Randomized Study of Oral Beclomethasone Dipropionate With Ten Days of Prednisone for Treatment of Gastrointestinal GVHD

Summary

Patients with gastrointestinal graft-vs.-host disease are randomized to oral beclomethasone dipropionate (BDP) 8 mg/day or identical placebo tablets for 50 days, along with a 10-day induction course of prednisone. At study day 10, patients whose symptoms of GVHD are under control undergo a rapid prednisone taper over 7 days, while study drug is continued to study day 50. After discontinuation of study drug at study day 50, patients are followed for 30 additional days, to study day 80. The primary endpoint is treatment failure by day 50, that is, a flare of the symptoms of GVHD that requires immunosuppressive therapy. Secondary endpoints are treatment failure by day 80, treatment-emergent adverse events, and survival at transplant day 200. The hypothesis to be tested is that a topically-active corticosteroid (beclomethasone dipropionate, BDP), taken orally, would allow rapid tapering of prednisone while maintaining control of intestinal GVHD.

Timeline

Start

2001-07

Primary completion

—

Completion

2004-12

Publications

• Background McDonald GB, Bouvier M, Hockenbery DM, Stern JM, Gooley T, Farrand A, Murakami C, Levine DS. Oral beclomethasone dipropionate for treatment of intestinal graft-versus-host disease: a randomized, controlled trial. Gastroenterology. 1998 Jul;115(1):28-35. doi: 10.1016/s0016-5085(98)70361-0.
• Background Baehr PH, Levine DS, Bouvier ME, Hockenbery DM, Gooley TA, Stern JG, Martin PJ, McDonald GB. Oral beclomethasone dipropionate for treatment of human intestinal graft-versus-host disease. Transplantation. 1995 Dec 15;60(11):1231-8.
• Results Hockenbery DM, Cruickshank S, Rodell TC, McDonald GB. A phase 3 randomized, placebo-controlled study of oral beclomethasone 17, 21-dipropionate (BDP) in conjunction with ten days of high-dose prednisone therapy for patients with gastrointestinal graft vs. host disease. Proceedings of the American Association for Cancer Research 45 (Supplement): 109, 2005. Presented at the annual meeting of the American Association for Cancer Research, Anaheim, CA, 2005.

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Indications