Original Article

Clinical Rheumatology

, Volume 26, Issue 8, pp 1320-1327

First online:

Efficacy prediction of cevimeline in patients with Sjögren’s syndrome

  • Hiroyuki YamadaAffiliated withDepartment of Pathology, Tsurumi University School of Dental Medicine
  • , Yoichi NakagawaAffiliated withSecond Department of Oral and Maxillofacial Surgery, Tsurumi University School of Dental Medicine
  • , Ei WakamatsuAffiliated withDepartment of Internal Medicine, University of Tsukuba
  • , Takayuki SumidaAffiliated withDepartment of Internal Medicine, University of Tsukuba
  • , Shigeo YamachikaAffiliated withSecond Department of Oral and Maxillofacial Surgery, Tsurumi University School of Dental Medicine
  • , Yoshiaki NomuraAffiliated withDepartment of Preventive Dentistry and Public Health, Tsurumi University School of Dental Medicine
  • , Kenji MishimaAffiliated withDepartment of Pathology, Tsurumi University School of Dental Medicine
  • , Ichiro SaitoAffiliated withDepartment of Pathology, Tsurumi University School of Dental Medicine Email author 

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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

Cevimeline Labial minor salivary gland Muscarinic type 3 receptor Sialography Sjögren’s syndrome