Impact of medications on salivary flow rate in patients with xerostomia: a retrospective study by the Xeromeds Consortium.

Autor: Fortuna G; Department of Oral Medicine/Oral & Maxillofacial Surgery, Atrium Health Carolinas Medical Center, 1000 Blythe Blvd, Charlotte, NC, 28203, USA.; Department of Oral Medicine, Glasgow Dental Hospital and School, University of Glasgow, Glasgow, G2 3JZ, UK., Whitmire S; Department of Oral Medicine/Oral & Maxillofacial Surgery, Atrium Health Carolinas Medical Center, 1000 Blythe Blvd, Charlotte, NC, 28203, USA., Sullivan K; Department of Oral Medicine/Oral & Maxillofacial Surgery, Atrium Health Carolinas Medical Center, 1000 Blythe Blvd, Charlotte, NC, 28203, USA., Alajbeg I; Department of Oral Medicine, University of Zagreb, Zagreb, Croatia., Andabak-Rogulj A; Department of Oral Medicine, University of Zagreb, Zagreb, Croatia., Pedersen AML; Section for Oral Medicine and Pathology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Noerre Allé 20, 2200, Copenhagen N, Denmark., Vissink A; Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Centrum Groningen, PO Box 30.001, 9700 RB, Groningen, the Netherlands., di Fede O; Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy., Aria M; Department of Economics and Statistics, Federico II University of Naples, 80126, Naples, Italy., Jager DJ; Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam UMC and Academic Center for Dentistry (ACTA), Amsterdam Institute for Infection and Immunity, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands., Noll J; Department of Oral Medicine/Oral & Maxillofacial Surgery, Atrium Health Carolinas Medical Center, 1000 Blythe Blvd, Charlotte, NC, 28203, USA., Jensen SB; Department of Dentistry and Oral Health, Aarhus University, Vennelyst Boulevard 9, 8000, Aarhus C, Denmark., Wolff A; Saliwell Ltd, Harutzim, Tel Aviv, Israel., Brennan MT; Department of Oral Medicine/Oral & Maxillofacial Surgery, Atrium Health Carolinas Medical Center, 1000 Blythe Blvd, Charlotte, NC, 28203, USA. mike.brennan@atriumhealth.org.; Department of Otolaryngology/Head and Neck Surgery, Wake Forest University School of Medicine, Winston Salem, NC, USA. mike.brennan@atriumhealth.org.
Jazyk: angličtina
Zdroj: Clinical oral investigations [Clin Oral Investig] 2023 Jan; Vol. 27 (1), pp. 235-248. Date of Electronic Publication: 2022 Oct 21.
DOI: 10.1007/s00784-022-04717-1
Abstrakt: Objectives: This study evaluates the impact of systemic medications and polypharmacy on unstimulated (UWS) and chewing-stimulated whole saliva (SWS) flow rates in patients with xerostomia.
Material and Methods: This cross-sectional multicenter study is based on data of patients referred to five oral medicine outpatient practices in Europe and USA from January 2000 and April 2014. Relevant demographic, social, medical history and current medications were collected.
Results: The study included 1144 patients, 972 (85%) females, with a mean (SD) age of 59 (14.1) years. In unmatched patients, the UWS flow rate was lower in patients taking a medication (vs. not taking a medication) from the following drug categories: opioid analgesics, anticonvulsants, antidepressants, antihypertensives, benzodiazepines, corticosteroids, diuretics, disease-modifying antirheumatic drugs (DMARDs) and hormones. There was a greater negative effect on SWS flow rate in patients taking (vs. not taking) anticonvulsants, antidepressants, benzodiazepines, corticosteroids, and DMARDs. In matched patients, both UWS (0.22 vs. 0.19 ml/min; p = 0.03) and SWS (0.97 vs. 0.85 ml/min; p = .017) flow rates were higher in patients on non-opioid analgesics (vs. not taking). The UWS flow rate was lower in patients taking antidepressants (vs. not taking) (0.16 vs. 0.22 ml/min p = .002) and higher (and within normal range) in patients taking sex hormones (vs. not taking) (0.25 vs. 0.16 ml/min; p = .005). On the other hand, SWS was lower in patients taking corticosteroid (vs. not taking) (0.76 vs. 1.07 ml/min; p = .002), and in patients taking DMARDs (vs. not taking) (0.71 vs. 0.98 ml/min; p = .021). Finally, differences in medians of both UWS and SWS were statistically significant in patients taking 1 or more than 1 opioid analgesic (vs. not taking, p ≤ .0001 and p = .031, respectively), 1 or more than 1 anticonvulsants (vs. not taking, p = .008 and p = .007), 1 or more than 1 antidepressants (vs. not taking, p < .0001 for both), 1 or more than 1 DMARDs (vs. not taking, p = .042, and p = .003).
Conclusions: A greater negative impact on UWS and SWS flow rates was seen in patients taking more than one medication from the same drug class. Intake of antidepressants, corticosteroids and DMARDs is associated with lower whole saliva flow rates.
Clinical Relevance: Salivary flow rate can be modified by some specific medications, mostly by polypharmacy.
(© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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