Placebo-controlled trial finds no benefit from pilocarpine drops for dry mouth in frail and life-limited patients

A double-blind, placebo-controlled randomised controlled trial in the Netherlands (n=92, across hospitals and nursing homes) tested topical pilocarpine drops against placebo for xerostomia (dry mouth) in patients with a life-limiting condition or frailty Primary Study (van der Meulen et al.1, PMID: 42641502). No significant difference was found between arms at four weeks. The trial was underpowered, and this null result should be read as inconclusive rather than as definitive evidence of no effect.

The finding functions as a caution rather than a positive recommendation: it does not support routine prescribing of topical pilocarpine for xerostomia in frail or end-of-life patients pending an adequately powered trial, but nor does it rule out a real effect that this trial was not large enough to detect.