Management of xerostomia in older patients : a randomised controlled trial evaluating the efficacy of a new oral lubricant solution

Drugs Aging. 2007;24(11):957-65. doi: 10.2165/00002512-200724110-00007.

Abstract

Background: Xerostomia is a subjective sensation of mouth dryness that may frequently occur in older patients.

Objective: To compare the clinical efficacy and acceptability of a new oxygenated glycerol triester (OGT) oral spray taken five times daily with that of a commercially available saliva substitute Saliveze in the treatment of xerostomia.

Methods: Forty-one institutionalised patients (28 women, 13 men; mean age 84 +/- 7 years) were randomly assigned to receive either OGT or Saliveze in a 2-week, randomised, parallel-group study. Clinical assessment of xerostomia included evaluation of mouth dryness using a self-rated, 10cm long visual analogue scale (VAS), objective assessment of oral tissue condition using a four-point ordinal scale and subjective assessment of symptoms of xerostomia using dichotomous responses to a questionnaire. The primary endpoint was the day (D) 14 patient-based mouth dryness score measured on a self-rated VAS.

Results: At D14, OGT resulted in significantly greater efficacy with respect to mouth dryness (mean between-treatment difference 2.1 +/- 0.1, 95% CI 1.9, 2.3; p = 0.001), swallowing difficulty (1.8 +/- 0.3, 95% CI 1.5, 2.1; p = 0.001), speech difficulty (1.1 +/- 0.2, 95% CI 1.0, 2.4; p = 0.04) and overall sensation of symptom relief (2.7 +/- 1.2, 95% CI 1.9, 3.8; p = 0.001). Objective assessment of oral tissues also showed significantly better improvement with OGT spray with respect to dryness (p = 0.01), stickiness (p = 0.005) and dullness (p = 0.001) of oral mucosa; severity of mucositis (p = 0.01); and thickening of the tongue (p = 0.03). A significant difference in taste acceptability was also noted in favour of OGT (1.4 +/- 0.6, 95% CI 1.2, 1.9; p = 0.04).

Conclusion: OGT lubricant oral spray was superior to Saliveze in improving xerostomia and oral tissue condition in older institutionalised patients.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Aerosols
  • Aged / physiology*
  • Aged, 80 and over
  • Double-Blind Method
  • Endpoint Determination
  • Female
  • Glycerol / administration & dosage
  • Glycerol / adverse effects
  • Glycerol / therapeutic use*
  • Hospitalization
  • Humans
  • Long-Term Care
  • Lubricants / administration & dosage
  • Lubricants / adverse effects
  • Lubricants / therapeutic use*
  • Male
  • Mouth / pathology
  • Pharmaceutical Solutions
  • Surveys and Questionnaires
  • Treatment Outcome
  • Xerostomia / drug therapy*
  • Xerostomia / pathology

Substances

  • Aerosols
  • Lubricants
  • Pharmaceutical Solutions
  • Glycerol