Established and novel approaches for the management of hyposalivation and xerostomia

Current Pharmaceutical Design

Volumn 18, Issue 34, 2012, Pages 5515-5521

  Wolff, Andy ^a   Fox, Philip C ^b,c   Porter, Stephen ^d   Konttinen, Yrjö T ^e,f  

^a Saliwell Ltd   (Israel)

^b PC Fox Consulting   (Italy)

^c UCL Eastman Dental Institute ^*

^d UNIVERSITY COLLEGE LONDON   (United Kingdom)

^e ORTON Orthopeadic Hospital   (Finland)

^f NONE   (Finland)

Author keywords

Acupuncture; Cevimeline; Dry mouth; Electrostimulation; Hyposalivation; Mouthwashes; Pilocarpine; Xerostomia

Indexed keywords

ALPHA INTERFERON; ALPHA TOCOPHEROL; ANETHOLETRITHIONE; AQUAPORIN 1; BETHANECHOL; BIOENE ORAL BALANCE GEL; BIOTENE; BIOXTRA; BROMHEXINE; CEPHARANTHINE; CEVIMELINE; CLEMASTINE; ETANERCEPT; FREEDENT; GLANDOSANE; INFLIXIMAB; METHYLPREDNISOLONE; MOISTURIZING ORAL GEL; MOUTH GUM; MOUTHWASH; NIZATIDINE; PARACETAMOL; PILOCARPINE; PLACEBO; PREDNISONE; RITUXIMAB; SALIVA NATURA; SALIVA SUBSTITUTE; SALIVIX; THALIDOMIDE; TOOTHPASTE; UNCLASSIFIED DRUG; V6; XEROSTOM;

ABDOMINAL CRAMP; ABSENCE OF SIDE EFFECTS; ACUPUNCTURE; APPLICATION SITE REACTION; ARTHRALGIA; BIOLOGICAL THERAPY; CHILL; DIARRHEA; DRUG CONTRAINDICATION; DRUG EFFICACY; DRUG FEVER; DRUG RECEPTOR BINDING; DRUG SAFETY; DRUG TOLERABILITY; DYSPEPSIA; ELECTROSTIMULATION; FLUSHING; HEADACHE; HEAT; HUMAN; HYPNOSIS; HYPOSALIVATION; LACRIMATION; MOUTH HYGIENE; MYALGIA; NAUSEA; NONHUMAN; NONVIRAL GENE THERAPY; NOSE SECRETION; PALLIATIVE THERAPY; PRIORITY JOURNAL; QUALITY OF LIFE; REVIEW; RHINITIS; SERUM SICKNESS; SIDE EFFECT; SINUSITIS; SJOEGREN SYNDROME; SWEATING; SYSTEMIC THERAPY; TOOTH DISEASE; UNSPECIFIED SIDE EFFECT; UPPER RESPIRATORY TRACT INFECTION; URINARY URGENCY; VIRAL GENE THERAPY; VITAMIN SUPPLEMENTATION; WEAKNESS; XEROSTOMIA;

ACUPUNCTURE THERAPY; ANIMALS; ELECTRIC STIMULATION THERAPY; GENETIC THERAPY; HUMANS; PALLIATIVE CARE; SALIVA; SALIVARY GLANDS; XEROSTOMIA;

EID: 84867729587     PISSN: 13816128     EISSN: 18734286     Source Type: Journal    
DOI: 10.2174/138161212803307509     Document Type: Review

References (72)

