Sodium bicarbonate not to be recommended for cancer treatment-associated oral mucositis: Study

Oral mucositis (OM) is a major side effect of cancer therapy, which is associated with significant symptoms, treatment delays and increased costs for the health system. It is an important component of the quality of life of cancer patients and, until now, there has been no gold standard regarding prevention or treatment of this pathology. Notwithstanding the paucity of treatment guidelines (due to limited evidence from high-quality, rigorous studies), sodium bicarbonate (SB) rinses are one of the most used agents for Oral mucositis management.

A systematic review (2000–2022) was performed in order to compare and examine different agents versus sodium bicarbonate (SB) in preventing or treating Oral mucositis. Eleven randomized controlled trials (RCT) were evaluated: four were conducted for the prevention and seven for the management of Oral mucositis. The risk of bias of RCTs was assessed using the revised Cochrane risk of bias tool for randomized trials. According to the RoB2 evaluation for randomized trials, four RCTs were judged to be at a high risk of bias, two were rated as ‘problematic’, while five were deemed to be a low risk of bias.

The results revealed that there was no evidence for supporting Sodium bicarbonate in Oral mucositis treatment regarding management and prevention. Results showed in this review takes on a strategic importance in the use of Sodium bicarbonate for Oral mucositis management or prevention; indiscriminate use of Sodium bicarbonate could be counterproductive because it causes a sudden pH increase and it delays proper Oral mucositis pharmacological treatment.

Reference:

Di Fede, O., Canepa, F., Maniscalco, L. et al. Prevention and the treatment of oral mucositis: the efficacy of sodium bicarbonate vs other agents: a systematic review. BMC Oral Health 23, 4 (2023). https://doi.org/10.1186/s12903-022-02586-4

Keywords:

Sodium bicarbonate, prescribed, recommended, cancer treatment–associated, oral mucositis,BMC Oral Health, Di Fede, O., Canepa, F., Maniscalco