Comparing the effectiveness and adverse effects of pilocarpine and cevimeline in patients with hyposalivation
Objectives Pilocarpine (PILO) and cevimeline (CEV) are muscarinic acetylcholine receptor agonists that stimulate salivary gland function. The aim of this investigation was to retrospectively run a head‐to‐head comparison for their effectiveness and frequency of adverse effects in patients with hypos...
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| Veröffentlicht in: | Oral diseases 2019-11, Vol.25 (8), p.1937-1944 |
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| container_title | Oral diseases |
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| creator | Farag, Arwa M. Holliday, Craig Cimmino, Joseph Roomian, Tamar Papas, Athena |
| description | Objectives
Pilocarpine (PILO) and cevimeline (CEV) are muscarinic acetylcholine receptor agonists that stimulate salivary gland function. The aim of this investigation was to retrospectively run a head‐to‐head comparison for their effectiveness and frequency of adverse effects in patients with hyposalivation.
Methods
A retrospective chart review was conducted for patients seen at the Oral Medicine Clinic at Tufts University School of Dental Medicine (TUSDM) and was prescribed PILO or CEV. Patients’ demographics, medical history/medication, stimulated salivary (SS), and unstimulated salivary (US) flow recorded at the initial visit and at 3‐ and 6‐month follow‐ups were collected. Changes in dosage/frequency, side effects, and drug discontinuation were also reported.
Results
A total of 110 patients’ charts were reviewed. The majority of subjects (91%) were females with an average age of 61. At 3‐month follow‐up, the use of CEV showed significant improvement in SS compared to PILO (p = .033) but not in US (p = .10). At 6‐month follow‐up, there was no significant difference in SS or US between the two groups (SS: p = .09; US: p = .71). The use of PILO was associated with a higher proportion of adverse effects compared to CEV (p = .04). The overall adherence rate was significantly higher in the CEV group (p = .0056).
Conclusions
The effectiveness of CEV and PILO is comparable. However, PILO seems to be associated with more reporting of side effects. |
| doi_str_mv | 10.1111/odi.13192 |
| format | Article |
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Pilocarpine (PILO) and cevimeline (CEV) are muscarinic acetylcholine receptor agonists that stimulate salivary gland function. The aim of this investigation was to retrospectively run a head‐to‐head comparison for their effectiveness and frequency of adverse effects in patients with hyposalivation.
Methods
A retrospective chart review was conducted for patients seen at the Oral Medicine Clinic at Tufts University School of Dental Medicine (TUSDM) and was prescribed PILO or CEV. Patients’ demographics, medical history/medication, stimulated salivary (SS), and unstimulated salivary (US) flow recorded at the initial visit and at 3‐ and 6‐month follow‐ups were collected. Changes in dosage/frequency, side effects, and drug discontinuation were also reported.
Results
A total of 110 patients’ charts were reviewed. The majority of subjects (91%) were females with an average age of 61. At 3‐month follow‐up, the use of CEV showed significant improvement in SS compared to PILO (p = .033) but not in US (p = .10). At 6‐month follow‐up, there was no significant difference in SS or US between the two groups (SS: p = .09; US: p = .71). The use of PILO was associated with a higher proportion of adverse effects compared to CEV (p = .04). The overall adherence rate was significantly higher in the CEV group (p = .0056).
Conclusions
The effectiveness of CEV and PILO is comparable. However, PILO seems to be associated with more reporting of side effects.</description><identifier>ISSN: 1354-523X</identifier><identifier>EISSN: 1601-0825</identifier><identifier>DOI: 10.1111/odi.13192</identifier><identifier>PMID: 31520497</identifier><language>eng</language><publisher>Denmark: Wiley Subscription Services, Inc</publisher><subject>Acetylcholine receptors (muscarinic) ; Adult ; Aged ; cevimeline ; Demography ; Dentistry ; dry mouth ; Female ; Follow-Up Studies ; Humans ; hyposalivation ; Middle Aged ; Muscarinic Agonists - therapeutic use ; Pilocarpine ; Pilocarpine - administration & dosage ; Pilocarpine - therapeutic use ; Quinuclidines - administration & dosage ; Quinuclidines - therapeutic use ; Retrospective Studies ; Salivary gland ; sialagogues ; Side effects ; Thiophenes - administration & dosage ; Thiophenes - therapeutic use ; Time Factors ; Xerostomia - drug therapy</subject><ispartof>Oral diseases, 2019-11, Vol.25 (8), p.1937-1944</ispartof><rights>2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. All rights reserved</rights><rights>2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. All rights reserved.</rights><rights>Copyright © 2019 John Wiley & Sons A/S</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3532-521d7fdec8e47653e20db2fe0d5fa9cfcb4d329ee1a2ca596c01a0f505e9a8db3</citedby><cites>FETCH-LOGICAL-c3532-521d7fdec8e47653e20db2fe0d5fa9cfcb4d329ee1a2ca596c01a0f505e9a8db3</cites><orcidid>0000-0003-3762-3474</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fodi.13192$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fodi.13192$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31520497$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Farag, Arwa M.</creatorcontrib><creatorcontrib>Holliday, Craig</creatorcontrib><creatorcontrib>Cimmino, Joseph</creatorcontrib><creatorcontrib>Roomian, Tamar</creatorcontrib><creatorcontrib>Papas, Athena</creatorcontrib><title>Comparing the effectiveness and adverse effects of pilocarpine and cevimeline in patients with hyposalivation</title><title>Oral diseases</title><addtitle>Oral Dis</addtitle><description>Objectives
Pilocarpine (PILO) and cevimeline (CEV) are muscarinic acetylcholine receptor agonists that stimulate salivary gland function. The aim of this investigation was to retrospectively run a head‐to‐head comparison for their effectiveness and frequency of adverse effects in patients with hyposalivation.
