| Pilocarpine hydrochloride for symptomatic relief of xerostomia due to chronic graft-versus-host disease or total-body irradiation after bone-marrow transplantation for hematologic malignancies. | |
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MedLine Citation:
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PMID: 9086444 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Xerostomia due to chronic graft-versus-host disease (GVHD) or total-body irradiation (TBI) is an important cause of morbidity after BMT. The ophthalmic or oral form of pilocarpine, a parasympathomimetic agent with predominantly muscarinic activity, was given orally to 13 patients with moderate (n = 6) or severe (n = 7) xerostomia due to chronic GVHD (n = 7) or TBI (n = 6). The duration of 19 courses of therapy was 7-245 days (median 73). Ten patients (77%) noticed significant improvement in salivation and relief of symptoms which reached its maximum after 7-186 days (median 46). Difficulty in eating and speaking reduced, and there was a beneficial effect on the oral mucosa and teeth. Xerophthalmia improved in one of six patients. Five patients had adverse reactions: wheezing (n = 1), and increased sweating without (n = 3) or with (n = 1) abdominal cramps (n = 1): leading to discontinuation of pilocarpine in one. Three patients stopped pilocarpine, became symptomatic again, but the benefits were reproducible on restarting pilocarpine. The ophthalmic preparation was as effective as the oral, and was one-tenth the cost of the oral. We conclude that oral pilocarpine is effective in relieving xerostomia associated with chronic GVHD and TBI. The time taken for a response to be seen is variable, and unless significant adverse effects are encountered, pilocarpine should be continued for 6-8 weeks before it is considered to have failed. |
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Authors:
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S Singhal; R Powles; J Treleaven; H Rattenbury; J Mehta |
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Publication Detail:
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Type: Clinical Trial; Journal Article |
Journal Detail:
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Title: Leukemia & lymphoma Volume: 24 ISSN: 1042-8194 ISO Abbreviation: Leuk. Lymphoma Publication Date: 1997 Feb |
Date Detail:
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Created Date: 1997-07-08 Completed Date: 1997-07-08 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 9007422 Medline TA: Leuk Lymphoma Country: SWITZERLAND |
Other Details:
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Languages: eng Pagination: 539-43 Citation Subset: IM |
Affiliation:
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Leukaemia Unit, Royal Marsden Hospital, Surrey, UK. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Bone Marrow Transplantation
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immunology* Chronic Disease Graft vs Host Disease / complications* Hematologic Neoplasms / complications, therapy* Humans Parasympathomimetics / therapeutic use* Pilocarpine / therapeutic use* Whole-Body Irradiation / adverse effects* Xerostomia / drug therapy*, etiology |
| Chemical | |
Reg. No./Substance:
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0/Parasympathomimetics; 92-13-7/Pilocarpine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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