The treatment of Sjögren's syndrome patients with pilocarpine-tablets

Therapeutic progress in Sjögren's syndrome has lagged behind our recognition and understanding of clinical manifestations and disease pathogenesis. Past treatment of sicca symptoms with immunosuppressives has been unsuccessful. The use of secretagogues (e.g. pilocarpine-HCl) to stimulate flow from exocrine glands represents a novel approach that has dramatically altered our management strategy for Sjögren's syndrome. Clinical studies with pilocarpine (Salagen) tablets in the United States have demonstrated significant subjective and objective benefit for xerostomia and related oral symptoms at doses of 20 mg/day or more. Symptomatic relief of xerophthalmia and other xeroses due to Sjögren's syndrome may also occur. Data from human and animal models suggest that regular use of pilocarpine may not only improve patient quality of life but potentially prevent complications as well. Better methods of patient selection for therapy are needed since clinical response to pilocarpine cannot be predicted based on the duration of patient symptoms.