Efficacy of Cevimeline on Xerostomia in Sjogren's Syndrome Patients: A Systematic Review and Meta-Analysis of Randomized Clinical Trials Publisher



Karimi M¹ ; Hajikolaei FA² ; Hoseinpour F³ ; Hashemi SA⁴ ; Fatehi A⁵ ; Pakmehr SA⁶ ; Deravi N⁷ ; Naziri M⁸ ; Belbasi M⁹ ; Khoshravesh S¹⁰ ; Vaezzadeh SH¹¹
Source: Current Therapeutic Research - Clinical and Experimental Published:2025

Abstract

Background: Xerostomia, or dry mouth, is a common and debilitating symptom in patients with Sjogren's syndrome, affecting their quality of life. Although Cevimeline, a muscarinic agonist, has been investigated as a potential treatment, its efficacy and optimal dosage remain uncertain. This study aims to assess the effectiveness of Cevimeline in relieving xerostomia in patients with Sjogren's syndrome by a meta-analysis of randomized clinical trials (RCT). Method: A comprehensive search was conducted across PubMed, Scopus, Cochrane, and Web of Science databases, utilizing Medical Subject Headings terms and keywords related to “cevimeline,” “xerostomia,” and “Sjogren's syndrome” from inception until January 3, 2024. Studies were selected based on predefined inclusion criteria, focusing on clinical trials involving human subjects treated with cevimeline for xerostomia in Sjogren's syndrome. Data extraction was performed systematically, and statistical analysis was conducted using STATA software. Result: This meta-analysis included three RCTs with a total of 302 patients with Sjogren's syndrome (Cevimeline = 187; Placebo = 115). The analysis demonstrated that Cevimeline significantly reduces xerostomia (regarded as salivary flow, mouth dryness) in patients with Sjogren's syndrome with a pooled odds ratio –5.79 (95% CI [–10.55, –1.03]; I2 = 39.6%). Conclusions: In summary, cevimeline significantly increases salivary flow secretion rates in patients with Sjogren's syndrome. With a favorable safety profile at recommended dosages, cevimeline represents a viable therapeutic option for managing xerostomia, particularly in patients with mild to moderate salivary gland destruction. © 2024 The Author(s)