Antifungal agents in preventing oral candidiasis in clinical oncology: A network meta‐analysis
Objective This review examined the comparative efficacy and safety of antifungal agents in preventing oral candidiasis among patients on cancer treatment. Methods We performed a systematic review and network meta‐analysis based on randomised controlled trials that compared antifungal agents to place...
Gespeichert in:
| Veröffentlicht in: | Oral diseases 2021-10, Vol.27 (7), p.1631-1643 |
|---|---|
| Hauptverfasser: | , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1643 |
|---|---|
| container_issue | 7 |
| container_start_page | 1631 |
| container_title | Oral diseases |
| container_volume | 27 |
| creator | Shen Loo, Yee Yee Wong, Tse Veettil, Sajesh K. Se Wong, Pei Gopinath, Divya Mooi Ching, Siew Kunnath Menon, Rohit |
| description | Objective
This review examined the comparative efficacy and safety of antifungal agents in preventing oral candidiasis among patients on cancer treatment.
Methods
We performed a systematic review and network meta‐analysis based on randomised controlled trials that compared antifungal agents to placebo or other antifungal agents used in patients undergoing cancer treatment. Relative ranking of antifungal agents was evaluated with surface under the cumulative ranking (SUCRA) probability score. A total of 20 randomised controlled trials (3,215 participants) comparing 11 interventions were included.
Results
Compared with placebo, clotrimazole was ranked the best agent for preventing the incidence of oral candidiasis (risk ratio (RR), 0.21 [95% CI 0.08 to 0.55]; SUCRA = 0.89). Fluconazole was ranked the safest among other antifungal agents (SUCRA = 0.80), whereas clotrimazole (SUCRA = 0.36) and amphotericin B (SUCRA = 0.18) were ranked low for safety. Amphotericin B was associated with highest risk of adverse events (RR, 3.52 [95% CI 1.27 to 9.75]).
Conclusion
Clotrimazole is the most effective in preventing oral candidiasis, whereas fluconazole has the most favourable risk‐benefit profile in patients undergoing cancer treatment. However, we are unable to recommend clotrimazole as the best choice to prevent oral candidiasis due to unavailability of studies comparing clotrimazole with other antifungal agents. |
| doi_str_mv | 10.1111/odi.13588 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2431805675</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2577396044</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3658-2579d63fea6cbe7423a244527ad89df8c69c228ed8922ec6a699fb5ffde66c783</originalsourceid><addsrcrecordid>eNp10E1PwyAYB_DGaOKcHvwGTbzooRuF8lJvy3xbsmQXTbwho7RhMpjQuvTmR_Az-knEzZOJXHjg-T2E_JPkPAejPK6xq_QoR5ixg2SQE5BngEF8GGuEiwxD9HycnISwAiCnJYKD5GViW113thEmFY2ybUi1TTdevcda2yZ1PnaksJWutAh615ZGWy3jvbPSGdf01-kktardOv-arlUrvj4-hRWmj_40OaqFCersdx8mT3e3j9OHbL64n00n80wiglkGMS0rgmoliFwqWkAkYFFgSEXFyqpmkpQSQqbiCUIliSBlWS9xXVeKEEkZGiaX-3c33r11KrR8rYNUxgirXBc4LFDOACYUR3rxh65c5-N_o8KUopKAoojqaq-kdyF4VfON12vhe54D_pM1j1nzXdbRjvd2q43q_4d8cTPbT3wDZ6yCEg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2577396044</pqid></control><display><type>article</type><title>Antifungal agents in preventing oral candidiasis in clinical oncology: A network meta‐analysis</title><source>Access via Wiley Online Library</source><creator>Shen Loo, Yee ; Yee Wong, Tse ; Veettil, Sajesh K. ; Se Wong, Pei ; Gopinath, Divya ; Mooi Ching, Siew ; Kunnath Menon, Rohit</creator><creatorcontrib>Shen Loo, Yee ; Yee Wong, Tse ; Veettil, Sajesh K. ; Se Wong, Pei ; Gopinath, Divya ; Mooi Ching, Siew ; Kunnath Menon, Rohit</creatorcontrib><description>Objective
This review examined the comparative efficacy and safety of antifungal agents in preventing oral candidiasis among patients on cancer treatment.
