Clinical Rheumatology

, Volume 26, Issue 8, pp 1320–1327

Efficacy prediction of cevimeline in patients with Sjögren’s syndrome

Authors

  • Hiroyuki Yamada
    • Department of PathologyTsurumi University School of Dental Medicine
  • Yoichi Nakagawa
    • Second Department of Oral and Maxillofacial SurgeryTsurumi University School of Dental Medicine
  • Ei Wakamatsu
    • Department of Internal MedicineUniversity of Tsukuba
  • Takayuki Sumida
    • Department of Internal MedicineUniversity of Tsukuba
  • Shigeo Yamachika
    • Second Department of Oral and Maxillofacial SurgeryTsurumi University School of Dental Medicine
  • Yoshiaki Nomura
    • Department of Preventive Dentistry and Public HealthTsurumi University School of Dental Medicine
  • Kenji Mishima
    • Department of PathologyTsurumi University School of Dental Medicine
    • Department of PathologyTsurumi University School of Dental Medicine
Original Article

DOI: 10.1007/s10067-006-0507-8

Cite this article as:
Yamada, H., Nakagawa, Y., Wakamatsu, E. et al. Clin Rheumatol (2007) 26: 1320. doi:10.1007/s10067-006-0507-8

Abstract

The objective of this study was to examine the clinical and immunological factors influencing the efficacy of cevimeline hydrochloride hydrate (cevimeline) for the treatment of xerostomia in patients with Sjögren’s syndrome (SS). Thirty primary SS patients who were medicated with cevimeline were enrolled in this study. Whole stimulated sialometry (WSS) was compared between pre- and posttreatment points (4 weeks after oral cevimeline administration) and the increment rate of WSS was calculated. Multiple regression was employed to examine the relative contributions of the clinical and immunological factors, including age, pretreatment WSS, duration of disease, sialography, minor salivary gland biopsy, anti-Ro/SS-A antibodies, anti-La/SS-B antibodies, and antibodies to muscarinic type 3 receptors to the posttreatment WSS. Patients with normal sialography findings, negative minor salivary gland biopsy, and absence of anti-La/SS-B antibodies had significantly higher increment rates of WSS compared with those with positive findings (p = 0.042, 0.002, and 0.018, respectively). Results of the multiple regression analysis showed that sialography (coefficient = −0.867, p = 0.004) and minor salivary gland biopsy (coefficient = −0.869, p = 0.003) had significant associations with the posttreatment WSS. Our preliminary results demonstrated the relationship between the effect of cevimeline on saliva secretion and the degree of salivary gland destruction evaluated by sialography and histopathological findings in the labial minor salivary glands. These diagnostic approaches could provide useful prognostic information on the efficacy of cevimeline in SS patients.

Keywords

CevimelineLabial minor salivary glandMuscarinic type 3 receptorSialographySjögren’s syndrome

Copyright information

© Clinical Rheumatology 2007