Acute Oral Mucositis Pain Clinical Trial
Official title:
A Phase III Placebo-Controlled, Randomized Three-Arm Study of Doxepin and a Topical Rinse in the Treatment of Acute Oral Mucositis Pain in Patients Receiving Radiotherapy With or Without Chemotherapy
The purpose of this study is to test whether a mouthwash made with a drug called doxepin can reduce the pain caused by mouth sores resulting from radiation therapy. A number of mouth rinse preparations exist for patients with treatment-related oral mucositis pain such as the DLA rinse, an over-the-counter medication. This study will evaluate the effects of doxepin compared to DLA (diphenhydramine, lidocaine and antacids) and placebo.Doxepin is approved by the Food and Drug Administration (FDA) for the treatment of depression, anxiety, long-term pain management, as well as management of rash.
Patients are stratified according to sex (male vs. female), concurrent use of chemotherapy
(no vs. yes), patient age at registration (< 60 years old vs. ≥ 60 years old and RTOG acute
radiation morbidity criteria (1 vs. 2 vs 3 or more). Protocol therapy will consist of 2
cycles. Patients are randomized to one of three treatment regimens, which include doxepin,
DLA and placebo. Cycle One will consist of one day. The care provider or nurse will confirm
that the oral pain is at least 4 out of 10 severity level at the time of the rinse on the
first day of the study. Patient will be asked to complete the baseline evaluation in the Oral
Symptoms booklet. If the pain score is less than 4 then administration will be delayed until
the pain is at least 4. Cycle Two will consist of an optional continuation phase lasting up
to 7 days. Initiation of the Cycle 2/Continuation Phase may be delayed up to one week after
Cycle 1/Day 1.
Primary Objective:
1. Determine whether the doxepin rinse or DLA rinse is more effective than placebo in
reducing OM-related pain in patients undergoing RT to the oral cavity, as measured by a
patient-reported questionnaire at baseline, 5 minutes, 15 minutes, 30 minutes, 1 hour, 2
hours, and 4 hours.
Secondary Objectives:
1. Assess the adverse event profile of the doxepin rinse, the DLA rinse agent, and the
placebo using a patient-reported questionnaire at 5 minutes, 15 minutes, 30 minutes, 1
hour, 2 hours, and 4 hours for domains of unpleasant taste, burning or stinging
discomfort, and drowsiness.
2. Compare the incidence of using additional analgesics between 1 and 4 hours after the
initial mouthwash, between the doxepin oral rinse, the DLA rinse agent, and the placebo
arms.
3. Compare the length of time that each study product is used by patients in the one-week
continuation phase.
4. Compare the daily pain scores in the one-week continuation phase for the three study
arms.
5. Compare the 24-hour morphine equivalent dose used in the continuation phase for the
three study arms.
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