Oral pilocarpine for the treatment of salivary gland dysfunction due to radiotherapy

Oral pilocarpine appears to alleviate the symptoms of radiation-induced salivary gland dysfunction. Adverse effects appears to be dose dependent.

A Cochrane review included 3 studies with a total of 298 subjects. Pilocarpine hydrochloride was more effective than placebo, and at least as effective as artificial saliva in those participants that responded. The response rate was 42 to 51%. The time to response was up to 12 weeks. The side effect rate was high, and side effects were the main reason for withdrawal (six to 15% patients taking 5 mg three times daily). The side effects were usually the result of generalised parasympathomimetic stimulation (e.g. sweating, headaches, urinary frequency, vasodilatation).

Comment: The quality of evidence is downgraded by imprecise results (limited study size for each comparison).

Ədəbiyyat

1. Davies AN, Thompson J. Parasympathomimetic drugs for the treatment of salivary gland dysfunction due to radiotherapy. Cochrane Database Syst Rev 2015;10():CD003782.