Miconazole mucoadhesive buccal tablet in high-dose therapy with autologous stem cell transplantation (HDT/ASCT)-induced mucositis

• Published in: Supportive care in cancer Vol. 23; no. 2; pp. 359 - 364
• Main Authors: Orvain, C., Moles-Moreau, M. P., François, S., Mercier, M., Moal, F., Hamel, J. F., Parot-Schinkel, E., Ifrah, N., Hunault-Berger, M., Tanguy-Schmidt, A.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.02.2015; Springer; Springer Nature B.V; Springer Verlag (Germany)
• Subjects: Adolescent; Adult; Aged; Amphotericin B; Amphotericin B - therapeutic use; Analgesics; Antifungal Agents - therapeutic use; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Antiparasitic agents; Cancer; Care and treatment; Chemotherapy; Dosage and administration; Drug therapy; Female; Hematopoietic Stem Cell Transplantation - adverse effects; Humans; Induction Chemotherapy; Life Sciences; Lymphomas; Male; Medicine; Medicine & Public Health; Miconazole; Miconazole - therapeutic use; Middle Aged; Mucositis - chemically induced; Mucositis - drug therapy; Mucositis - prevention & control; Multiple Myeloma - drug therapy; Nursing; Nursing Research; Oncology; Original Article; Pain Medicine; Prospective Studies; Rehabilitation Medicine; Stem cells; Stomatitis - drug therapy; Stomatitis - prevention & control; Tablets; Transplantation; Transplantation, Autologous - adverse effects; Transplants & implants; Treatment Outcome; Young Adult; Infectious complications; Mucositis; High-dose therapy/autologous stem cell transplantation (HDT/ASCT); Miconazole
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-014-2365-2

Oral mucositis is a major cause of morbidity in high-dose therapy/autologous stem cell transplantation (HDT/ASCT), where microbial colonization has an important pathological implication. In this study, we evaluated the impact of miconazole mucoadhesive buccal tablet (MBT) on mucositis-related complications. During two consecutive 34-month periods, patients treated with HDT/ASCT in our hematology department received either miconazole MBT (60 patients) or conventional oral amphotericin B suspensions three times a day (44 patients) in order to prevent or decrease chemotherapy-induced mucositis. The use of miconazole MBT is associated with less infectious complications as indicated by shorter antibiotic use (7.8 vs. 12.3 days; p  < 0.0001), shorter intravenous antifungal use (1.4 vs. 3.6 days; p  = 0.02), and a trend towards less yeast contamination in stool samples. Less patients required any analgesic drugs during hospitalization in the miconazole MBT group (18 vs. 7 %; p  = 0.09). Indirect indicators of chemotherapy-induced mucositis (duration of hospitalization, morphine use) were in favor of miconazole MBT in patients with multiple myeloma (MM) but not for those with lymphoma. This study suggests that miconazole MBT provides a valid alternative to oral amphotericin B suspensions in regards to mucositis-related complications. A prospective and randomized study is warranted to establish the definite role of miconazole MBT.