A study of the effectiveness and side effects of salivation-inducers in patients with Sjögren’s syndrome ～ Comparison between cevimeline hydrochloride and pilocarpine hydrochloride ～

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  • SHINOZAKI Shouichi
    Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University
  • MORIYAMA Masafumi
    Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University
  • HAYASHIDA Jun-Nosuke
    Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University
  • TANAKA Akihiko
    Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University
  • MAEHARA Takashi
    Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University
  • FURUKAWA Sachiko
    Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University
  • OHTA Miho
    Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University
  • IMABAYASHI Yumi
    Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University
  • NAKAMURA Seiji
    Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University

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Other Title
  • シェーグレン症候群患者に対する唾液分泌促進薬の有効性と副作用の検討～セビメリン塩酸塩とピロカルピンと塩酸塩の比較～
  • シェーグレン ショウコウグン カンジャ ニ タイスル ダエキ ブンピ ソクシンヤク ノ ユウコウセイ ト フクサヨウ ノ ケントウ : セビメリン エンサンエン ト ピロカルピン ト エンサンエン ノ ヒカク

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Abstract

Objectives: Cevimeline hydrochloride (CH) and pilocarpine hydrochloride (PH) are recognized as salivation-inducers with a high affinity for M3 muscarinic receptors. However, these drugs have a high frequency of side effects, including digestive symptoms and hyperhidrosis. We compared the effectiveness and side effects of these two drugs before and after a medication change.<br>Materials and Methods: Seventy-six patients with Sjögren's syndrome were divided into the following four groups: 1) CH group, CH was administered for 12 months; 2) PH group, PH was administered for 12 months; 3) CH-PH group, CH was administered for 6 months followed by PH for 6 months; 4) PH-CH group, PH was administered for 6 months followed by CH for 6 months. We measured the salivary flow rate and recorded the subjective symptoms in each group.<br>Results: In each group, stimulated whole saliva (SWS) and unstimulated whole saliva (UWS) significantly increased after 3 months and 6 months, respectively, and subjective symptoms improved after 3 months. The incremental changes in both SWS and UWS did not differ significantly between the groups. The CH and PH groups both had digestive symptoms (32.3% and 32.1%, respectively) and hyperhidrosis (29.0% and 39.3%, respectively). We found no significant difference in salivary flow rate or subjective symptoms after the medication change. However, the frequencies of side effects in the CH-PH and PH-CH groups decreased significantly for both digestive symptoms (9.7% and 10.7%, respectively) and hyperhidrosis (25.8% and 14.3%, respectively).<br>Conclusions: After changing the salivation-inducing drug, there was no significant difference in salivary function or subjective symptoms, while the frequency of side effects markedly decreased. These results suggest that changing the salivation-inducing drug effectively reduces side effects.

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