Evaluation of Oral Beclomethasone Dipropionate for Prevention of Acute Graft-versus-Host Disease.

Publication Type:

Journal Article

Source:

Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation, Volume 18, Issue 6, p.922-929 (2012)

Keywords:

2012, Center-Authored Paper, Clinical Research Division, December 2011, Vaccine and Infectious Disease Division

Abstract:

Results from 2 randomized trials have shown that oral beclomethasone dipropionate (BDP) is effective for treatment of acute gastrointestinal graft-versus-host disease (GVHD). Here, we report results of a double-blind, randomized placebo-controlled phase II study designed to test the hypothesis that acute GVHD could be prevented by administration of oral BDP, beginning before hematopoietic cell transplantation (HCT) and continuing until day 75 after HCT after myeloablative conditioning. Study drug (BDP or placebo) was administered as 1 mg immediate-release formulation plus 1 mg delayed-release formulation orally 4 times daily. According to the primary endpoint, systemic glucocorticoid treatment for GVHD was given to 60 of the 92 participants (65%) in the BDP arm, versus 31 of 46 participants (67%) in the placebo arm. The secondary efficacy endpoints showed no statistically significant differences between the 2 arms. The proportion of participants who took at least 90% of the prescribed study drug during the first 4 weeks after HCT was 54% overall. Lower severity of mucositis strongly correlated with higher adherence to the schedule of study drug administration. Inconsistent adherence related to mucositis during recovery after myeloablative conditioning may have obscured a beneficial therapeutic effect in the current study.