Effectiveness of a recent topical sialogogue in the management of drug-induced xerostomia

Objectives: Use of certain drugs is the most common aetiology of xerostomia. Systemic sialogogues provide a longer effect than topic ones, but also induce relevant side effects. Topical sialogogues, as malic acid, allow a safe use as they induce no systemic side-effects or pharmacological interactions, being especially interesting in cases of mild hyposalivation and oral dryness, mainly the chronic use of xerostomizing drugs. The aim of this study was to evaluate the clinical effect of 1% malic acid in patients affected by xerostomia due to antihypertensives or antidepressants. Study Design: 10 patients with drug-induced xerostomia were prospectively evaluated before and after using malic acid spray during three weeks. Xerostomia Inventory (XI) was used to evaluate subjective improvement. Unstimulated and stimulated salivary flow rates were determinated. Results: Severity significantly decreased, from 38.22 to 31.00 points (p = 0.011) after using the product. 77.8% of subjects did not complain about xerostomia at the end and 66.6% achieved an improvement > 6 points. Unstimulated flow rate singnificantly increased, from 0.163 to 0.226 mL/min (p = 0.021) at the third week. Conclusions: 1% malic acid spray induces some improvement in the management of mild and reversible xerostomia. Carrying out of randomized controlled trials is justified according to this study.