Casein glycomacropeptide for active distal ulcerative colitis: a randomized pilot study

Eur J Clin Invest. 2016 Jun;46(6):555-63. doi: 10.1111/eci.12634.

Abstract

Background: In ulcerative colitis (UC), dietary supplements may have anti-inflammatory properties and improve disease course. We investigated the effects of casein glycomacropeptide (CGMP), a fraction of bovine whey protein, in active UC.

Materials and methods: In a randomized open-label intervention study, 24 patients with active UC involving 10-40 cm of the distal colon were randomized in a 2 : 1 ratio into two groups. The first group was administered their usual treatment plus a daily supplement of CGMP 30 g, and the second group was administered a dose escalation to 4800 mg oral mesalamine daily (standard treatment) for 4 weeks. Clinical, endoscopic, mucosal and circulating disease activity markers were monitored. Acceptance of and adherence to CGMP up to 8 weeks were documented.

Results: After 4 weeks of treatment, 10 of 16 (63%) patients who received CGMP had an unchanged or decreased Simple Clinical Colitis Activity Index (SCCAI), which was similar to the four of eight (50%) (P = 0·67) patients on the standard treatment. The number of patients in which SCCAI decreased by three or more did not differ between the two groups: nine of 16 (56%) in the CGMP group vs. four of eight (50%) in the standard treatment group (P = 0·77). Changes in disease extent and severity were similar between the two groups. CGMP was well tolerated and accepted by the patients.

Conclusions: The addition of CGMP as a nutritional therapy to standard treatment was safe and accepted by patients with active distal UC. The disease-modifying effect of CGMP was similar to that of the mesalamine dose escalation.

Keywords: Casein glycomacropeptide; clinical trial; inflammatory bowel diseases; ulcerative colitis.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Caseins / therapeutic use*
  • Colitis, Ulcerative / drug therapy*
  • Dietary Supplements
  • Female
  • Glycopeptides / therapeutic use*
  • Humans
  • Male
  • Mesalamine / therapeutic use
  • Middle Aged
  • Pilot Projects
  • Rectal Diseases / drug therapy*
  • Severity of Illness Index
  • Sigmoid Diseases / drug therapy*
  • Treatment Outcome
  • Young Adult

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Caseins
  • Glycopeptides
  • kappa-casein glycomacropeptide
  • Mesalamine