Oral Hygiene Regimen in Patients on HCT

NCT ID: NCT02662374

Last Updated: 2016-01-25

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

45 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-09-30

Study Completion Date

2016-05-31

Brief Summary

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Oral mucositis is one of the most common debilitating forms of mucositis that arise from high dose chemotherapy and radiotherapy. It is reported that almost 75% patients undergoing hematopoietic cell transplantation (HCT) develop oral mucositis at different levels of severity. The objective of this prospective study was to assess the efficacy of the addition of supersaturated calcium phosphate oral spray and the addition of an extra soft tooth brush to the basic OH in addition to the currently existing oral hygiene protocol regimen (0.2% Chlorhexidine Gluconate + 3% Sodium Bicarbonate+ Nystatin 100000 U/ml) in reducing the severity of oral mucositis among patients receiving chemotherapy for HCT.

60 patients receiving chemotherapy for HCT were randomly allocated to four groups of 15 patients each The oral mucositis was recorded according to WHO criteria and the progression of the oral mucositis was monitored from the day of admission (day

* 1\) to the day of discharge (day 28). The absolute neutrophil count, platelet counts and salivary flow rate of all patients was recorded.

Detailed Description

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This study will be prospective randomized case controlled study

Oral mucositis and oral hygiene protocol intervention:

45 patients admitted at King Faisal specialist hospital and Research Center in Riyadh for HCT and receiving chemotherapy regimen will be observed for the incidence and severity of oral mucositis.

Inclusion criteria:

* 3 to 16 years patients
* Male and female
* Allogeneic transplant
* Patient receiving conditioning regime

* CYTOXAN, ATG, FLUDARABINE
* BUSULPHAN/CYTOXAN/ATG WITH MTX
* BUSULPHAN/CYTOXAN WITH MTX
* FLUDARABINE/BUSULPHAN

Exclusion criteria:

* Patient age greater than 16 years and less than 3 years.
* Previous radiotherapy
* Had more than one graft.

Data Collection The child's age, gender, living area, type of disease, conditioning treatment protocol, absolute neutrophil count level, platelet count, use of opiate analgesics and patient reported outcome (pain, ability to eat, saliva flow rate and it is thickness) will be recorded.

Each patient will be examined once daily until discharge using the WHO criteria (see appendix I) At day -1

* All patient will receive an oral examination before chemo regimen or HCT started using the WHO oral health assessment form and the OM form as baseline for each patient.
* Start of the oral health protocol

Day 0, day 5, day10, day20, and day 25 Examination by tongue depressor and penlight to fill the OM form only and application of the oral hygiene protocol.

Oral health care protocol (OHCP):

Patients who fit the inclusion criteria will be randomly assigned to one of the following three groups Control group (15 patient) The control group will receive oral hygiene using the following protocol

* Chlorhexidine gluconate as a mouth wash 4 times daily
* Sodium bicarbonate mouth wash 4 times daily
* Patient can rinse by sterile water any time
* Nystatin will be administered 4 times.

Test group1 (15 patient)

* Twice a day oral prophylaxis by extra soft brush and water
* Chlorhexidine gluconate as a mouth wash 4 times daily
* Sodium bicarbonate mouth wash 4 times daily
* Patient can rinse by sterile water any time
* Nystatin will be administered 4 times.

Test group 2(15 patient)

* Supersaturated Calcium Spray 4 times daily
* Chlorhexidine gluconate as a mouth wash 4 times daily
* Sodium bicarbonate mouth wash 4 times daily
* Patient can rinse by sterile water any time
* Nystatin will be administered 4 times.

Test group 3(15 patient)

* Twice a day oral prophylaxis by extra soft brush and water Supersaturated Calcium Spray 4 times daily.
* Chlorhexidine gluconate as a mouth wash 4 times daily
* Sodium bicarbonate mouth wash 4 times daily
* Patient can rinse by sterile water any time
* Nystatin will be administered 4 times.

