Asp-PSC is a ground-breaking clinical trial, funded by Cancer Research UK, that aims to see if the risk of cancer for people with primary sclerosing cholangitis (PSC) can be reduced.

PSC is a rare autoimmune liver disease affecting around 3,000 to 4,000 people in the UK. It is closely associated with inflammatory bowel disease (IBD) and most people with PSC also have IBD. Sadly, there is no effective medical treatment for PSC, and one of the complications of the disease is an increased risk of getting certain cancers. Some of these cancers are challenging to detect and treat and this makes life with PSC uncertain and unpredictable.

Previous studies looking at other health conditions have suggested that taking aspirin may reduce the risk of developing cancer in the bowel, bile duct and other areas. Whether aspirin helps people with PSC is not yet known, and the Asp-PSC trial is designed to find out.

Each participant in the Asp-PSC trial will be given a low dose of aspirin or a dummy drug (placebo) and will be closely monitored over 5 years. During this time, they will have regular scans, give additional blood and urine samples, and complete questionnaires about how they feel every 6 months.

The Asp-PSC clinical trial is one of the largest ever clinical trials for PSC. Nearly a thousand people who have both a diagnosis of IBD and have had PSC for 1 year or longer will take part. Hospitals from all over the UK will be involved to give as many people as possible the chance to take part. It will also be one of the longest ever running PSC studies, lasting over a decade in total.

Some of the data and samples collected during the study will be used to design future studies, which will help us to understand why some people with PSC get cancer and others do not. This information will be crucial for understanding PSC and developing new treatments.

The Asp-PSC research team is led by Professor Shahid Khan (Imperial College London, Clinical Trials Unit/ Imperial College Healthcare NHS Trust), Dr Simon Rushbrook (Norfolk and Norwich University Hospitals NHS Trust/ UK-PSC), Dr Palak Trivedi (NIHR Birmingham BRC/ University Hospitals Birmingham NHS Foundation Trust/ UK-PSC), Mr Hassan Malik (Liverpool University Hospitals NHS Foundation Trust/ BASO), Professor Ruth Langley (MRC Clinical Trials Unit at University College London, Clinical Chair of the UK Therapeutic Cancer Prevention Network), and the two charities, AMMF and PSC Support. 

The Asp-PSC study is expected to begin recruiting volunteers to take part in February 2024.