1. Porter SR, Fedele S, Habbab KM. Xerostomia in head and neck malignancy. Oral Oncol 2010; 46(6): 460-3.
2. Nieuw Amerongen AV, Veerman ECI. Saliva - the defender of the oral cavity. Oral Dis 2002; 8:12-22.
3. Ghezzi EM, Lange LA, Ship JA. Determination of variation of stimulated salivary flow rates. J Dent Res 2000; 79(11):1874-8.
4. Porter SR, Scully C, Hegarty AM. An update of the etiology and management of xerostomia. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004; 97(1): 28-46.
5. Ramos-Casals M, Tzioufas AG, Stone JH, Sisó A, Bosch X: Treatment of primary Sjögren syndrome: a systematic review. JAMA 2010; 304: 452-60.
6. Jensen SB, Pedersen AM, Vissink A, et al. A systematic review of salivary gland hypofunction and xerostomia induced by cancer therapies: management strategies and economic impact. Support Care Cancer 2010; 18: 1061-79.
7. Vissink A, Mitchell JB, Baum BJ, et al. Clinical management of salivary gland hypofunction and xerostomia in head-and-neck cancer patients: successes and barriers. Int J Radiat Oncol Biol Phys 2010; 78: 983-91.
8. von Bultzingslowen I, Sollecito TP, Fox PC, et al. Salivary dysfunction associated with systemic diseases: systematic review and clinical management recommendations. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007; 103 Suppl:S57. e1-15.
9. Brennan MT, Shariff G, Lockhart PB, Fox PC. Treatment of xerostomia: a systematic review of therapeutic trials. Dent Clin North Am 2002; 46: 847-56.
10. Andersson G, Johansson G, Attstrom R, Edwardsson S, Glantz PO, Larsson K. Comparison of the effect of the linseed extract Salinum and a methyl cellulose preparation on the symptoms of dry mouth. Gerodontology 1995; 12(1): 12-7.
11. Furumoto EK, Barker GJ, Carter-Hanson C, Barker BF. Subjective and clinical evaluation of oral lubricants in xerostomic patients. Spec Care Dentist 1998; 18(3): 113-8.
12. Nagy K, Urban E, Fazekas O, Thurzo L, Nagy E. Controlled study of lactoperoxidase gel on oral flora and saliva in irradiated patients with oral cancer. J Craniofac Surg 2007; 18(5): 1157-64.
13. Epstein JB, Emerton S, Le ND, Stevenson-Moore P. A doubleblind crossover trial of Oral Balance gel and Biotene toothpaste versus placebo in patients with xerostomia following radiation therapy. Oral Oncol 1999; 35(2): 132-7.
14. Momm F, Volegova-Neher NJ, Schulte-Monting J, Guttenberger R. Different saliva substitutes for treatment of xerostomia following radiotherapy. A prospective crossover study. Strahlenther Onkol 2005; 181(4): 231-6.
15. Sweeney MP, Bagg J, Baxter WP, Aitchison TC. Clinical trial of a mucin-containing oral spray for treatment of xerostomia in hospice patients. Palliat Med 1997; 11 (3): 225-32.
16. Shirodaria S, Kilbourn T, Richardson M. Subjective assessment of a new moisturizing mouth spray for the symptomatic relief of dry mouth. J Clin Dent 2006; 17(2): 45-51.
17. Johansson G, Andersson G, Edwardsson S, Bjorn AL, Manthorpe R, Attstrom R. Effects of mouthrinses with linseed extract Salinum without/with chlorhexidine on oral conditions in patients with Sjögren's syndrome. A double blind crossover investigation. Gerodontology 2001; 18(2): 87-94.
18. Mouly S, Salom M, Tillet Y, et al. Management of xerostomia in older patients: a randomised controlled trial evaluating the efficacy of a new oral lubricant solution. Drugs Aging 2007; 24(11): 957-65.
19. Persson A, Lingström P, Bergdahl M, Claesson R, van Dijken JW. Buffering effect of a prophylactic gel on dental plaque in institutionalised elderly. Gerodontology 2007; 24 (2): 98-104.
