{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T06:05:27Z","timestamp":1791266727307,"version":"4.1.0"},"reference-count":50,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T00:00:00Z","timestamp":1768867200000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Chronic graft\u2010versus\u2010host disease (cGVHD) is a complex, immune\u2010mediated, multisystem disease with a high symptom burden. While treatment with systemic corticosteroids is first\u2010line, approximately 70% of patients require additional treatments because of either inadequate efficacy or steroid toxicity, highlighting the need for effective steroid\u2010sparing therapies. Belumosudil, an oral ROCK2 inhibitor, has been studied in trials and real\u2010world cohorts with varying results. We set out to systematically evaluate and meta\u2010analyze the efficacy and safety of belumosudil in cGVHD. We systematically searched PubMed, Scopus, Web of Science, and Cochrane Library databases for relevant studies published up until August 2025. Eligibility criteria were predefined to identify relevant studies assessing belumosudil for cGVHD. Quality assessment of included studies was assessed using the MINORS tool. Meta\u2010analysis was conducted using Comprehensive Meta\u2010Analysis (v.3), adopting an inverse variance random effect model. Systematic literature search yielded inclusion of eleven studies (total participants\u00a0=\u00a0477 patients). At 12 months, the pooled overall response rate (ORR) was 73% (95% CI 64\u201381) and 58% of patients showed a reduction in corticosteroid use with 95% CI (46%\u201370%), with improvement in patient\u2010reported quality of life assessed by the Lee Symptom Scale. In a meta\u2010regression analysis, higher baseline cGVHD severity independently predicted corticosteroid tapering success (\n                    <jats:italic>\u03b2<\/jats:italic>\n                    \u00a0=\u00a00.027; OR\u00a0=\u00a01.03;\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a00.031). Overall survival was 87% (95% CI 82\u201391) at 12 months and 85% (95% CI 79\u201390) at 24 months; failure\u2010free survival at 12 months was 65% (95% CI 52\u201375). Regarding safety of belumosudil, any\u2010grade adverse events occurred in 98% (95% CI 95\u201399), serious adverse events in 38.9% (95% CI 32.6\u201345.6); common events were diarrhea 22.1%, headache 22.3%, and fatigue 20.5%. Belumosudil exhibits significant clinical efficacy in cGVHD refractory or dependent on steroids, evidenced by a high objective response rate at 12 months, substantial steroid\u2010sparing benefits, durable survival, and amelioration of disease\u2010associated symptoms.\n                  <\/jats:p>","DOI":"10.1111\/ctr.70458","type":"journal-article","created":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T14:20:03Z","timestamp":1768918803000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Organ Responses, Survival, and Safety of Belumosudil in Chronic Graft\u2010Versus\u2010Host Disease: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"40","author":[{"given":"Ahmed Farid","family":"Gadelmawla","sequence":"first","affiliation":[{"name":"Faculty of Medicine Menoufia University  Menoufia Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3571-7708","authenticated-orcid":false,"given":"Mohamed A.","family":"Alsaied","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Mansoura University  Mansoura Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5412-046X","authenticated-orcid":false,"given":"Mohanad A.","family":"Alkuwaiti","sequence":"additional","affiliation":[{"name":"College of Medicine Imam Abdulrahman Bin Faisal University  Dammam Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Najmah A.","family":"Alsaihati","sequence":"additional","affiliation":[{"name":"College of Medicine Imam Abdulrahman Bin Faisal University  Dammam Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahad","family":"Al\u2010Hemidin","sequence":"additional","affiliation":[{"name":"College of Medicine King Saud University  Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hussam","family":"Al\u2010Dakhil","sequence":"additional","affiliation":[{"name":"College of Medicine Qassim University  Buraydah Saudia Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Majed S.","family":"Alshertan","sequence":"additional","affiliation":[{"name":"College of Medicine Hail University  Hail Saudia Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaden A.","family":"Aljohani","sequence":"additional","affiliation":[{"name":"College of Pharmacy Hail University  Hail Saudia Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shatha S.","family":"Aloglla","sequence":"additional","affiliation":[{"name":"Clinical Science Department, College of Medicine Princess Nourah bint Abdulrahman University  Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Munirah","family":"Aljoudi","sequence":"additional","affiliation":[{"name":"College of Pharmacy Ummul Al Qura University  Mecca Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Al\u2010Wusaybie","sequence":"additional","affiliation":[{"name":"College of Medicine Qassim University  Buraydah Saudia Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naif","family":"Aljamlan","sequence":"additional","affiliation":[{"name":"College of Medicine King Saud University  Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatimah S.","family":"Alshahrani","sequence":"additional","affiliation":[{"name":"College of Medicine King Saud University  Riyadh Saudi Arabia"},{"name":"Division of Infectious Diseases, Department of Internal Medicine King Saud University Medical City King Saud University  Riyadh Saudi Arabia"},{"name":"Infection Prevention and Control Department King Saud University Medical City  Riyadh Saudia 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