Around half of Crohn’s disease patients need surgery to remove a damaged section of bowel within five years of diagnosis, and most then experience a recurrence. This multicentre trial tests whether the drug 6-mercaptopurine, already used to manage Crohn’s symptoms, can prevent that post-surgical return of the disease. Previous studies on this question have been too small, retrospective, or poorly designed to give a clear answer. The trial will measure symptom recurrence as its primary outcome, with endoscopic checks and the need for further surgery as secondary measures. If the drug proves effective, uptake could be rapid and widespread. For patients, that would mean fewer relapses, less need for repeat operations, and a better quality of life after surgery. For the health system, it could reduce the long-term costs of managing a chronic, relapsing bowel condition. The trial directly addresses a gap in post-surgical care that has persisted for decades.
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Crohn s disease is a chronic disabling condition affecting the bowel. Although medical treatment is effective approximately 50% of patient will need an operation to remove an affected segment of bowel over the first 5 years after diagnosis. Recurrence following surgery occurs in the majority of patients. 6-Mercaptopurine is an effective treatment for the reduction of symptoms and maintenance of well being in Crohn s disease but its use to prevent post operative recurrence is poorly defined. Previous studies have been small, retrospective or flawed in design. In this multicentre study we wish to assess the value of the drug 6-mercaptopurine to prevent recurrence of Crohn s disease following surgery. We will use the recurrence of symptoms as the primary outcome measure, with endoscopic examination of the relevant area and the need for further sugery as secondary outcome measures. If this trial were to show an effect of the drug we would anticipate a wide uptake and improved quality of life for patients with Crohn s disease following surgery.
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