20. van der Reijden WA, van der Kwaak H, Vissink A, Veerman EC, Amerongen AV. Treatment of xerostomia with polymerbased saliva substitutes in patients with Sjögren's syndrome. Arthritis Rheum 1996; 39(1): 57-63.
21. Bots CP, Brand HS, Veerman EC, et al. The management of xerostomia in patients on haemodialysis: comparison of artificial saliva and chewing gum. Palliat Med 2005; 19(3): 202-7.
22. th December 2011).
23. McMillan AS, Tsang CS, Wong MC, Kam AY. Efficacy of a novel lubricating system in the management of radiotherapy-related xerostomia. Oral Oncol 2006; 42(8): 842-8.
24. Nadimi H, Wesamaa H, Janket SJ, Bollu P, Meurman JH. Are sugar-free confections really beneficial for dental health? Br Dent J 2011; 211(7): E15.
25. Güneri P, Alpöz E, Epstein JB, Çankaya H, Ate M. In vitro antimicrobial effects of commercially available mouth-wetting agents. Spec Care Dentist 2011; 31(4): 123-8.
26. Johansson G, Andersson G, Attstöm R, Edwardsson S. Oral mucous membrane flora in patients using saliva substitutes. Gerodontology 2000; 17(2): 87-90.
27. Hahnel S, Behr M, Handel G, Bürgers R. Saliva substitutes for the treatment of radiation-induced xerostomia--a review. Support Care Cancer 2009; 17(11): 1331-43.
28. Fox PC, van der Ven PF, Baum BJ, Mandel ID. Pilocarpine for the treatment of xerostomia associated with salivary gland dysfunction. Oral Surg Oral Med Oral Pathol 1986; 61(3): 243-8.
29. Johnson JT, Ferretti GA, Nethery WJ, et al. Oral pilocarpine for post-irradiation xerostomia in patients with head and neck cancer. N Engl J Med 1993; 329(6): 390-5.
30. LeVeque FG, Montgomery M, Potter D, et al. A multicenter, randomized, double-blind, placebo-controlled, dose-titration study of oral pilocarpine for treatment of radiation-induced xerostomia in head and neck cancer patients. J Clin Oncol 1993; 11(6): 1124-31.
31. Vivino FB, Al-Hashimi I, Khan Z, et al. Pilocarpine tablets for the treatment of dry mouth and dry eye symptoms in patients with Sjögren syndrome: a randomized, placebo-controlled, fixed-dose, multicenter trial. Arch Intern Med 1999; 159(2): 174-81.
32. Papas AS, Sherrer YS, Charney M, et al. Successful Treatment of Dry Mouth and Dry Eye Symptoms in Sjögren's Syndrome Patients With Oral Pilocarpine: A Randomized, Placebo-Controlled, DoseAdjustment Study. J Clin Rheumatol 2004; 10(4): 169-77.
33. Petrone D, Condemi JJ, Fife R, Gluck O, Cohen S, Dalgin P. A double-blind, randomized, placebo-controlled study of cevimeline in Sjögren's syndrome patients with xerostomia and keratoconjunctivitis sicca. Arthritis Rheum 2002; 46(3): 748-54.
34. Fife RS, Chase WF, Dore RK, et al. Cevimeline for the treatment of xerostomia in patients with Sjögren syndrome: a randomized trial. Arch Intern Med 2002; 162(11): 1293-300.
35. Leung KC, McMillan AS, Wong MC, Leung WK, Mok MY, Lau CS. The efficacy of cevimeline hydrochloride in the treatment of xerostomia in Sjögren's syndrome in southern Chinese patients: a randomised double-blind, placebo-controlled crossover study. Clin Rheumatol 2008; 27(4): 429-36.
36. Yamada H, Nakagawa Y, Wakamatsu E, et al. Efficacy prediction of cevimeline in patients with Sjögren's syndrome. Clin Rheumatol 2007; 26(8): 1320-7.
37. Witsell DL, Stinnett S, Chambers MS. Effectiveness of cevimeline to improve oral health in patients with postradiation xerostomia. Head Neck 2012. doi: 10.1002/hed.21894. [Epub ahead of print]
