A phase III, randomized, double-blind, placebo-controlled, study of iseganan for the reduction of stomatitis in patients receiving stomatotoxic chemotherapy

Francis J. Giles, Roberto Rodriguez, Daniel Weisdorf, John R. Wingard, Paul J. Martin, Thomas R. Fleming, Stuart L. Goldberg, Elias J. Anaissie, Brian J. Bolwell, Nelson J. Chao, Thomas C. Shea, Mark M. Brunvand, William Vaughan, Finn Petersen, Mark Schubert, Hillard M. Lazarus, Richard Maziarz, Margarida Silverman, Roy A. Beveridge, Rebecca RedmanJanis G. Pulliam, Patricia Devitt-Risse, Henry J. Fuchs, David D. Hurd

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

The invasion and colonization of oral cavity mucosal tissues by microflora may contribute to the pathophysiology of ulcerative oral mucositis (UOM). Iseganan is an analog of protegrin-1, a naturally occurring peptide with broad-spectrum microbicidal activity. A randomized, double-blind, placebo-controlled study was conducted to evaluate the efficacy and safety of iseganan in preventing UOM after stomatotoxic therapy. Patients received an oral rinse, consisting of iseganan 9 mg or placebo, to be swished/swallowed six times daily, starting with stomatotoxic therapy and continuing up to 21 days. Patients were assessed for stomatitis and UOM, and administered a questionnaire evaluating mouth pain and difficulty swallowing thrice weekly. The primary study efficacy endpoint was the proportion of patients who did not have peak stomatitis NCI-CTC grade ≥2. Between November 2001 and June 2002, 502 patients were randomized to receive iseganan (251) or placebo (251). Equivalent numbers of patients in both cohorts received bone marrow or peripheral blood allogeneic or autologous stem cell transplantation (SCT). Forty-three percent and 37% of iseganan and placebo patients, respectively, did not have peak stomatitis grade =2 (P=0.182). There was no significant difference between the cohorts in stomatitis severity, incidence of UOM, peak mouth pain, peak difficulty swallowing, amount of opiate analgesics used, or adverse event type or incidence. A major impact of Iseganan on reducing stomatitis, UOM, or its clinical sequelae in patients receiving stomatotoxic therapy was not detected on this study.

Original languageEnglish (US)
Pages (from-to)559-565
Number of pages7
JournalLeukemia Research
Volume28
Issue number6
DOIs
StatePublished - Jun 2004

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Stomatitis
Placebos
Drug Therapy
Necrotizing Ulcerative Gingivitis
Mouth
Deglutition
Opiate Alkaloids
Pain
antimicrobial peptide IB-367
Incidence
Stem Cell Transplantation
Analgesics
Mucous Membrane
Therapeutics
Bone Marrow
Safety
Peptides

Keywords

  • Iseganan
  • Oral mucositis
  • Stomatitis
  • Ulcerative

ASJC Scopus subject areas

  • Cancer Research
  • Hematology
  • Oncology

Cite this

A phase III, randomized, double-blind, placebo-controlled, study of iseganan for the reduction of stomatitis in patients receiving stomatotoxic chemotherapy. / Giles, Francis J.; Rodriguez, Roberto; Weisdorf, Daniel; Wingard, John R.; Martin, Paul J.; Fleming, Thomas R.; Goldberg, Stuart L.; Anaissie, Elias J.; Bolwell, Brian J.; Chao, Nelson J.; Shea, Thomas C.; Brunvand, Mark M.; Vaughan, William; Petersen, Finn; Schubert, Mark; Lazarus, Hillard M.; Maziarz, Richard; Silverman, Margarida; Beveridge, Roy A.; Redman, Rebecca; Pulliam, Janis G.; Devitt-Risse, Patricia; Fuchs, Henry J.; Hurd, David D.

In: Leukemia Research, Vol. 28, No. 6, 06.2004, p. 559-565.

Research output: Contribution to journalArticle

Giles, FJ, Rodriguez, R, Weisdorf, D, Wingard, JR, Martin, PJ, Fleming, TR, Goldberg, SL, Anaissie, EJ, Bolwell, BJ, Chao, NJ, Shea, TC, Brunvand, MM, Vaughan, W, Petersen, F, Schubert, M, Lazarus, HM, Maziarz, R, Silverman, M, Beveridge, RA, Redman, R, Pulliam, JG, Devitt-Risse, P, Fuchs, HJ & Hurd, DD 2004, 'A phase III, randomized, double-blind, placebo-controlled, study of iseganan for the reduction of stomatitis in patients receiving stomatotoxic chemotherapy', Leukemia Research, vol. 28, no. 6, pp. 559-565. https://doi.org/10.1016/j.leukres.2003.10.021
Giles, Francis J. ; Rodriguez, Roberto ; Weisdorf, Daniel ; Wingard, John R. ; Martin, Paul J. ; Fleming, Thomas R. ; Goldberg, Stuart L. ; Anaissie, Elias J. ; Bolwell, Brian J. ; Chao, Nelson J. ; Shea, Thomas C. ; Brunvand, Mark M. ; Vaughan, William ; Petersen, Finn ; Schubert, Mark ; Lazarus, Hillard M. ; Maziarz, Richard ; Silverman, Margarida ; Beveridge, Roy A. ; Redman, Rebecca ; Pulliam, Janis G. ; Devitt-Risse, Patricia ; Fuchs, Henry J. ; Hurd, David D. / A phase III, randomized, double-blind, placebo-controlled, study of iseganan for the reduction of stomatitis in patients receiving stomatotoxic chemotherapy. In: Leukemia Research. 2004 ; Vol. 28, No. 6. pp. 559-565.
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AU - Wingard, John R.

AU - Martin, Paul J.

AU - Fleming, Thomas R.

AU - Goldberg, Stuart L.

AU - Anaissie, Elias J.

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AU - Silverman, Margarida

AU - Beveridge, Roy A.

AU - Redman, Rebecca

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AU - Devitt-Risse, Patricia

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AU - Hurd, David D.

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N2 - The invasion and colonization of oral cavity mucosal tissues by microflora may contribute to the pathophysiology of ulcerative oral mucositis (UOM). Iseganan is an analog of protegrin-1, a naturally occurring peptide with broad-spectrum microbicidal activity. A randomized, double-blind, placebo-controlled study was conducted to evaluate the efficacy and safety of iseganan in preventing UOM after stomatotoxic therapy. Patients received an oral rinse, consisting of iseganan 9 mg or placebo, to be swished/swallowed six times daily, starting with stomatotoxic therapy and continuing up to 21 days. Patients were assessed for stomatitis and UOM, and administered a questionnaire evaluating mouth pain and difficulty swallowing thrice weekly. The primary study efficacy endpoint was the proportion of patients who did not have peak stomatitis NCI-CTC grade ≥2. Between November 2001 and June 2002, 502 patients were randomized to receive iseganan (251) or placebo (251). Equivalent numbers of patients in both cohorts received bone marrow or peripheral blood allogeneic or autologous stem cell transplantation (SCT). Forty-three percent and 37% of iseganan and placebo patients, respectively, did not have peak stomatitis grade =2 (P=0.182). There was no significant difference between the cohorts in stomatitis severity, incidence of UOM, peak mouth pain, peak difficulty swallowing, amount of opiate analgesics used, or adverse event type or incidence. A major impact of Iseganan on reducing stomatitis, UOM, or its clinical sequelae in patients receiving stomatotoxic therapy was not detected on this study.

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