A Pilot Study on the Modified Multiple Divided Dosing of Pilocarpine Hydrochloride for Paient Suffered from Xerostomia Due to Sjögren’s Syndrome

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  • IWABUCHI Hiroshi
    Department of Dentomaxillofacial Diagnosis and Treatment Division of Oral and Maxillofacial Surgery, Kanagawa Dental University Department of Dentistry and Oral Surgery, National Hospital Organization Tochigi Medical Center
  • ISHIDA Takafumi
    Department of Oral Surgery Kanagawa Dental University Hospital
  • SATO Mariko
    Kanagawa Dental University Department of Clinical Research, National Hospital Organization Tochigi Medical Center
  • IWABUCHI Emi
    Department of Dentistry and Oral Surgery, National Hospital Organization Tochigi Medical Center

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Other Title
  • シェーグレン症候群に伴う口腔乾燥症に対するピロカルピン塩酸塩の 改定小量多分割投与法の有効性に関する探索的研究
  • シェーグレン ショウコウグン ニ トモナウ コウコウ カンソウショウ ニ タイスル ピロカルピン エンサンエン ノ カイテイ ショウリョウ タブンカツ トウヨホウ ノ ユウコウセイ ニ カンスル タンサクテキ ケンキュウ

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Abstract

This study aimed to examine the effects of modified multiple divided dosing of pilocarpine hydrochloride （3.75mg, 4 times daily） as compared with the conventional dosing regimen on patient satisfaction with treatment. The subjects were patients with Sjögren’s syndrome who had reduced salivary secretion （≤10ml by 10-minute gum test） after treatment with a conventional pilocarpine hydrochloride-dosing regimen for at least 1 year. The patients were switched from conventional dosing to modified multiple divided dosing （without a washout period）, and the study treatment was continued for 8 weeks. They underwent a 10-minute gum test, assessment of subjective symptoms of dry mouth, and so on, before and after the study treatment. Twenty-six patients were eligible for the study. The mean salivary secretion on the 10-minute gum test decreased significantly from 6.57±0.90ml （at conventional dosing） to 5.75±0.91ml （after 8 weeks of modified multiple divided dosing）. In addition, for further analysis, the patients were divided into severe and mild groups based on the subjective symptom of dry mouth at night. The mean subjective symptom score of dry mouth at night in the severe group significantly decreased from 3.57±0.79 （at conventional dosing） to 1.86±1.07 （after 8 weeks of modified multiple divided dosing）. These results suggest that treatment with modified multiple divided dosing of pilocarpine hydrochloride is effective for improving dry mouth in patients with severe subjective symptoms of nighttime dry mouth.

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