シェーグレン症候群患者に対するセビメリンの効果予測の検討

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  • Efficacy prediction of cevimeline in patients with Sjögren’s syndrome
  • 二次出版 シェーグレン症候群患者に対するセビメリンの効果予測の検討
  • 2ジ シュッパン シェーグレン ショウコウグン カンジャ ニ タイスル セビメリン ノ コウカ ヨソク ノ ケントウ

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The objective of this study was to examine clinical and immunological factors influencing the efficacy ofcevimeline hydrochloride hydrate （cevimeline） for the treatment of xerostomia in patients with Sjögren’s syndrome （SS）. Thirty patients with primary SS who received cevimeline were enrolled in this study. Whole stimulated sialometry （WSS） was performed before and after treatment （4 weeks after oral cevimeline was begun）, and the increment rate of WSS was calculated. Multiple regression analysis was employed to examine the relative contributions of 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 results of WSS. Patients with normal sialographic findings, negative results of minor salivary gland biopsy, and absence of anti-La/SS-B antibodies had significantly higher increment rates of WSS than those with positive findings （p ＝ 0.042, 0.002, and 0.018, respectively）. The results of multiple regression analysis showed that sialography （coefficient ＝− 0.867, p ＝ 0.004） and minor salivary gland biopsy （coefficient ＝− 0.869, p ＝ 0.003） were significantly associated with the posttreatment WSS findings. Our preliminary results demonstrated a relation between the effect of cevimeline on saliva secretion and the degree of salivary gland destruction as 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.

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