Efficacy of Beclomethasone Dipropionate in Lowering Fecal Calprotectin Levels in Patients with Ulcerative Colitis in Clinical Remission and at Risk of Relapse: The Becalcu Randomized, Controlled Trial

Dig Dis. 2024;42(6):600-609. doi: 10.1159/000540792. Epub 2024 Aug 22.

Abstract

Introduction: Identifying novel treatment strategies for patients with ulcerative colitis (UC) and at risk of relapse is critical. The objective of this study was to assess the efficacy of beclomethasone dipropionate (BDP) in lowering fecal calprotectin (FC) levels in UC patients in clinical remission and at risk of relapse.

Methods: This multicenter study comprised a double-blind, randomized, placebo-controlled phase (part I) and an open-label, non-randomized phase (part II). Eligible participants with UC in clinical remission treated with 5-aminosalicylic acid and with FC levels ≥250 μg/g were randomized to receive 5 mg/day of BDP or placebo for 4 weeks (part I). At week 5, patients with FC ≥100 μg/g were treated with 5 mg/day of BDP for 4 weeks (part II), and FC levels were tested at week 9.

Results: Forty-three patients were randomized: 22 received BDP (group A) and 21 placebo (group B). At week 4, 13 patients (59.1%) in group A and 3 (17.6%) in group B had FC levels <100 μg/g (p value = 0.010). In the double-blind phase of the study, no patient relapsed in group A and 4 in group B (p value = 0.049). Both treatment groups showed a favorable safety profile, with the most common adverse events being gastrointestinal disorders.

Conclusion: In this multicenter, randomized clinical trial including patients with UC in clinical remission but with elevated FC, BDP was efficacious in reducing FC and well-tolerated.

Keywords: Beclomethasone dipropionate; Fecal calprotectin; Remission; Ulcerative colitis.

Publication types

  • Randomized Controlled Trial
  • Multicenter Study

MeSH terms

  • Adult
  • Anti-Inflammatory Agents / therapeutic use
  • Beclomethasone* / administration & dosage
  • Beclomethasone* / therapeutic use
  • Colitis, Ulcerative* / drug therapy
  • Colitis, Ulcerative* / metabolism
  • Double-Blind Method
  • Feces* / chemistry
  • Female
  • Humans
  • Leukocyte L1 Antigen Complex* / analysis
  • Leukocyte L1 Antigen Complex* / metabolism
  • Male
  • Middle Aged
  • Recurrence
  • Remission Induction
  • Treatment Outcome
  • Young Adult

Substances

  • Anti-Inflammatory Agents
  • Beclomethasone
  • Leukocyte L1 Antigen Complex

Grants and funding

This work was supported by Chiesi España S.A.U.