Findings

What do systematic reviews say?

16 questions · 18 findings · 3 reviews · Oral Health

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No studies found 3 · 16.7%GRADE not reported 10 · 55.6%Very low 4 · 22.2%Low 1 · 5.6%Moderate 0 · 0%High 0 · 0%

Pilocarpine vs no treatment/placebo

Salivary flow rate (unstimulated) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

It is very uncertain whether pilocarpine changes salivary flow rate (unstimulated) compared with no treatment/placebo (very low certainty).

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
Up to and including 3 months postRT
MD -0.06 [-0.23, 0.11]
1 study · 24 participants
Very low

Pilocarpine vs no treatment/placebo

Salivary flow rate (stimulated) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
Any time point
No evidence of a difference between treatment groups for stimulated salivary flow at any time point (Analysis 1.5)
8 studies
GRADE not reported

Biperiden plus pilocarpine vs no treatment

Salivary flow rate (unstimulated) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
End of RT
Insufficient evidence, from a single trial of 60 participants, to determine the effect on unstimulated salivary flow rate at the end of RT (Rode 1999; Analysis 2.1)
1 study · 60 participants
GRADE not reported

Pilocarpine lozenge (3 mg or 5 mg) vs placebo control

Salivary flow rate · Adults seeking treatment for the symptom of dry mouth (xerostomia) due to any cause (e.g. medication, Sjogren's syndrome, radiotherapy,…

1 finding from 1 review

Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
Single dose (up to 3 hours)
Statistically significant increase in saliva production vs placebo (P <= 0.05); maximum salivary output 60 to 90 minutes post-lozenge; no data presented.
1 study · 33 participants
GRADE not reported

Pilocarpine vs placebo

Salivary flow rate · Patients with radiation-induced salivary gland dysfunction

1 finding from 1 review

Parasympathomimetic drugs for the treatment of salivary gland dysfunction due to radiotherapy 2015 · Cochrane All outcomes
Only two studies measured salivary flow rates (Johnson 1993; LeVeque 1993); no usable summary/pooled data reported.
2 studies
GRADE not reported

Pilocarpine vs no treatment/placebo

Quality of life (McMaster HNRQ, 1-7 scale) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

It is very uncertain whether pilocarpine changes quality of life (McMaster HNRQ, 1-7 scale) compared with no treatment/placebo (very low certainty).

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
Up to and including 6 months postRT
MD 0.20 [-0.19, 0.59]
1 study · 90 participants
Very low

Pilocarpine vs no treatment/placebo

Dry mouth (xerostomia) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Pilocarpine led to lower xerostomia (objective, LENT-SOMA scale) compared with no treatment/placebo; GRADE not reported.

3 findings from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
6 months postRT
MD -0.40 [-0.69, -0.11]
1 study · 39 participants
GRADE not reported
Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
End of RT; 3 months postRT
RR 1.00 [0.92, 1.08]
2 studies · 48 participants
GRADE not reported
Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
Up to and including 6 months postRT
SMD -0.35 [-1.04, 0.33]
2 studies · 126 participants
Very low

Pilocarpine vs no treatment/placebo

Overall survival · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

It is very uncertain whether pilocarpine changes overall survival compared with no treatment/placebo (very low certainty).

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
Up to and including 6 months postRT
RR 1.07 [0.80, 1.43]
1 study · 60 participants
Very low

Pilocarpine vs no treatment/placebo

Other oral related symptoms (oral discomfort, eating difficulty, mucosal pain, oral complications) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
End of RT
Insufficient evidence of a difference: oral discomfort MD -18.00 (95% CI -37.41 to 1.41); eating difficulties MD -14.40 (95% CI -35.38 to 6.58); mucosal pain MD -14.80 (95% CI -37.07 to 7.47); oral complications RR…
2 studies
GRADE not reported

Pilocarpine vs no treatment/placebo

Adverse effects (other reported events) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
No evidence of a difference for any other adverse event (nausea, vomiting, chilling, headache, lacrimation, dysphasia, weakness, nervousness, rhinitis, blurred vision, urinary frequency, dizziness, palpitation, skin…
Studies not reported
GRADE not reported

Pilocarpine vs no treatment/placebo

Speech difficulties (VAS 0-100 mm) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Pilocarpine led to higher speech difficulties (VAS 0-100 mm) compared with no treatment/placebo; GRADE not reported.

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
End of RT
MD 20.20 [1.93, 38.47]
1 study · 34 participants
GRADE not reported

Pilocarpine vs no treatment/placebo

Adverse effects ‐ Sweating · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Pilocarpine may leads to higher sweating (adverse effect) compared with no treatment/placebo (low certainty).

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
RR 2.98 [1.43, 6.22]
5 studies · 389 participants
Low

Biperiden plus pilocarpine vs no treatment

Survival · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

The review found no eligible studies for this question.

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
Survival not reported.
0 studies
No studies found

Biperiden plus pilocarpine vs no treatment

Side effects · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

The review found no eligible studies for this question.

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
No data were reported on side effects.
0 studies
No studies found

Biperiden plus pilocarpine vs no treatment

Dysphagia (WHO grade 3+) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Biperiden plus pilocarpine showed no clear difference in dysphagia (WHO grade 3+) compared with no treatment; GRADE not reported.

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
12 months postRT
RR 0.25 [0.03, 2.11]
1 study · 60 participants
GRADE not reported

Biperiden plus pilocarpine vs no treatment

Dry mouth (xerostomia) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

The review found no eligible studies for this question.

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
No xerostomia data related to the effectiveness of biperiden and pilocarpine were reported (Rode 1999).
0 studies
No studies found