Oral Mucositis – New Treatment Options

About

Oral Mucositis is a common side effect of chemotherapy and or radiation treatment in which painful mouth sores develop. Strategies for treatment of mucositis seek to provide symptomatic relief as well as address the underlying pathobiology. A basic principle of treating oral mucositis is maximizing contact time between therapeutic agents and the oral mucosal tissue. Poor contact time between medication and mucosa could detract from desired outcomes. 

At HDRX, a mucoadhesive polymer technology is utilized to hold medication in contact with the injured oral tissue. Mucoadhesive technology optimizes contact time between medication and oral mucosa.

Insights into the inflammatory and destructive processes underlying mucositis have led to research of new therapeutic agents. Some therapeutic agents that can be delivered via the HDRX mucoadhesive polymer technology are described below. 

Symptomatic Support

Mucoadhesive polymer technology provides hydration support and facilitates extended contact

between membranes and prescribed therapy. 

Supersaturated calcium phosphate mouth rinse treatment has been found to reduce the severity and duration of oral mucositis, resulting in the less frequent use of pain killers among patients treated with BEAM, a high-dose chemotherapy treatment. 

Lidocaine provides relief for mucositis-associated pain.  

Pathobiological Support

Anti-Inflammatory

Pentoxifylline is an anti-inflammatory inhibiting IL-1B, IL6, IL8, and TNF-a and has been shown to reduce the severity of radiotherapy-induced mouth pain in head and neck cancer patients. Anti-Oxidant

Glutamine (GLN) is an amino acid with immunomodulatory properties. GLN has been shown to decrease oxidative stress-related gene expression and increases antioxidant potential. In head and neck cancer patients, GLN has been shown to reduce frequency and duration of grade 3 and grade 4 mucositis.

N-Acetyl-cysteine is a thiol-containing amino acid with anti-oxidant activity and potential radioprotective properties. 

Epithelial Growth Factor

Phenytoin is an epithelial growth factor stimulant demonstrating resolution of mucositis lesions in an average of 4.5 days.  

Features of HDRX Compounds for Mucositis

  1. Mucoadhesive delivery- enhanced contact time to deliver curative ingredients to injured mucous membrane.  
  2. Room temperature storage
  3. Sugar-Free, Alcohol-free
  4. Multi-ingredient Synergy

Consult with a Health Dimensions (HDRX) clinical pharmacist today, 800.836.2303. 

 

Resources:

Effects of glutamine supplementation on oxidative stress-related gene expression and antioxidant properties in rats with streptozotocin-induced type 2 diabetes – PubMed (nih.gov)

 

Modulation of radiation-induced oral mucositis by pentoxifylline: preclinical 

studies. Strahlenther Onkol. 2015 Mar;191(3):242-7. doi: 10.1007/s00066-014-0775-1. Epub 

2014 Oct 29.

 

Efficacy of topical phenytoin on chemotherapy-induced oral mucositis; a pilot study – PubMed (nih.gov)

 

Radioprotection and Radiomitigation: From the Bench to Clinical Practice (nih.gov)