Non-Cochrane · intervention · PM42505716

Protective and Healing Effects of Zinc L-Carnosine on the Oral Mucosa: A Systematic Review and Meta-Analysis.

De Francesco Pierpaolo, Vescovi Paolo, Pedrazzi Giuseppe, et al. · Dentistry journal · 2026 · PubMed · doi:10.3390/dj14070408

Findings

Population Patients with or at risk of oral mucosal injury (HSCT or chemotherapy, radiotherapy or chemoradiotherapy for head and neck cancer)

4 findings

Zinc L-carnosine (polaprezinc) in any formulation (mouthwash, lozenge, mucoadhesive suspension)Standard oral care, no prophylaxis, azulene gargle, sodium bicarbonate mouthwash or delayed ZnCOral mucositis (grade >= 2), incidence
HSCT and head and neck RT/CRT · Random-effects model (Paule-Mandel, Hartung-Knapp)
OR 0.36 [0.10, 1.29]
Low
Downgraded: risk of bias, imprecision, inconsistency, indirectness
4 studies · 335 participants
Zinc L-carnosine (polaprezinc) in any formulation (mouthwash, lozenge, mucoadhesive suspension)Standard oral care, no prophylaxis, azulene gargle, sodium bicarbonate mouthwash or delayed ZnCOral mucositis (grade >= 2), incidence
HSCT and head and neck RT/CRT · Common-effect model (inverse variance)
OR 0.56 [0.33, 0.95]
Low
Downgraded: risk of bias, imprecision, inconsistency, indirectness
4 studies · 335 participants
Zinc L-carnosine (polaprezinc) in any formulation (mouthwash, lozenge, mucoadhesive suspension)Standard oral care, no prophylaxis, azulene gargle, sodium bicarbonate mouthwash or delayed ZnCSevere oral mucositis (grade >= 3), incidence
HSCT and head and neck RT/CRT · Random-effects model (Paule-Mandel, Hartung-Knapp)
OR 0.44 [0.18, 1.06]
Low
Downgraded: risk of bias, imprecision, inconsistency, indirectness
7 studies · 532 participants
Zinc L-carnosine (polaprezinc) in any formulation (mouthwash, lozenge, mucoadhesive suspension)Standard oral care, no prophylaxis, azulene gargle, sodium bicarbonate mouthwash or delayed ZnCSevere oral mucositis (grade >= 3), incidence
HSCT and head and neck RT/CRT · Common-effect model (inverse variance)
OR 0.48 [0.32, 0.72]
Low
Downgraded: risk of bias, imprecision, inconsistency, indirectness
7 studies · 532 participants

Included primary studies 8

Open in Studies
StudyYearAlso included byOutcomes it informs hereTrial data
Dell'Olio 2023
The Effect of a Zinc-L-Carnosine Mouthwash in the Management of Oral Surgical Wounds: Preliminary Results of a Prospective Cohort Study.
PMID:37504247
2023this review onlynot statednot extracted yet
Doi 2015
Polaprezinc reduces the severity of radiation-induced mucositis in head and neck cancer patients.
PMID:25798271
2015this review onlySevere oral mucositis (grade >= 3), incidencenot extracted yet
Funato 2018
Prophylactic Effect of Polaprezinc, a Zinc-L-carnosine, Against Chemotherapy-induced Oral Mucositis in Pediatric Patients Undergoing…
PMID:30061237
2018this review onlySevere oral mucositis (grade >= 3), incidencenot extracted yet
Hayashi 2016
Preparation and clinical evaluation of a novel lozenge containing polaprezinc, a zinc-L-carnosine, for prevention of oral mucositis in…
PMID:27418192
2016this review onlySevere oral mucositis (grade >= 3), incidence; Oral mucositis (grade >= 2), incidencenot extracted yet
Kitagawa 2021
Polaprezinc for prevention of oral mucositis in patients receiving chemotherapy followed by hematopoietic stem cell transplantation: A…
PMID:32984946
2021this review onlySevere oral mucositis (grade >= 3), incidence; Oral mucositis (grade >= 2), incidencenot extracted yet
Nakagaki 2024
A randomised trial of topical polaprezinc to prevent oral mucositis in patients undergoing haematopoietic stem cell transplantation (ToPaZ…
PMID:38112867
2023this review onlySevere oral mucositis (grade >= 3), incidence; Oral mucositis (grade >= 2), incidencenot extracted yet
Suzuki 2016
Effect of polaprezinc on oral mucositis, irradiation period, and time to discharge in patients with head and neck cancer.
PMID:27002591
2016this review onlySevere oral mucositis (grade >= 3), incidence; Oral mucositis (grade >= 2), incidencenot extracted yet
Tsubura-Okubo 2021
Oral management with polaprezinc solution reduces adverse events in haematopoietic stem cell transplantation patients.
PMID:33144049
2021this review onlySevere oral mucositis (grade >= 3), incidencenot extracted yet

Review question

ElementPlanned (methods)Found (results)
PopulationAll in vivo human studies of patients with or at risk of oral mucosal damagePatients undergoing HSCT, high-dose chemotherapy, head and neck radiotherapy or chemoradiotherapy, and oral surgery (n=544)
InterventionZinc L-carnosine (polaprezinc) in any formulation or doseZinc L-carnosine as mouthwash, lozenge, or mucoadhesive suspension (sodium alginate, polyacrylic acid, carboxyvinyl polymer)
ComparisonAny type of treatment or no treatmentStandard oral care, azulene gargle, sodium bicarbonate mouthwash, delayed zinc L-carnosine
OutcomesOral mucosal protection (incidence of grade 2 or worse and grade 3 or worse oral mucositis); oral mucosal healing (time to resolution, wound healing scores); secondary: pain, oral function, adverse events, discomfortSevere (grade >=3) oral mucositis (7 studies, n=532); grade >=2 oral mucositis (4 studies, n=335); mucosal healing; pain and analgesic use; oral function; adverse events
Study designsAny study design; English language, published 2015 to 20262 RCTs and 6 non-randomized studies (prospective or retrospective cohorts)
TimingNot specifiedNot specified