Chemotherapy-induced oral mucositis management: A retrospective analysis of MuGard, Caphosol, and standard supportive care measures

Abstract

Background Oral mucositis, a common complication of several different anticancer therapies, causes significant morbidity in cancer patients. It is characterized by the destruction of the mucosa throughout the gastrointestinal tract including the oral cavity. Limited data exist regarding the treatment of established oral mucositis with oral mucoadhesive hydrogel (MuGard) or supersaturated calcium phosphate oral rise (Caphosol) compared to standard topical therapies. Objectives To evaluate the effects of MuGard and Caphosol compared to standard topical therapy in the treatment of established oral mucositis. Methods A retrospective chart review was performed including adults receiving MuGard, Caphosol, and/or standard topical therapy for the treatment of established oral mucositis while admitted to a community teaching hospital. A post hoc propensity score was used to match patients receiving newer agents (Mugard/Caphosol) to those receiving standard topical therapy (ST). Results One hundred and forty-seven patients were included for analysis (125 ST, 15 MuGard, 7 Caphosol). From this population, 14 patients in each group were matched. The primary endpoint of median change in average daily pain score at days 3 and 7, compared to baseline, demonstrated no difference between matched groups at day 3 (ST 0, MuGard/Caphosol 0.18, p = 0.830) or day 7 (ST 0, MuGard/Caphosol 0.8, p = 0.494). No differences were noted between groups in opioid usage, oral mucositis symptom duration or progression, or incidence of documented infection. Conclusion MuGard and Caphosol did not demonstrate any benefits compared to standard topical therapy at reducing pain scores or increasing mucosal recovery in the treatment of oral mucositis.

Randomized controlled and double-blinded study of Caphosol versus saline oral rinses in pediatric patients with cancer

“…[17][18][19] Favorable results were also reported in the adult population with head and neck cancer undergoing radiotherapy or radiochemotherapy. 20 A few randomized trials 13,21,22 Participants in our study were pediatric cancer patients undergoing conventional chemotherapy with a mean age of 6.5 years. The outcome analysis was based on the assessment of both health care professionals (WHO scale) and patient/caretakers (ChIMES).…”

“…12 Caphosol is a super-saturated Ca(2+)/PO(4) (3-) containing mouth rinse that is suggested to enhance healing of the mucosal signalling pathways resulting in reduced inflammation, and activation of mucosa healing and epithelial proliferation. 13 Since there is little evidence about the effects of Caphosol solution as a preventive mouth rinse in pediatric oncology patients, we compared Caphosol to saline rinses as a mucositis preventive measure in a randomized and double-blinded trial.…”

Randomized controlled and double‐blinded study of Caphosol versus saline oral rinses in pediatric patients with cancer

“…Recently, the use of the Caphosol (Jazz Pharmaceuticals plc) solution has gained popularity 12 . Caphosol is a super‐saturated Ca(2+)/PO(4)(3−) containing mouth rinse that is suggested to enhance healing of the mucosal lesions 13 . Caphosol is a high‐ionic solution that permeates the oral mucosa and activates different signaling pathways resulting in reduced inflammation, and activation of mucosa healing and epithelial proliferation 13 …”

“…12 Caphosol is a super-saturated Ca(2+)/PO(4)(3−) containing mouth rinse that is suggested to enhance healing of the mucosal lesions. 13 Caphosol is a high-ionic solution that permeates the oral mucosa and activates different signaling pathways resulting in reduced inflammation, and activation of mucosa healing and epithelial proliferation. 13 Since there is no evidence about the effects of Caphosol solution as a preventive measure in pediatric oncology patients, we compared Caphosol to saline rinses as a preventive measure against mucositis in a randomized and double-blinded crossover trial.…”

“…13 Caphosol is a high-ionic solution that permeates the oral mucosa and activates different signaling pathways resulting in reduced inflammation, and activation of mucosa healing and epithelial proliferation. 13 Since there is no evidence about the effects of Caphosol solution as a preventive measure in pediatric oncology patients, we compared Caphosol to saline rinses as a preventive measure against mucositis in a randomized and double-blinded crossover trial. We hypothesized that the frequency and severity of OM would be three times higher after the saline rinse compared to Caphosol rinse.…”