{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T23:11:23Z","timestamp":1779923483051,"version":"3.53.1"},"reference-count":69,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,9,27]],"date-time":"2018-09-27T00:00:00Z","timestamp":1538006400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Oral Diseases"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Systematic review with meta\u2010analysis of interventions for dry mouth symptoms and hyposalivation of Sj\u00f6gren's syndrome (SS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>We searched MEDLINE, Cochrane Central and EMBASE up to February 2018 for randomized trials of interventions for dry mouth and hyposalivation of SS. The primary outcome was the mean change in xerostomia symptoms. The secondary outcomes included changes in salivary flow and quality of life. We used the Cochrane risk of bias tool for individual studies and the GRADE method to summarize the quality of evidence across studies for the included outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010six studies (3,274 patients) were included in the systematic review. Results from the meta\u2010analyses showed high\u2010quality evidence that pilocarpine was superior to placebo in reducing dry mouth symptoms. We found moderate quality of evidence that pilocarpine, rituximab and interferon\u2010alpha were more effective than placebo in increasing salivary flow, with the relevant effect size being large for pilocarpine, and notably smaller for rituximab and interferon\u2010alpha.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Clinicians should be very confident in the beneficial effects of pilocarpine upon dry mouth symptoms of SS and moderately confident that pilocarpine, rituximab and interferon\u2010alpha can have beneficial effects upon salivary flow. Adverse events are common. The use of other treatment modalities cannot be supported on the basis of current evidence.<\/jats:p><\/jats:sec>","DOI":"10.1111\/odi.12952","type":"journal-article","created":{"date-parts":[[2018,8,7]],"date-time":"2018-08-07T19:44:15Z","timestamp":1533671055000},"page":"1027-1047","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":58,"title":["Interventions for dry mouth and hyposalivation in Sj\u00f6gren\u2019s syndrome: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"25","author":[{"given":"Arwa","family":"Al Hamad","sequence":"first","affiliation":[{"name":"Division of Oral Medicine UCL Eastman Dental Institute, University College London London UK"},{"name":"Dental Services King Abdulaziz Medical City Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0218-8292","authenticated-orcid":false,"given":"Giovanni","family":"Lodi","sequence":"additional","affiliation":[{"name":"<sup>3<\/sup>Dipartimento di Scienze Biomediche, Chirurgiche e Odontoiatriche Universit\u00e0 degli Studi di Milano Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3328-2759","authenticated-orcid":false,"given":"Stephen","family":"Porter","sequence":"additional","affiliation":[{"name":"Division of Oral Medicine UCL Eastman Dental Institute, University College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Fedele","sequence":"additional","affiliation":[{"name":"Division of Oral Medicine UCL Eastman Dental Institute, University College London London UK"},{"name":"NIHR University College London Hospitals Biomedical Research Centre London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3164-854X","authenticated-orcid":false,"given":"Valeria","family":"Mercadante","sequence":"additional","affiliation":[{"name":"Division of Oral Medicine UCL Eastman Dental Institute, University College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,9,27]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.328.7454.1490"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d561"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.40093"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10103-014-1590-8"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bdj.2012.890"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.16442"},{"key":"e_1_2_7_8_1","volume-title":"Statistical power analysis for the behavioral sciences","author":"Cohen J.","year":"1988"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.2217\/imt.13.49"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.11199"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0714.2011.01038.x"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2015.11.018"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.7326\/M13-1085"},{"key":"e_1_2_7_14_1","doi-asserted-by":"crossref","first-page":"e0150749","DOI":"10.1371\/journal.pone.0150749","article-title":"Rituximab effectiveness and safety for treating primary sj\u00f6gren's syndrome (pSS): Systematic review and meta\u2010analysis","volume":"11","author":"Do Valle Souza F. 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