Conditions

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Oral Mucositis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Participants

Study Groups

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Control

0.02% Chlorohexidine Gluconate: Mouth Rinse, 5ml, qid 3% Sodium Bicarbonate, Mouth Rinse, 5ml, qid Nystatin 10000U/ml : Mouth rinse, 5ml, qid

Group Type ACTIVE_COMPARATOR

.02% Chlorohexidine Gluconate

Intervention Type DRUG

5ml of the drug in mouthwash form to be swished four times a day

3% Sodium Bicarbonate

Intervention Type DRUG

5ml of the drug in the form of a prepared solution to be swished four times a day

Nystatin 10000U/ml

Intervention Type DRUG

5ml of the drug in mouthwash form to be swished and swallowed four times a day

Group 1

0.02% Chlorohexidine Gluconate: Mouth Rinse, 5ml, qid 3% Sodium Bicarbonate, Mouth Rinse, 5ml, qid Nystatin 10000U/ml : Mouth rinse, 5ml, qid Extra soft toothbrush, brushing with saline bd

Group Type EXPERIMENTAL

.02% Chlorohexidine Gluconate

Intervention Type DRUG

5ml of the drug in mouthwash form to be swished four times a day

3% Sodium Bicarbonate

Intervention Type DRUG

5ml of the drug in the form of a prepared solution to be swished four times a day

Nystatin 10000U/ml

Intervention Type DRUG

5ml of the drug in mouthwash form to be swished and swallowed four times a day

Extra Soft Toothbrush

Intervention Type DEVICE

To be moistened with 0.9% normal Saline and used twice daily to remove dental plaque

Group 2

0.02% Chlorohexidine Gluconate: Mouth Rinse, 5ml, qid 3% Sodium Bicarbonate, Mouth Rinse, 5ml, qid Nystatin 10000U/ml : Mouth rinse, 5ml, qid Supersaturated Calcium Phosphate Spray, 5ml qid

Group Type EXPERIMENTAL

.02% Chlorohexidine Gluconate

Intervention Type DRUG

5ml of the drug in mouthwash form to be swished four times a day

3% Sodium Bicarbonate

Intervention Type DRUG

5ml of the drug in the form of a prepared solution to be swished four times a day

Nystatin 10000U/ml

Intervention Type DRUG

5ml of the drug in mouthwash form to be swished and swallowed four times a day

Supersaturated Calcium Phosphate

Intervention Type DRUG

5ml of the solution to be swished four times a day

Interventions

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.02% Chlorohexidine Gluconate

5ml of the drug in mouthwash form to be swished four times a day

Intervention Type DRUG

3% Sodium Bicarbonate

5ml of the drug in the form of a prepared solution to be swished four times a day

Intervention Type DRUG

Nystatin 10000U/ml

5ml of the drug in mouthwash form to be swished and swallowed four times a day

Intervention Type DRUG

Extra Soft Toothbrush

To be moistened with 0.9% normal Saline and used twice daily to remove dental plaque

Intervention Type DEVICE

Supersaturated Calcium Phosphate

5ml of the solution to be swished four times a day

Intervention Type DRUG

Other Intervention Names

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Clorasept (ArRiyadh Pharmaceuticals, Riyadh, Saudi Arabia) 3% Na2CO3 Mycostatin (Amman Pharmacuetical Corp. Amman, Jordan Moistir (Kingswood laboratories Inc., Indianapolis IN USA)

Eligibility Criteria

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Inclusion Criteria

* 3 to 16 years patients
* Male and female
* Allogeneic transplant
* Patient receiving conditioning regime

* CYTOXAN, ATG, FLUDARABINE
* BUSULPHAN/CYTOXAN/ATG WITH MTX
* BUSULPHAN/CYTOXAN WITH MTX
* FLUDARABINE/BUSULPHAN

Exclusion Criteria

* Patient age greater than 16 years and less than 3 years.
* Previous radiotherapy
* Had more than one graft.
Minimum Eligible Age

3 Years

Maximum Eligible Age

16 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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King Faisal Specialist Hospital & Research Center

OTHER

Sponsor Role collaborator

Riyadh Colleges of Dentistry and Pharmacy

OTHER

Sponsor Role lead

Responsible Party

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Sarah Ali Mubaraki

Post Graduate in Pediatric Dentistry

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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abdullah R alshammery, PhD

Role: STUDY_DIRECTOR

RiyadhCPD

Other Identifiers

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RiyadhCDP

Identifier Type: -

Identifier Source: org_study_id

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