Nonabsorbable corticosteroids use in the treatment of gastrointestinal graft-versus-host disease.
For over a decade, nonabsorbable corticosteroids have been employed in the treatment of gastrointestinal graft-versus-host-disease (GVHD) in hematopoietic stem cell transplant (HSCT), as monotherapy or in combination with systemic corticosteroids. The majority of the evidence showing a favorable outcome consisted of case series, small phase II trials and a large randomized phase III trial. The 2 most commonly studied molecules were oral budesonide and beclomethasone diproprionate. Although these reports hint at some benefit with the local treatment strategy, their methodologic inconsistencies preclude meaningful adoption to everyday clinical practice. This review evaluates the current evidence of nonabsorbable corticosteroids in HSCT and sets forth recommendations for future trials with these agents.
Ibrahim
Rami B
RB
Karmanos Cancer Institute and Wayne State University, Detroit, Michigan 48201, USA. ibrahim@karmanos.org
Abidi
Muneer H
MH
Cronin
Simon M
SM
Lum
Lawrence G
LG
Al-Kadhimi
Zaid
Z
Ratanatharathorn
Voravit
V
Uberti
Joseph P
JP
D001507:Beclomethasone / Q000627:therapeutic use*; D019819:Budesonide / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D005767:Gastrointestinal Diseases / Q000188:drug therapy*; D005938:Glucocorticoids / Q000627:therapeutic use*; D006086:Graft vs Host Disease / Q000188:drug therapy*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D016896:Treatment Outcome
D005938:Glucocorticoids; D019819:Budesonide; D001507:Beclomethasone