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Effectiveness of cevimeline to improve oral health in patients with postradiation xerostomia.

Author(s): Witsell DL, Stinnett S, Chambers MS.

Affiliation(s): Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA. david.witsell@duke.edu

Publication date & source: 2012, Head Neck. , 34(8):1136-42

BACKGROUND: We assessed the effectiveness of cevimeline 30 mg 3 times daily in patient-reported oral health (Oral Health Impact Profile [OHIP-49]) and quality of life (QOL) in patients with xerostomia. METHODS: In our investigator-initiated, multicenter, randomized, double-blind, placebo-controlled study, patients who received >40 Gy of radiation therapy to the head and neck including at least 3 major salivary glands were randomized to cevimeline 30 mg or placebo orally 3 times daily for 6 weeks. Patients had to have grade 1 or 2 xerostomia and be >16 weeks posttreatment. Clinical data were collected and questionnaires administered at baseline and week 6. The primary outcome was change in OHIP-49 total score from baseline to week 6. RESULTS: No statistically significant differences in oral health or QOL were observed. During the 6 weeks of the study, the severity of xerostomia decreased from baseline. CONCLUSIONS: Xerostomia is a significant sequela of treatment of head and neck cancer that may improve with time. The role of oral parasympathetic muscarinic secretogogues in alleviating patient symptoms and complaints remains unclear.

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