Methods
A retrospective chart review was conducted for patients seen at the Oral Medicine Clinic at Tufts University School of Dental Medicine (TUSDM) and was prescribed PILO or CEV. Patients’ demographics, medical history/medication, stimulated salivary (SS), and unstimulated salivary (US) flow recorded at the initial visit and at 3‐ and 6‐month follow‐ups were collected. Changes in dosage/frequency, side effects, and drug discontinuation were also reported.
Results
A total of 110 patients’ charts were reviewed. The majority of subjects (91%) were females with an average age of 61. At 3‐month follow‐up, the use of CEV showed significant improvement in SS compared to PILO (p = .033) but not in US (p = .10). At 6‐month follow‐up, there was no significant difference in SS or US between the two groups (SS: p = .09; US: p = .71). The use of PILO was associated with a higher proportion of adverse effects compared to CEV (p = .04). The overall adherence rate was significantly higher in the CEV group (p = .0056).
Conclusions
The effectiveness of CEV and PILO is comparable. However, PILO seems to be associated with more reporting of side effects.</description><subject>Acetylcholine receptors (muscarinic)</subject><subject>Adult</subject><subject>Aged</subject><subject>cevimeline</subject><subject>Demography</subject><subject>Dentistry</subject><subject>dry mouth</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>hyposalivation</subject><subject>Middle Aged</subject><subject>Muscarinic Agonists - therapeutic use</subject><subject>Pilocarpine</subject><subject>Pilocarpine - administration & dosage</subject><subject>Pilocarpine - therapeutic use</subject><subject>Quinuclidines - administration & dosage</subject><subject>Quinuclidines - therapeutic use</subject><subject>Retrospective Studies</subject><subject>Salivary gland</subject><subject>sialagogues</subject><subject>Side effects</subject><subject>Thiophenes - administration & dosage</subject><subject>Thiophenes - therapeutic use</subject><subject>Time Factors</subject><subject>Xerostomia - drug therapy</subject><issn>1354-523X</issn><issn>1601-0825</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp10ctOAyEUBmBiNLZWF76AmcSNLlq5lE5ZmnpNTNxo4o5QOFiaGRhh2qZvL7WtCxPZwIEvf044CJ0TPCB53QTjBoQRQQ9Ql4ww6eMx5Yf5zPiwzyn76KCTlOYYk1Iweow6jHCKh6LsonoS6kZF5z-LdgYFWAu6dUvwkFKhvCmUWUJM-5dUBFs0rgpaxcZ5-CEalq6GalM6XzSqdeCzXLl2VszWTUiqcst8G_wpOrKqSnC223vo_eH-bfLUf3l9fJ7cvvQ144zmlokprQE9hmE54gwoNlNqARtuldBWT4eGUQFAFNWKi5HGRGHLMQehxmbKeuhqm9vE8LWA1MraJQ1VpTyERZKUCiwwEWSc6eUfOg-L6HN3kjKGuaC85Fldb5WOIaUIVjbR1SquJcFyMwOZZyB_ZpDtxS5xMa3B_Mr9p2dwswUrV8H6_yT5eve8jfwGpqSSig</recordid><startdate>201911</startdate><enddate>201911</enddate><creator>Farag, Arwa M.</creator><creator>Holliday, Craig</creator><creator>Cimmino, Joseph</creator><creator>Roomian, Tamar</creator><creator>Papas, Athena</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3762-3474</orcidid></search><sort><creationdate>201911</creationdate><title>Comparing the effectiveness and adverse effects of pilocarpine and cevimeline in patients with hyposalivation</title><author>Farag, Arwa M. ; Holliday, Craig ; Cimmino, Joseph ; Roomian, Tamar ; Papas, Athena</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3532-521d7fdec8e47653e20db2fe0d5fa9cfcb4d329ee1a2ca596c01a0f505e9a8db3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Acetylcholine receptors (muscarinic)</topic><topic>Adult</topic><topic>Aged</topic><topic>cevimeline</topic><topic>Demography</topic><topic>Dentistry</topic><topic>dry mouth</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>hyposalivation</topic><topic>Middle Aged</topic><topic>Muscarinic Agonists - therapeutic use</topic><topic>Pilocarpine</topic><topic>Pilocarpine - administration & dosage</topic><topic>Pilocarpine - therapeutic use</topic><topic>Quinuclidines - administration & dosage</topic><topic>Quinuclidines - therapeutic use</topic><topic>Retrospective Studies</topic><topic>Salivary gland</topic><topic>sialagogues</topic><topic>Side effects</topic><topic>Thiophenes - administration & dosage</topic><topic>Thiophenes - therapeutic use</topic><topic>Time Factors</topic><topic>Xerostomia - drug therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Farag, Arwa M.