Vitamin E in the management of oral mucositis: Systematic review with meta-analysis of randomized clinical trials

This review aims to evaluate the efficacy of vitamin E in the treatment of oral mucositis (OM). This review was conducted in accordance with Reporting Items for Systematic Reviews and Meta-analyses and registered in the International Prospective Register of Systematic Reviews (PROSPERO). The search was conducted in seven databases and in the Brazilian repository of Theses and Dissertations of CAPES, consulted as a complementary source identifying clinical trials that evaluated the use of vitamin E alone in cancer patients for the treatment of OM. The risk of bias was assessed using the Joanna Briggs Institute tool. The data were extracted and systematized in a meta-analysis using a fixed-effect model in RStudio software. Fourteen articles were included, which evaluated 715 patients, with 330 patients in the intervention group and 385 in the control group. Among the included studies, 64.3% (n = 9) showed a significant reduction in the incidence of severe OM with the use of vitamin E (p < 0.05). The risk of bias assessment indicated low methodological risk, with 65% (n = 9) classified as low overall risk. The meta-analysis showed a lower incidence of severe mucositis (grades 3-4) in the vitamin E group compared to controls (RR: 0.37; 95% CI: 0.25-0.57), with a consistent effect in pediatric (RR: 0.14; 95% CI: 0.05-0.35) and non-pediatric (RR: 0.57; 95% CI: 0.35-0.92) populations. The results suggest a potential benefit of vitamin E in the management of OM induced by antineoplastic therapies, especially in reducing the incidence of more severe forms of this condition.