38. Chambers MS, Jones CU, Biel MA, et al. Open-label, long-term safety study of cevimeline in the treatment of postirradiation xerostomia. Int J Radiat Oncol Biol Phys 2007; 69(5): 1369-76.
39. Hamada T, Nakane T, Kimura T, et al. Treatment of xerostomia with the bile secretion-stimulating drug anethole trithione: a clinical trial. Am J Med Sci 1999; 318(3): 146-51.
40. Epstein JB, Burchell JL, Emerton S, Le ND, Silverman S Jr. A clinical trial of bethanechol in patients with xerostomia after radiation therapy. A pilot study. Oral Surg Oral Med Oral Pathol 1994; 77(6): 610-4.
41. Gorsky M, Epstein JB, Parry J, Epstein MS, Le ND, Silverman S Jr. The efficacy of pilocarpine and bethanechol upon saliva production in cancer patients with hyposalivation following radiation therapy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004; 97(2): 190-5.
42. Jham BC, Teixeira IV, Aboud CG, Carvalho AL, Coelho Mde M, Freire AR. A randomized phase III prospective trial of bethanechol to prevent radiotherapy-induced salivary gland damage in patients with head and neck cancer. Oral Oncol 2007; 43(2): 137-42.
43. Kasama T, Shiozawa F, Isozaki T, et al. Effect of the H2 receptor antagonist nizatidine on xerostomia in patients with primary Sjögren's syndrome. Mod Rheumatol 2008; 18(5): 455-9.
44. Dawidson I: Studies on the influence of sensory stimulation (acupuncture) on neuropeptide release in the saliva. Thesis, Karolinska Institutet, Stockholm, Sweden, 78 p, 1999.
45. O'Sullivan EM, Higginson IJ: Clinical effectiveness and safety of acupuncture in the treatment of irradiation-induced xerostomia in patients with head and neck cancer: a systematic review. Acupunct Med 2010; 28: 191-9.
46. Talal N, Quinn JH, Daniels TE. The clinical effects of electrostimulation on salivary function of Sjogren's syndrome patients. A placebo controlled study. Rheumatol Int 1992; 12: 43-5.
47. Hargitai IA, Sherman RG, Strother JM. The effects of electrostimulation on parotid saliva flow: a pilot study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005; 99: 316-20.
48. Strietzel FP, Martin-Granizo R, Fedele S, et al. Electrostimulating device in the management of xerostomia. Oral Dis 2007; 13(2): 206-13.
49. Strietzel FP, Lafaurie GI, Mendoza GR, et al. Efficacy and safety of an intraoral electrostimulation device for xerostomia relief: a multicenter, randomized trial. Arthritis Rheum 2011; 63: 180-90.
50. Alajbeg I, Falcão DP, Tran SD, et al. Intraoral Electrostimulator for Xerostomia Relief: A Long-term, Multicenter, Open-label, Uncontrolled, Clinical Trial. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2012, in press.
51. Meijer JM, Meiners PM, Vissink A, et al. Effectiveness of rituximab treatment in primary Sjögren's syndrome: a randomized, double-blind, placebo-controlled trial. Arthritis Rheum 2010; 62: 960-8.
52. Pijpe J, van Imhoff GW, Spijkervet FK, et al. Rituximab treatment in patients with primary Sjögren's syndrome: an open-label phase II study. Arthritis Rheum 2005; 52(9): 2740-50.
53. Mariette X, Ravaud P, Steinfeld S, et al. Inefficacy of infliximab in primary Sjögren's syndrome: results of the randomized, controlled Trial of Remicade in Primary Sjögren's Syndrome (TRIPSS). Arthritis Rheum 2004; 50(4): 1270-6.
54. Sankar V, Brennan MT, Kok MR, et al. Etanercept in Sjögren's syndrome: a twelve-week randomized, double-blind, placebocontrolled pilot clinical trial. Arthritis Rheum 2004; 50(7): 2240-5.
