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 ZnC | Oral 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 ZnC | Oral 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 ZnC | Severe 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 ZnC | Severe 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| Study | Year | Also included by | Outcomes it informs here | Trial 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 | 2023 | this review only | not stated | not extracted yet |
| Doi 2015 Polaprezinc reduces the severity of radiation-induced mucositis in head and neck cancer patients. PMID:25798271 | 2015 | this review only | Severe oral mucositis (grade >= 3), incidence | not extracted yet |
| Funato 2018 Prophylactic Effect of Polaprezinc, a Zinc-L-carnosine, Against Chemotherapy-induced Oral Mucositis in Pediatric Patients Undergoing… PMID:30061237 | 2018 | this review only | Severe oral mucositis (grade >= 3), incidence | not 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 | 2016 | this review only | Severe oral mucositis (grade >= 3), incidence; Oral mucositis (grade >= 2), incidence | not extracted yet |
| Kitagawa 2021 Polaprezinc for prevention of oral mucositis in patients receiving chemotherapy followed by hematopoietic stem cell transplantation: A… PMID:32984946 | 2021 | this review only | Severe oral mucositis (grade >= 3), incidence; Oral mucositis (grade >= 2), incidence | not extracted yet |
| Nakagaki 2024 A randomised trial of topical polaprezinc to prevent oral mucositis in patients undergoing haematopoietic stem cell transplantation (ToPaZ… PMID:38112867 | 2023 | this review only | Severe oral mucositis (grade >= 3), incidence; Oral mucositis (grade >= 2), incidence | not 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 | 2016 | this review only | Severe oral mucositis (grade >= 3), incidence; Oral mucositis (grade >= 2), incidence | not extracted yet |
| Tsubura-Okubo 2021 Oral management with polaprezinc solution reduces adverse events in haematopoietic stem cell transplantation patients. PMID:33144049 | 2021 | this review only | Severe oral mucositis (grade >= 3), incidence | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | All in vivo human studies of patients with or at risk of oral mucosal damage | Patients undergoing HSCT, high-dose chemotherapy, head and neck radiotherapy or chemoradiotherapy, and oral surgery (n=544) |
| Intervention | Zinc L-carnosine (polaprezinc) in any formulation or dose | Zinc L-carnosine as mouthwash, lozenge, or mucoadhesive suspension (sodium alginate, polyacrylic acid, carboxyvinyl polymer) |
| Comparison | Any type of treatment or no treatment | Standard oral care, azulene gargle, sodium bicarbonate mouthwash, delayed zinc L-carnosine |
| Outcomes | Oral 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, discomfort | Severe (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 designs | Any study design; English language, published 2015 to 2026 | 2 RCTs and 6 non-randomized studies (prospective or retrospective cohorts) |
| Timing | Not specified | Not specified |