Drug-Induced Sialolithiasis-A Big-Data Retrospective Study.

Area of Science:

• Otolaryngology
• Pharmacology
• Geriatric Medicine

Background:

• Sialolithiasis (salivary stones) is multifactorial, with systemic medications suspected as a cause, especially in the elderly.
• Evidence linking specific drug classes to sialolithiasis remains limited.
• This study investigates the association between common medications and sialolithiasis in older adults.

Purpose of the Study:

• To examine the relationship between prevalent medication classes and sialolithiasis in an older Israeli population.
• To provide robust evidence for the role of drug-induced hyposalivation in sialolithiasis etiology.

Main Methods:

• A nationwide retrospective case-control study (2005-2024) utilized the Clalit Health Services database.
• Sialolithiasis cases were matched 1:3 with controls by age and gender.
• Logistic regression analyzed associations between sialolithiasis and specific medication classes (antihyperlipidemic, antihypertensive, psychiatric, neurologic, antidiabetic) after stratification.

Main Results:

• The study included 32,088 individuals (8015 cases).
• Neurologic (OR 1.31), antihyperlipidemic (OR 1.18), psychiatric (OR 1.16), and antihypertensive (OR 1.08) medications were significantly associated with increased sialolithiasis odds.
• Antidiabetic medications showed no significant association.

Conclusions:

• This large-scale study strongly supports the concept of Drug-Induced Sialolithiasis.
• Four common medication classes are independently associated with higher sialolithiasis risk in older adults.
• Medication-induced hyposalivation is a major, quantifiable risk factor in sialolithiasis development.