Research Update: STOP-ACEi Trial

Many of you are involved in the STOP-ACEi trial which is ongoing at 38 renal units across the UK. The trial aims to address the current uncertainty and inconsistent practice with use of ACE inhibitors and ARBs in the advanced stages of CKD. Participants with advanced progressive CKD are randomised to either continue or STOP existing treatment with ACEi/ARBs, and then followed up for 3 years. There has been a lot of interest in this clinical question both nationally and internationally, and I was interested to see it was a subject of debate at this summer’s meetings in Madrid, Edinburgh and Liverpool, with no real consensus as to what to do, which emphasises the continued importance of this study.

I am hugely grateful to all the renal researchers involved who have made a fantastic effort. There are now 360 patients in the trial – the largest of its kind – and we need just 50 more to complete recruitment. But the trial has not been without its challenges and recruitment has been slower than anticipated. At current rates we will complete recruitment in March 2018, but there is no guarantee the NIHR funding body will allow us this additional time when they next review the progress in December 2017. If each centre can recruit another 2 participants, we will reach the target and complete the recruitment stage.

It’s imperative that we have a solid evidence base and know we are doing the right thing for patients before practice changes without the support of trial data. We are on the home straight now and I encourage all centres to make a final push for recruitment. Please look again at your clinic lists and patient databases. I am confident that the renal community can rise to the challenge and we can resolve this important research question.

If I can be of any help, do not hesitate to contact me (sunil.bhandari@hey.nhs.uk), or the Trial Coordinator in Birmingham (Marie Valente, stopacei@trials.bham.ac.uk).