55. Pillemer SR, Leakan RA, Sankar V, et al. Prominent adverse effects of thalidomide in primary Sjögren's syndrome. Arthritis Rheum 2004; 51(3): 505-6.
56. Moutsopoulos NM, Angelov N, Sankar V, Leakan RA, Pillemer S, Wahl SM. Immunological consequences of thalidomide treatment in Sjögren's syndrome. Ann Rheum Dis 2006; 65(1): 112-4.
57. Mastrangeli A, O'Connell B, Aladib W, Fox PC, Baum BJ, Crystal RG. Direct in vivo adenovirus-mediated gene transfer to salivary glands. Am J Physiol 1994; 266: G1146-55.
58. Samuni Y, Baum BJ: Gene delivery in salivary glands: from the bench to the clinic. Biochim Biophys Acta 2011; 1812:1515-21.
59. Delporte C, O'Connell BC, He X, et al. Increased fluid secretion after adenoviral-mediated transfer of the aquaporin-1 cDNA to irradiated rat salivary glands. Proc Natl Acad Sci USA 1997; 94: 3268-73.
60. Shan Z, Li J, Zheng C, Liu X, et al. Increased fluid secretion after adenoviral-mediated transfer of the human aquaporin-1 cDNA to irradiated miniature pig parotid glands. Mol Ther 2005; 11:444-51.
61. Zheng C, Goldsmith CM, Mineshiba F, et al. Toxicity and biodistribution of a first-generation recombinant adenoviral vector, encoding aquaporin-1, after retroductal delivery to a single rat submandibular gland. Hum Gene Ther 2006; 17:1122-33.
62. Baum BJ, Zheng C, Alevizos I, et al. Development of a gene transfer-based treatment for radiation-induced salivary hypofunction. Oral Oncol 2010; 46: 4-8.
63. Shiozawa S, Tanaka Y, Shiozawa K. Single-blinded controlled trial of low-dose oral IFN-alpha for the treatment of xerostomia in patients with Sjögren's syndrome. J Interferon Cytokine Res 1998; 18(4): 255-62.
64. Ship JA, Fox PC, Michalek JE, Cummins MJ, Richards AB. Treatment of primary Sjögren's syndrome with low-dose natural human interferon-alpha administered by the oral mucosal route: a phase II clinical trial. IFN Protocol Study Group. J Interferon Cytokine Res 1999; 19(8): 943-51.
65. Cummins MJ, Papas A, Kammer GM, Fox PC. Treatment of primary Sjögren's syndrome with low-dose human interferon alfa administered by the oromucosal route: combined phase III results. Arthritis Rheum 2003; 49(4): 585-93.
66. Schiff E, Mogilner JG, Sella E, et al. Hypnosis for postradiation xerostomia in head and neck cancer patients: a pilot study. J Pain Symptom Manage 2009; 37(6): 1086-92.
67. Teguh DN, Levendag PC, Noever I, et al. Early hyperbaric oxygen therapy for reducing radiotherapy side effects: early results of a randomized trial in oropharyngeal and nasopharyngeal cancer. Int J Radiat Oncol Biol Phys 2009; 75(3): 711-6.
68. Mavragani CP, Moutsopoulos NM, Moutsopoulos HM. The management of Sjögren's syndrome. Nat Clin Pract Rheumatol 2006; 2(5):252-61.
69. Feng J, van der Zwaag M, Stokman MA, van Os R, Coppes RP. Isolation and characterization of human salivary gland cells for stem cell transplantation to reduce radiation-induced hyposalivation. Radiother Oncol 2009; 92(3): 466-71.
70. Chitra S, Shyamala Devi CS. Effects of radiation and alphatocopherol on saliva flow rate, amylase activity, total protein and electrolyte levels in oral cavity cancer. Indian J Dent Res 2008; 19(3): 213-8.
71. Shimazu R, Tanaka G, Tomiyama R, Kuratomi Y, Inokuchi A. Cepharanthin effect on radiation-induced xerostomia and taste disorder in patients with head and neck cancer. Nihon Jibiinkoka Gakkai Kaiho 2009; 112(9): 648-55.
72. Sreebny LM, Valdini A. Xerostomia. A neglected symptom. Arch Intern Med 1987; 147: 1333-7.