > 1 and rectal bleeding (RB) subscore of 0 (annex 1).
Key exclusion criteria (19 listed)
- Steroid use ≤ 6 months prior to enrolment.
- Currently treated by steroid, immunosuppressive agents or biologics.
- Pregnancy or planned pregnancy during the study.
- Breastfeeding.
- Non-compliant subject or inability to follow study protocol.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| treatment withdrawalthe patients will stop their treatment, as long as possible until symptom reappearance, if any | Drug | STOP, treatment withdrawal |
Primary outcome
The primary endpoint of this study will be a composite criterion of treatment safety, efficacy, and patient satisfaction during the first 52 weeks of the follow-up.
Time frame: 1 year
treatment safety, during the first 52 weeks of the follow-up.
The primary endpoint of this study will be a composite criterion of treatment safety, efficacy, and patient satisfaction during the first 52 weeks of the follow-up.
Time frame: 1 year
treatment efficacy, during the first 52 weeks of the follow-up.
The primary endpoint of this study will be a composite criterion of treatment safety, efficacy, and patient satisfaction during the first 52 weeks of the follow-up.
Time frame: 1 year
patient satisfaction during the first 52 weeks of the follow-up.
8 secondary outcomes
Safety: occurrence of herpes zoster, infection, cardiovascular event, biochemical parameter, malignancies, adverse event leading to discontinuation, and all adverse events (serious or not) during the whole follow-up.
Time frame: 2 years
Remission rate at the end the first 52 weeks of the follow-up
Time frame: 1 year
Assess the treatment success of this innovative therapeutic strategy at the end of the first 52 weeks of the follow-up and after 104 weeks of follow-up.
Time frame: 2 years
Partial Mayo score at each visit of the entire follow-up
Time frame: 2 years
Number of days under treatment and cumulative dose of treatment per patient between randomization and primary endpoint
Time frame: 1 year
Number of days under induction dose of JAK inhibitor at the end the first 52 weeks of the follow-up.
Time frame: 1 year
Mayo endoscopic subscore at week 52 and week 104
Time frame: 2 years
Proportion of patients relapsing for each arm
Time frame: 2 years
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 22 Jul 2026.
- Individual participant dataSharing planned: Undecided
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Lucas GUILLO, DR principal investigator
AP-HM
22 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 4 study testing treatment withdrawal in people with Ulcerative Colitis in Remission, run by Assistance Publique Hopitaux De Marseille at 22 sites in France.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 14 inclusion and 19 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 22 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 22 sites in France. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Amandine ROLLAND-BRUN (+33 04 91 38 12 45 ext. +33, amandine.rolland@ap-hm.fr), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
The primary endpoint of this study will be a composite criterion of treatment safety, efficacy, and patient satisfaction during the first 52 weeks of the follow-up. (time frame: 1 year). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 Jul 2026.