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Effectiveness of glutamine in the management of oral mucositis in cancer patients: a meta-analysis of randomized controlled trials

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A Correction to this article was published on 13 May 2021

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Abstract

Objective

The aim of this meta-analysis was to evaluate the effectiveness of glutamine for preventing or treating moderate-to-severe oral mucositis induced by chemotherapy or radiation therapy in patients with cancer.

Methods

PubMed, Cochrane Library, and Embase were searched for eligible randomized controlled trials (RCTs) up to June 2020. The outcomes analyzed were oral mucositis (at all levels of severity). Data were pooled using the random-effects model and are expressed as risk ratios (RRs) and corresponding 95% confidence intervals (CIs). Heterogeneity was assessed and quantified using I2.

Results

Sixteen RCTs were included in this review. In this meta-analysis, compared with placebo, glutamine significantly reduced the incidence of grade 3 and 4 oral mucositis induced by chemotherapy or radiation therapy (RR, 0.53; 95% CI, 0.32–0.88). In subgroup analysis, oral glutamine administration (RR, 0.56; 95% CI, 0.34–0.92) and a medium or low daily dose of glutamine (RR, 0.58; 95% CI, 0.44–0.77; RR, 0.53; 95% CI, 0.28–0.94; respectively) decreased risk. Glutamine caused a borderline significant reduction in the risk of grade 3 and 4 oral mucositis induced by radiotherapy (RR, 0.75; 95% CI, 0.58–0.99) and especially in its prevention (RR, 0.51; 95% CI, 0.28–0.94).

Conclusions

Glutamine significantly reduces the risk of oral mucositis during chemotherapy or radiation therapy. Furthermore, large prospective trials are required to support these findings.

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All data, models, and code generated or used during the study appear in the submitted article.

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Authors and Affiliations

  1. Department of Pharmacy, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, #289, Jianguo Road, Xindian District, New Taipei City, 23142, Taiwan

    Tzu-Rong Peng, Li-Jou Yang & Ta-Wei Wu

  2. Department of Pharmacy, Chia-Nan University of Pharmacy and Science, Tainan, Taiwan

    Hung-Hong Lin

  3. School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan

    Ta-Wei Wu

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  1. Tzu-Rong Peng
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Contributions

Conceptualization, T.-R.P. and H.-H.L.; methodology, T.-R.P.; software, T.-R.P.; validation, T.-R.P., L.-J.Y., and H.-H.L.; formal analysis, T.-R.P. and L.-J.Y.; investigation, H.-H.L.; data curation, L.-J.Y.; writing—original draft preparation, T.-R.P.; writing—review and editing, H.-H.L. and T.-W.W. All authors have read and agreed to the published version of the manuscript.

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Correspondence to Ta-Wei Wu.

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Peng, TR., Lin, HH., Yang, LJ. et al. Effectiveness of glutamine in the management of oral mucositis in cancer patients: a meta-analysis of randomized controlled trials. Support Care Cancer 29, 4885–4892 (2021). https://doi.org/10.1007/s00520-021-06060-9

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