Can besudil reduce hormone dependence? Clinical research data analysis

Chronic graft-versus-host disease (cGVHD) has long been treated with glucocorticoids as the first-line treatment standard, but continued use of steroids can easily lead to many complications, such as osteoporosis, hyperglycemia, mood disorders, and secondary infections. Besudil mesylatetablets (Belumosudil)’s advent provides a new direction for reducing dependence on hormone use. As a type of immunomodulator that acts on the ROCK2 signaling pathway, besudil affects the balance of Th17 and Treg cells and reduces the levels of inflammatory cytokines, thereby inhibiting tissue fibrosis and chronic inflammatory response, and achieving the purpose of alleviating the symptoms of cGVHD. Its mechanism is different from the broad-spectrum immunosuppression of glucocorticoids, and is more towards the selective regulation of immune function, thus providing an important auxiliary tool for hormone reduction.

In multiple overseas studies, besudil has been used in patients with cGVHD who have failed at least two previous systemic treatments. Data show that besudil can enable a considerable proportion of patients to reduce or completely discontinue glucocorticoid doses while maintaining or improving disease control, and some patients even achieve long-term steroid-free remission while maintaining efficacy. Although the specific hormone reduction path varies from person to person, in clinical management, besudil is often used as part of a steroid sustained-release strategy, especially for cases with significant hormone-related toxicity or difficult to break away from hormone dependence.

In addition, long-term use of besudil has not been associated with metabolic disorders or central nervous system side effects common with hormonal drugs, and its reusability and tolerability support its stable role in the chronic management ofcGVHD. For patients who wish to reduce their hormone burden, besudil may not only delay the occurrence of hormone-related complications but also improve quality of life and long-term survival expectations.

Reference: https://www.drugs.com/pro/rezurock.html