Congress Abstracts 2003

95

GELCLAIR™: A NEW, PROMISING, COST-EFFECTIVE, ORAL AGENT FOR THE REDUCTION OF MUCOSITIS SEQUELAE. Patricia Buchsel, RN, MSN, FAAN, and Elaine DeMeyer, RN, MN, AOCN^®, Creative Cancer Care, Dallas, TX.

Mucositis and stomatitis are experienced by 47%–75% of patients with cancer receiving immunosuppressive chemotherapy and irradiation (Sonis, 1993). A wide variety of treatment approaches exist, but results of most agents are disappointing. New, effective, cost-effective, and easy-to-use oral agents are needed to treat pain, secondary infection, and improve quality of life for patients with treatment-related mucositis. Gelclair™ (Propharma, Inc., Dallas, TX) is a new agent that shows promise in mucositis management. A recent open-label clinical trial indicates that grades of mucositis (43%), levels of pain (83%), and patient ability to eat and drink (83%) were diminished in a study cohort of 30 evaluable patients undergoing chemotherapy and irradiation for a variety of cancers (DeCordi, 2001). Another study by Innocenti et al. evaluated 30 patients with human immunosuppressive virus having painful inflammatory and ulcerative conditions of the mouth and oropharynx. Patients were assessed for mucositis pain using a visual numerical scale ranging from 1–10, with 10 being the highest number related to worst pain experienced. A mean reduction of 7.5 points from baseline was reported between five and seven hours after the first dose of Gelclair™. After one week of treatment, an overall improvement from baseline scores related to pain and discomfort on swallowing food, liquids, and saliva was reported by 87% of patients. Forty percent of the patients felt that the optimum effect of a dose of Gelclair™ persisted for 2–3 hours, and fifty-seven percent felt that pain relief lasted longer than three hours. Overall, patients reported that Gelclair™ was easy to use and well tolerated. Although randomized clinical trials are needed to further test the efficacy of Gelclair™, it appears to be a new promising cost effect agent that diminishes the painful sequelae of mucositis. In addition, nursing time currently required for mucositis management and patient and caregiver teaching can be shortened.