Effect of the H2 receptor antagonist nizatidine on xerostomia in patients with primary Sjögren’s syndrome

Abstract

In Sjögren's syndrome (SS), oral dryness (xerostomia) is frequently the most bothersome symptom. An H2 histamine receptor antagonist is often administered to SS patients to treat associated superficial gastritis. The aim of the present study was to assess the ability of nizatidine, an H2 receptor antagonist, to also relieve xerostomia in patients with primary SS. Twenty-seven patients with primary SS were randomly assigned to receive nizatidine (n=14, 300 mg a day) or another H2 blocker, famotidine (n=13, 40 mg a day; control), were followed for eight weeks, and were asked for both subjective and objective assessments of oral dryness using a visual analog scale (VAS; 1-100 mm) and the Saxon's test, respectively. Patients receiving oral nizatidine, but not famotidine, obtained significant objective relief from their xerostomia (Saxon's test; baseline, 0.57 g/2 min; after eight weeks, 0.90 g/2 min, P<0.05). VAS scores indicated that nizatidine also provides mild improvement (20% improvement over baseline) of xerostomia-related clinical conditions, including mouth dryness and difficulty in chewing, tasting and swallowing food. Both drugs were generally well tolerated, without adverse effects. The present preliminary study suggests that nizatidine may represent a new option for the treatment of xerostomia in SS.

Salivary hypofunction: An update on aetiology, diagnosis and therapeutics

“…To stimulate salivary secretion, other drugs such as bromhexine 183 and nizatidine 184,185 are described in the literature. Bromhexine is a drug with mucolytic properties, used in respiratory infections, which also enhances salivary and lachrymal secretion.…”

“…Both have shown favourable results in SFR and have been used in patients with Sjö gren syndrome. [183][184][185] Sugar-free chewing gum and jellybeans can be utilized as topical salivary stimulants. They usually contain xylitol (low calorie sugar), which inhibits the growth of cariogenic bacteria and reduces the incidence of caries.…”

Established and Novel Approaches for the Management of Hyposalivation and Xerostomia

“…A small controlled, open-label trial in subjects with SS demonstrated improvement in stimulated salivary output and complaints of dry mouth [43]. The medication was well-tolerated and there were no significant AEs recorded.…”

Sjogren’s syndrome: promising, new treatment options besides nizatidine

“…I read with great interest the recent article by Kasama et al [1]. The authors have clearly shown that nizatidine is beneficial in Sjögren's syndrome as it improves symptoms such as xerostomia.…”