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The Standard Care Versus Celecoxib Outcome Trial (SCOTLSSS)

This study has been completed.
University of Glasgow
University of Nottingham
Information provided by (Responsible Party):
Thomas M MacDonald, University of Dundee Identifier:
First received: March 14, 2007
Last updated: January 7, 2016
Last verified: January 2016

The Standard Care versus Celecoxib Outcome Trial (SCOT) is a large streamline safety study designed to compare the cardiovascular safety of celecoxib versus traditional non-selective Non Steroidal Anti-Inflammatory Drug (NSAID) therapy.Traditional NSAID's are associated with significant morbidity and mortality from gastrointestinal toxicity. Cyclooxygenase 2 (Cox-2)selective agents are associated with reduced upper gastrointestinal toxicity.Traditional NSAID's and Cox-2 inhibitors may also be associated with cardiovascular and renal disorders. Data from both randomised and observational studies suggest that celecoxib has similar or reduced cardiovascular toxicity when compared to traditional NSAID's. However, the overall safety balance of a strategy of celecoxib therapy versus a strategy of NSAID therapy is unknown. The European Medicines Evaluation Agency (EMEA) has requested that studies of the cardiovascular safety of celecoxib be carried out within the indicated population of Europe. This study addresses these issues by comparing the cardiovascular safety of celecoxib therapy with traditional NSAID therapy in the setting of the EU healthcare system.

As of May 2013, 7300 patients had been randomised, and had accrued an average 4.2 years of follow up by the end of May 2014.

Condition Intervention Phase
Rheumatoid Arthritis
Drug: Celecoxib
Drug: non-selective Non steroidal anti inflammatory Drug
Phase 4

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Prevention
Official Title: Phase 4 Study A Large Streamline Safety Study Designed to Compare the Cardiovascular Safety od Celecoxib Versus Traditional Non-selective NSAID's

Resource links provided by NLM:

Further study details as provided by University of Dundee:

Primary Outcome Measures:
  • To compare cardiovascular safety of celecoxib and traditional NSAIDs prescribed for the treatment of arthritis. [ Time Frame: 4 years ]

Secondary Outcome Measures:
  • Is to demonstrate the superiority of celecoxib over traditional NSAIDs on ulcer-related upper gastrointestinal complications. [ Time Frame: 4 years ]

Enrollment: 7300
Study Start Date: June 2007
Study Completion Date: August 2015
Primary Completion Date: August 2015 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Celecoxib
Drug: Celecoxib
200-400mg daily in divided doses
Other Name: Celebrex
Active Comparator: NSAID
Drug: non-selective Non steroidal anti inflammatory Drug
taken orally
Other Names:
  • Diclofenac
  • Ibuprofen
  • Naproxen
  • meloxicam

Detailed Description:


The present proposal seeks to compare the cardiovascular and gastrointestinal safety and effectiveness of a strategy of initial randomisation to treatment with the selective COX-2 inhibitor celecoxib or to 'usual-care' with their current non-selective NSAID therapy (with or without cyto-protection with ulcer healing drug use in either celecoxib or 'usual-care' limbs).

Trial Design

This trial utilises the Prospective Randomised Open Blinded End point (PROBE) design . Patients with clinically diagnosed osteoarthritis (OA) or rheumatoid arthritis (RA) 60 years of age or more who are free from established cardiovascular disease and who require chronic NSAID therapy will be identified in the setting of primary care. Patients will be randomised to receive either celecoxib or to continue their previous standard NSAID therapy. They will then be followed up for an average of 4.2 years in the setting of the local National Healthcare system. The study will terminate when 277 adjudicated cardiovascular events have accrued. A summary is shown in the diagram below.


Ages Eligible for Study:   60 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Subjects 60 years or over Male & Female
  • Chronic NSAIDs use for 90 days or more in a 12 month period
  • Subjects who have a licensed indication for chronic non-selective NSAID or Celecoxib.
  • Eligible for treatment with either Celecoxib or alternative traditional non-selective NSAID.
  • Subjects who are willing to consent to their paper and electronic medical records and prescribing data to be accessed.
  • Subjects who are willing to be contacted and interviewed by trial investigators.

Exclusion Criteria:

  • Established cardiovascular disease including ischaemic heart disease, Myocardial Infarction, angina or acute coronary syndrome, cerebrovascular disease or cerebrovascular accident or transient ischaemic attack, established peripheral vascular disease and moderate to severe heart failure.
  Contacts and Locations
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Please refer to this study by its identifier: NCT00447759

University of Southern Denmark
Odense, Denmark, 5000
Julius Clinical Research
Zeist, Netherlands, 3703 CD Zeist
United Kingdom
University of Aberdeen
Aberdeen, United Kingdom, AB25 2ZN
University of Birmingham
Birmingham, United Kingdom, B15 2TT
University of Dundee
Dundee, United Kingdom, DD1 9SY
University of Edinburgh
Edinburgh, United Kingdom, EH4 2XU
University of Glasgow
Glasgow, United Kingdom, G11 6NT
NHS Highlands
Inverness, United Kingdom, IV2 3JH
University of Nottingham
Nottingham, United Kingdom, NG7 2UH
University of Oxford
Oxford, United Kingdom, OX1 2ET
Sponsors and Collaborators
University of Dundee
University of Glasgow
University of Nottingham
Principal Investigator: Thomas M MacDonald, MD MRCP FRCP University of Dundee
Principal Investigator: Ian Ford, FRCP FRSE University of Glasgow
Principal Investigator: Christopher J Hawkey, MRCP DM FRC University of Nottingham
  More Information

Additional Information:
Publications automatically indexed to this study by Identifier (NCT Number):
Responsible Party: Thomas M MacDonald, Professor, University of Dundee Identifier: NCT00447759     History of Changes
Other Study ID Numbers: SCOT Trial
Study First Received: March 14, 2007
Last Updated: January 7, 2016

Keywords provided by University of Dundee:
Rheumatoid Arthritis
Safety study
Cardiovascular safety
Clinical trial
PROBE design
University of Dundee
Medicines Monitoring Unit
Professor Tom MacDonald

Additional relevant MeSH terms:
Arthritis, Rheumatoid
Joint Diseases
Musculoskeletal Diseases
Rheumatic Diseases
Connective Tissue Diseases
Autoimmune Diseases
Immune System Diseases
Anti-Inflammatory Agents
Anti-Inflammatory Agents, Non-Steroidal
Cyclooxygenase 2 Inhibitors
Cyclooxygenase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Analgesics, Non-Narcotic
Sensory System Agents
Peripheral Nervous System Agents
Physiological Effects of Drugs
Antirheumatic Agents processed this record on April 24, 2017