Methods
We performed a systematic review and network meta‐analysis based on randomised controlled trials that compared antifungal agents to placebo or other antifungal agents used in patients undergoing cancer treatment. Relative ranking of antifungal agents was evaluated with surface under the cumulative ranking (SUCRA) probability score. A total of 20 randomised controlled trials (3,215 participants) comparing 11 interventions were included.
Results
Compared with placebo, clotrimazole was ranked the best agent for preventing the incidence of oral candidiasis (risk ratio (RR), 0.21 [95% CI 0.08 to 0.55]; SUCRA = 0.89). Fluconazole was ranked the safest among other antifungal agents (SUCRA = 0.80), whereas clotrimazole (SUCRA = 0.36) and amphotericin B (SUCRA = 0.18) were ranked low for safety. Amphotericin B was associated with highest risk of adverse events (RR, 3.52 [95% CI 1.27 to 9.75]).
Conclusion
Clotrimazole is the most effective in preventing oral candidiasis, whereas fluconazole has the most favourable risk‐benefit profile in patients undergoing cancer treatment. However, we are unable to recommend clotrimazole as the best choice to prevent oral candidiasis due to unavailability of studies comparing clotrimazole with other antifungal agents.</description><identifier>ISSN: 1354-523X</identifier><identifier>EISSN: 1601-0825</identifier><identifier>DOI: 10.1111/odi.13588</identifier><language>eng</language><publisher>Malden: Wiley Subscription Services, Inc</publisher><subject>Adverse events ; Amphotericin B ; Antifungal agents ; Cancer ; Cancer therapies ; Candidiasis ; Clinical trials ; Clotrimazole ; Dental schools ; Dentistry ; Fluconazole ; Meta-analysis ; network meta‐analysis ; oral candidiasis ; Patients ; Placebos ; prevention ; systematic review</subject><ispartof>Oral diseases, 2021-10, Vol.27 (7), p.1631-1643</ispartof><rights>2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. All rights reserved</rights><rights>2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3658-2579d63fea6cbe7423a244527ad89df8c69c228ed8922ec6a699fb5ffde66c783</citedby><cites>FETCH-LOGICAL-c3658-2579d63fea6cbe7423a244527ad89df8c69c228ed8922ec6a699fb5ffde66c783</cites><orcidid>0000-0002-7486-8721 ; 0000-0002-4279-7420</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fodi.13588$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fodi.13588$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids></links><search><creatorcontrib>Shen Loo, Yee</creatorcontrib><creatorcontrib>Yee Wong, Tse</creatorcontrib><creatorcontrib>Veettil, Sajesh K.</creatorcontrib><creatorcontrib>Se Wong, Pei</creatorcontrib><creatorcontrib>Gopinath, Divya</creatorcontrib><creatorcontrib>Mooi Ching, Siew</creatorcontrib><creatorcontrib>Kunnath Menon, Rohit</creatorcontrib><title>Antifungal agents in preventing oral candidiasis in clinical oncology: A network meta‐analysis</title><title>Oral diseases</title><description>Objective
This review examined the comparative efficacy and safety of antifungal agents in preventing oral candidiasis among patients on cancer treatment.
Methods
We performed a systematic review and network meta‐analysis based on randomised controlled trials that compared antifungal agents to placebo or other antifungal agents used in patients undergoing cancer treatment. Relative ranking of antifungal agents was evaluated with surface under the cumulative ranking (SUCRA) probability score. A total of 20 randomised controlled trials (3,215 participants) comparing 11 interventions were included.
