Document Detail


Cevimeline for the treatment of xerostomia in patients with Sjögren syndrome: a randomized trial.
MedLine Citation:
PMID:  12038948     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Cevimeline hydrochloride is a cholinergic agent with muscarinic agonist activity prominently affecting the M1 and M3 receptors prevalent in exocrine glands. We evaluated the safety and efficacy of cevimeline in the treatment of xerostomia in patients with Sjögren syndrome. METHODS: Seventy-five patients with Sjögren syndrome and associated salivary gland dysfunction were enrolled in a double-blind, randomized, placebo-controlled trial at 8 university- and office-based outpatient clinical facilities in the United States. Eligible study participants were randomized to receive 30 mg of cevimeline 3 times daily, 60 mg of cevimeline 3 times daily, or placebo for 6 weeks. Subjective responses were determined using global patient evaluation and visual analog scales. Salivary flow was measured objectively. RESULTS: Sixty-one participants completed the study. Patients in both cevimeline groups had significant improvements in dry mouth, as indicated by symptoms, salivary flow, and use of artificial saliva, compared with the placebo group. The drug was generally well tolerated, with expected adverse events resulting from the drug's muscarinic agonist action. Fourteen patients withdrew from the study because of adverse events, the most frequent being nausea. CONCLUSIONS: Therapy with cevimeline, 30 mg 3 times daily, seems to be well tolerated and to provide substantive relief of xerostomia symptoms. Although both dosages of cevimeline provided symptomatic improvement, 60 mg 3 times daily was associated with an increase in the occurrence of adverse events, particularly gastrointestinal tract disorders. Use of 30 mg of cevimeline provides a new option for the treatment of xerostomia in Sjögren syndrome.
Authors:
Rose S Fife; Walter F Chase; Robin K Dore; Craig W Wiesenhutter; Peter B Lockhart; Elizabeth Tindall; James Y Suen
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Archives of internal medicine     Volume:  162     ISSN:  0003-9926     ISO Abbreviation:  Arch. Intern. Med.     Publication Date:  2002 Jun 
Date Detail:
Created Date:  2002-05-31     Completed Date:  2002-06-21     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372440     Medline TA:  Arch Intern Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1293-300     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Indiana University School of Medicine, 535 Barnhill Dr, Room 150, Indianapolis, IN 46202, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Double-Blind Method
Female
Humans
Male
Middle Aged
Muscarinic Agonists / therapeutic use*
Quinuclidines / therapeutic use*
Sjogren's Syndrome / complications*
Thiophenes*
Xerostomia / drug therapy*,  etiology
Chemical
Reg. No./Substance:
0/Muscarinic Agonists; 0/Quinuclidines; 0/Thiophenes; 107233-08-9/cevimeline

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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