Cevimeline for the Treatment of Xerostomia in Patients With Sjögren Syndrome

Fife, Rose S.; Chase, Walter F.; Dore, Robin K.; Wiesenhutter, Craig W.; Lockhart, Peter B.; Tindall, Elizabeth A.; Suen, James Y.

doi:10.1001/archinte.162.11.1293

Cited by 174 publications

(91 citation statements)

References 7 publications

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“…Therefore, for early diagnosis requiring high sensitivity of a test, additional SGUS markers or other tests have to be identified and included. Given the availability of effective symptomatic therapies, such as pilocarpine or cevimeline (17,18), or the possibility of stopping disease progress with early aggressive biologic therapy (19), our score should not be applied for selection of patients for early treatment approaches. There was, however, no relationship between age or disease duration and SGUS score, but the number of included very early primary SS patients was low.…”

Section: Discussionmentioning

confidence: 99%

Primary Sjögren's Syndrome: Diagnostic and Prognostic Value of Salivary Gland Ultrasonography Using a Simplified Scoring System

Theander

Mandl

2014

Arthritis Care & Research

152

124

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Objective. To determine the usefulness and prognostic value of a simplified salivary gland ultrasonography (SGUS) scoring system in primary Sjögren's syndrome (SS). Methods. Patients with primary SS (n ‫؍‬ 105) and controls (n ‫؍‬ 57) were evaluated using a simplified SGUS scoring system. Parenchymal homogeneity in salivary glands was graded from 0 to 3, with grades 0 (normal) and 1 (mild inhomogeneity) being interpreted as normal or unspecific, and grades 2 (several rounded) and 3 (numerous or confluent hypoechoic lesions) as primary SS typical. Associations between SGUS and clinical, histologic, and laboratory disease characteristics were analyzed. Results. The characteristic hypoechoic lesions (score 2 or 3) were found in 52% of primary SS patients and in 1 (1.8%) of controls (P < 0.001). Specificity and positive predictive value of abnormal SGUS for primary SS were both 98%, sensitivity and negative predictive values were 52% and 53%, respectively. Age or disease duration did not influence the SGUS result. Dryness did not differ between normal or abnormal SGUS. However, patients with pathologic SGUS had significantly more often signs and symptoms of systemic complications, higher disease activity, and more frequently markers of lymphoma development, such as salivary gland swelling, skin vasculitis, germinal center-like structures in salivary gland biopsy findings, and CD4؉ T cell lymphopenia. Conclusion. SGUS using a simplified score for assessment of parenchyma dyshomogeneity is highly specific for primary SS and offers the advantage of identifying patients with severe disease or at risk of lymphoma. However, early disease may be missed. SGUS is easy and rapidly performed and may be considered as an item in future modified classification criteria.

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Section: Discussionmentioning

confidence: 99%

Primary Sjögren's Syndrome: Diagnostic and Prognostic Value of Salivary Gland Ultrasonography Using a Simplified Scoring System

Theander

Mandl

2014

Arthritis Care & Research

152

124

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“…Oral doses of cevimeline hydrochloride hydrate significantly improved subjective symptoms of dry mouth and dry eyes, and increased salivary flow 3) . However, adverse effects were frequently reported, such as nausea and abdominal pain.…”

Section: Discussionmentioning

confidence: 92%

Examination of The Cevimeline Hydrochloride Hydrate Concomitant Hachiazule and Xylocaine Gargle Therapy

Mese

Furuno

Sasaki

2005

J. Hard Tissue Biology.

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A gargling treatment by Hachiazele and Xylocaine is useful for a stomatitis treatment of the oral cancer patient with chemotherapy and/or radiotherapy. However, there is a little improvement of dry mouth. Aiming at improvement of dry mouth for the oral cancer patient with chemotherapy and/or radiotherapy, we reviewed the cevimeline hydrochloride hydrate concomitant Hachiazule and Xylocaine gargling therapeutic safety. Homeostasis for ten days of cevimeline hydrochloride hydrate was confirmed in all condition by an incompatibility examination. It was significant, and the group of cevimeline hydrochloride hydrate combination elevated salivation dosage in comparison with a non-concomitant group. In addition, the side effect did not accept both groups together. As for the cevimeline hydrochloride hydrate combination Haciazule and Xylocaine gargling treatment, it was thought that beneficial gargling was therapeutic for dry mouth of the oral cancer patient with chemotherapy and/or radiotherapy.

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“…In animal studies, cevimeline doses sufficient to induce salivation generally did not affect the central nervous system (oral administration of 3-10 mg/kg), general behavior, cardiovascular, respiratory, gastrointestinal, or urinary systems [1,3]. In human studies, while headache, dizziness, and nervousness were reported as adverse central nervous system events, they were not significantly different between the 60 mg three times daily (tid) patient group as compared to the placebo [4].…”

Section: Discussionmentioning

confidence: 96%