Results
Compared with placebo, clotrimazole was ranked the best agent for preventing the incidence of oral candidiasis (risk ratio (RR), 0.21 [95% CI 0.08 to 0.55]; SUCRA = 0.89). Fluconazole was ranked the safest among other antifungal agents (SUCRA = 0.80), whereas clotrimazole (SUCRA = 0.36) and amphotericin B (SUCRA = 0.18) were ranked low for safety. Amphotericin B was associated with highest risk of adverse events (RR, 3.52 [95% CI 1.27 to 9.75]).
Conclusion
Clotrimazole is the most effective in preventing oral candidiasis, whereas fluconazole has the most favourable risk‐benefit profile in patients undergoing cancer treatment. However, we are unable to recommend clotrimazole as the best choice to prevent oral candidiasis due to unavailability of studies comparing clotrimazole with other antifungal agents.</description><subject>Adverse events</subject><subject>Amphotericin B</subject><subject>Antifungal agents</subject><subject>Cancer</subject><subject>Cancer therapies</subject><subject>Candidiasis</subject><subject>Clinical trials</subject><subject>Clotrimazole</subject><subject>Dental schools</subject><subject>Dentistry</subject><subject>Fluconazole</subject><subject>Meta-analysis</subject><subject>network meta‐analysis</subject><subject>oral candidiasis</subject><subject>Patients</subject><subject>Placebos</subject><subject>prevention</subject><subject>systematic review</subject><issn>1354-523X</issn><issn>1601-0825</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp10E1PwyAYB_DGaOKcHvwGTbzooRuF8lJvy3xbsmQXTbwho7RhMpjQuvTmR_Az-knEzZOJXHjg-T2E_JPkPAejPK6xq_QoR5ixg2SQE5BngEF8GGuEiwxD9HycnISwAiCnJYKD5GViW113thEmFY2ybUi1TTdevcda2yZ1PnaksJWutAh615ZGWy3jvbPSGdf01-kktardOv-arlUrvj4-hRWmj_40OaqFCersdx8mT3e3j9OHbL64n00n80wiglkGMS0rgmoliFwqWkAkYFFgSEXFyqpmkpQSQqbiCUIliSBlWS9xXVeKEEkZGiaX-3c33r11KrR8rYNUxgirXBc4LFDOACYUR3rxh65c5-N_o8KUopKAoojqaq-kdyF4VfON12vhe54D_pM1j1nzXdbRjvd2q43q_4d8cTPbT3wDZ6yCEg</recordid><startdate>202110</startdate><enddate>202110</enddate><creator>Shen Loo, Yee</creator><creator>Yee Wong, Tse</creator><creator>Veettil, Sajesh K.</creator><creator>Se Wong, Pei</creator><creator>Gopinath, Divya</creator><creator>Mooi Ching, Siew</creator><creator>Kunnath Menon, Rohit</creator><general>Wiley Subscription Services, Inc</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7486-8721</orcidid><orcidid>https://orcid.org/0000-0002-4279-7420</orcidid></search><sort><creationdate>202110</creationdate><title>Antifungal agents in preventing oral candidiasis in clinical oncology: A network meta‐analysis</title><author>Shen Loo, Yee ; Yee Wong, Tse ; Veettil, Sajesh K. ; Se Wong, Pei ; Gopinath, Divya ; Mooi Ching, Siew ; Kunnath Menon, Rohit</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3658-2579d63fea6cbe7423a244527ad89df8c69c228ed8922ec6a699fb5ffde66c783</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adverse events</topic><topic>Amphotericin B</topic><topic>Antifungal agents</topic><topic>Cancer</topic><topic>Cancer therapies</topic><topic>Candidiasis</topic><topic>Clinical trials</topic><topic>Clotrimazole</topic><topic>Dental schools</topic><topic>Dentistry</topic><topic>Fluconazole</topic><topic>Meta-analysis</topic><topic>network meta‐analysis</topic><topic>oral candidiasis</topic><topic>Patients</topic><topic>Placebos</topic><topic>prevention</topic><topic>systematic review</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shen Loo, Yee</creatorcontrib><creatorcontrib>Yee Wong, Tse</creatorcontrib><creatorcontrib>Veettil, Sajesh K.</creatorcontrib><creatorcontrib>Se Wong, Pei</creatorcontrib><creatorcontrib>Gopinath, Divya</creatorcontrib><creatorcontrib>Mooi Ching, Siew</creatorcontrib><creatorcontrib>Kunnath Menon, Rohit</creatorcontrib><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Oral diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shen Loo, Yee</au><au>Yee Wong, Tse</au><au>Veettil, Sajesh K.</au><au>Se Wong, Pei</au><au>Gopinath, Divya</au><au>Mooi Ching, Siew</au><au>Kunnath Menon, Rohit</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Antifungal agents in preventing oral candidiasis in clinical oncology: A network meta‐analysis</atitle><jtitle>Oral diseases</jtitle><date>2021-10</date><risdate>2021</risdate><volume>27</volume><issue>7</issue><spage>1631</spage><epage>1643</epage><pages>1631-1643</pages><issn>1354-523X</issn><eissn>1601-0825</eissn><abstract>Objective
This review examined the comparative efficacy and safety of antifungal agents in preventing oral candidiasis among patients on cancer treatment.
