Beclomethasone dipropionate in Crohn's ileitis: A randomised, double-blind trial

Background: Steroids, the mainstay of Crohn's disease treatment, have been associated with systemic side effects. Aim: To evaluate the efficacy and tolerability of beclomethasone dipropionate for maintaining remission induced by a short course of systemic steroids in patients with Crohn's ileitis with or without right colonic involvement. Methods: Patients (n= 84) with active Crohn's disease who achieved remission during a 2-week prednisone run-in period were randomised to receive beclomethasone dipropionate for 24 weeks or continue prednisone for a further 2 weeks followed by placebo for 22 weeks. The primary outcome was relapse rate (Crohn's Disease Activity Index score > 150 and an increase of ≥60 points from baseline) or withdrawal due to disease deterioration. Results: The relapse rate was 23.3% and 53.8% in beclomethasone dipropionate and placebo groups, respectively (p= 0.027). According to Kaplan-Meier analysis, the cumulative relapse rate was 38.0% in the beclomethasone dipropionate group and 56.0% in the placebo group (p= 0.025). Six percent and 1.7% of all adverse events in the beclomethasone dipropionate and placebo groups, respectively, were endocrine-related. Conclusion: These results demonstrate that beclomethasone dipropionate significantly reduces the relapse rate in post-active Crohn's ileitis patients compared with placebo after induction of remission with a short course of systemic steroids, and is well tolerated. © 2010 Editrice Gastroenterologica Italiana S.r.l.