</creatorcontrib><creatorcontrib>Holliday, Craig</creatorcontrib><creatorcontrib>Cimmino, Joseph</creatorcontrib><creatorcontrib>Roomian, Tamar</creatorcontrib><creatorcontrib>Papas, Athena</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Oral diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Farag, Arwa M.</au><au>Holliday, Craig</au><au>Cimmino, Joseph</au><au>Roomian, Tamar</au><au>Papas, Athena</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparing the effectiveness and adverse effects of pilocarpine and cevimeline in patients with hyposalivation</atitle><jtitle>Oral diseases</jtitle><addtitle>Oral Dis</addtitle><date>2019-11</date><risdate>2019</risdate><volume>25</volume><issue>8</issue><spage>1937</spage><epage>1944</epage><pages>1937-1944</pages><issn>1354-523X</issn><eissn>1601-0825</eissn><abstract>Objectives
Pilocarpine (PILO) and cevimeline (CEV) are muscarinic acetylcholine receptor agonists that stimulate salivary gland function. The aim of this investigation was to retrospectively run a head‐to‐head comparison for their effectiveness and frequency of adverse effects in patients with hyposalivation.
Methods
A retrospective chart review was conducted for patients seen at the Oral Medicine Clinic at Tufts University School of Dental Medicine (TUSDM) and was prescribed PILO or CEV. Patients’ demographics, medical history/medication, stimulated salivary (SS), and unstimulated salivary (US) flow recorded at the initial visit and at 3‐ and 6‐month follow‐ups were collected. Changes in dosage/frequency, side effects, and drug discontinuation were also reported.
Results
A total of 110 patients’ charts were reviewed. The majority of subjects (91%) were females with an average age of 61. At 3‐month follow‐up, the use of CEV showed significant improvement in SS compared to PILO (p = .033) but not in US (p = .10). At 6‐month follow‐up, there was no significant difference in SS or US between the two groups (SS: p = .09; US: p = .71). The use of PILO was associated with a higher proportion of adverse effects compared to CEV (p = .04). The overall adherence rate was significantly higher in the CEV group (p = .0056).
Conclusions
The effectiveness of CEV and PILO is comparable. However, PILO seems to be associated with more reporting of side effects.</abstract><cop>Denmark</cop><pub>Wiley Subscription Services, Inc</pub><pmid>31520497</pmid><doi>10.1111/odi.13192</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-3762-3474</orcidid></addata></record> |
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| ispartof | Oral diseases, 2019-11, Vol.25 (8), p.1937-1944 |
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| language | eng |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Acetylcholine receptors (muscarinic) Adult Aged cevimeline Demography Dentistry dry mouth Female Follow-Up Studies Humans hyposalivation Middle Aged Muscarinic Agonists - therapeutic use Pilocarpine Pilocarpine - administration & dosage Pilocarpine - therapeutic use Quinuclidines - administration & dosage Quinuclidines - therapeutic use Retrospective Studies Salivary gland sialagogues Side effects Thiophenes - administration & dosage Thiophenes - therapeutic use Time Factors Xerostomia - drug therapy |
| title | Comparing the effectiveness and adverse effects of pilocarpine and cevimeline in patients with hyposalivation |
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