Methods
We performed a systematic review and network meta‐analysis based on randomised controlled trials that compared antifungal agents to placebo or other antifungal agents used in patients undergoing cancer treatment. Relative ranking of antifungal agents was evaluated with surface under the cumulative ranking (SUCRA) probability score. A total of 20 randomised controlled trials (3,215 participants) comparing 11 interventions were included.
Results
Compared with placebo, clotrimazole was ranked the best agent for preventing the incidence of oral candidiasis (risk ratio (RR), 0.21 [95% CI 0.08 to 0.55]; SUCRA = 0.89). Fluconazole was ranked the safest among other antifungal agents (SUCRA = 0.80), whereas clotrimazole (SUCRA = 0.36) and amphotericin B (SUCRA = 0.18) were ranked low for safety. Amphotericin B was associated with highest risk of adverse events (RR, 3.52 [95% CI 1.27 to 9.75]).
Conclusion
Clotrimazole is the most effective in preventing oral candidiasis, whereas fluconazole has the most favourable risk‐benefit profile in patients undergoing cancer treatment. However, we are unable to recommend clotrimazole as the best choice to prevent oral candidiasis due to unavailability of studies comparing clotrimazole with other antifungal agents.</abstract><cop>Malden</cop><pub>Wiley Subscription Services, Inc</pub><doi>10.1111/odi.13588</doi><tpages>13</tpages><orcidid>https://orcid.org/0000-0002-7486-8721</orcidid><orcidid>https://orcid.org/0000-0002-4279-7420</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1354-523X |
| ispartof | Oral diseases, 2021-10, Vol.27 (7), p.1631-1643 |
| issn | 1354-523X 1601-0825 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2431805675 |
| source | Access via Wiley Online Library |
| subjects | Adverse events Amphotericin B Antifungal agents Cancer Cancer therapies Candidiasis Clinical trials Clotrimazole Dental schools Dentistry Fluconazole Meta-analysis network meta‐analysis oral candidiasis Patients Placebos prevention systematic review |
| title | Antifungal agents in preventing oral candidiasis in clinical oncology: A network meta‐analysis |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-30T23%3A14%3A54IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Antifungal%20agents%20in%20preventing%20oral%20candidiasis%20in%20clinical%20oncology:%20A%20network%20meta%E2%80%90analysis&rft.jtitle=Oral%20diseases&rft.au=Shen%20Loo,%20Yee&rft.date=2021-10&rft.volume=27&rft.issue=7&rft.spage=1631&rft.epage=1643&rft.pages=1631-1643&rft.issn=1354-523X&rft.eissn=1601-0825&rft_id=info:doi/10.1111/odi.13588&rft_dat=%3Cproquest_cross%3E2577396044%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2577396044&rft_id=info:pmid/&rfr_iscdi=true |