Oral beclomethasone dipropionate: a topically active corticosteroid for the treatment of gastrointestinal graft-versus-host disease following allogeneic hematopoietic cell transplantation

Expert Opinion on Investigational Drugs
George B McDonald

Abstract

Beclomethasone dipropionate (BDP) is a topically active anti-inflammatory corticosteroid. Oral BDP is metabolized in the intestine to a potent metabolite, 17-beclomethasone monopropionate (17-BMP). An oral formulation (orBec; DOR BioPharma), consisting of a gastric release and an enteric-coated pill, was studied in patients with acute gastrointestinal graft-versus-host disease, an inflammatory disorder that is common after allogeneic hematopoietic cell transplantation. Randomized trials demonstrated that orBec is safe and effective in treating acute gastrointestinal graft-versus-host disease (GVHD) when used with a short induction course of prednisone, reducing the risk of GVHD treatment failure by > 60% and reducing mortality 1 year after randomization by 45%, with fewer deaths due to infection and recurrent malignancy. The type of conditioning and the type of donor had no effect on the frequency of GVHD treatment failure during the 80-day study period; the greatest benefit in terms of survival was among patients who had received reduced-intensity conditioning therapy and among those who received a graft from other than a human leukocyte antigen-matched sibling. orBec controls the intestinal inflammatory process of GVHD and av...Continue Reading

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Citations

Mar 24, 2010·Pediatric Clinics of North America·Paul A Carpenter, Margaret L Macmillan
Sep 28, 2010·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Alexandre A BoudreaultMichael Boeckh
Mar 13, 2010·Clinical Lymphoma, Myeloma & Leukemia·Somashekar G KrishnaElias Anaissie
Mar 17, 2009·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Rami B IbrahimJoseph P Uberti
Sep 15, 2009·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Fernanda N VillanuevaJ F San Miguel

Related Concepts

Anti-Inflammatory Agents
Bronchocort
Clinical Trials
Glucocorticoid Effect
Graft-vs-Host Disease
Transplantation, Homologous
Hemopoietic Stem Cell Transplant
Gastrointestinal Tract Structure

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