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Background The STOPAH trial was a double-blind, 2x2 factorial, phase III randomised clinical trial assessing the treatment of prednisolone and pentoxifylline in patients with severe alcoholic hepatitis; a study that aimed to evaluate 28-day mortality [1]. At the time of trial development, the benefits/harms of pentoxifylline in this patient population were unknown. Prednisolone had a significant though uncertain evidence base. No treatment interaction was assumed yet there was uncertainty about its effect. Therefore, pre-specified stopping rules to assist decision making in stopping treatment arms were required.

Design, method and application of stopping rules in a phase III 2x2 factorial randomised controlled trial