PMID- 34449931
OWN - NLM
STAT- MEDLINE
DCOM- 20220404
LR  - 20220405
IS  - 1468-1331 (Electronic)
IS  - 1351-5101 (Linking)
VI  - 29
IP  - 1
DP  - 2022 Jan
TI  - Efficacy and safety of botulinum toxin for treating sialorrhea: A systematic 
      review and meta-analysis.
PG  - 69-80
LID - 10.1111/ene.15083 [doi]
AB  - BACKGROUND AND PURPOSE: Sialorrhea often happens in patients with neurologic 
      disorders, and botulinum toxin (BoNT), which inhibits acetylcholine activation, 
      may be an effective treatment for drooling. This systematic review and 
      meta-analysis of randomized control trials aims to evaluate the efficacy and 
      safety of BoNT in adults and children with sialorrhea due to neurological 
      disorders. METHODS: The PubMed, Embase, and Cochrane databases were searched for 
      relevant studies published before August 2021. The pooled estimate of outcomes 
      was calculated using a random effect model. RESULTS: The review included 17 
      studies involving 981 patients. Compared with placebo, both BoNT type A (BoNT-A) 
      and BoNT type B (BoNT-B) alleviated drooling frequency and severity (mean 
      difference, 95% CI; BoNT-A: -1.20, -1.89 to -0.51; BoNT-B: -1.62, -2.07 to 
      -1.17), reduced saliva weight (BoNT-A: -1.70, -2.30 to -1.10; BoNT-B: -1.12, 
      -1.97 to -0.27), and improved global impression of change (BoNT-A: -1.30, -1.73 
      to -0.86; BoNT-B: -1.58, -1.95 to -1.21) in adults 4 weeks postinjection. BoNT-B 
      remained effective at 12 weeks. In children, BoNT-A and BoNT-B alleviated 
      sialorrhea symptoms (BoNT-A: -1.63, -2.42 to -0.85; BoNT-B: -5.20, -6.03 to 
      -4.37) and BoNT-A reduced saliva weight (-0.77, -1.54 to 0.00) at 4 weeks 
      postinjection. After 12 weeks, BoNT-B remained efficacious. Most adverse effects 
      (AEs) were mild to moderate and self-limited. CONCLUSIONS: There is moderate 
      certainty of evidence (COE) that either BoNT-A or BoNT-B could relieve sialorrhea 
      after 4 and 12 weeks of follow-up without significantly more severe AEs in 
      adults. However, the COE is very low to low in children.
CI  - (c) 2021 European Academy of Neurology.
FAU - Yu, Ya-Chien
AU  - Yu YC
AD  - School of Medicine, College of Medicine, Taipei Medical University, Taipei, 
      Taiwan.
FAU - Chung, Chen-Chih
AU  - Chung CC
AUID- ORCID: 0000-0001-6743-6667
AD  - Taipei Neuroscience Institute, Taipei Medical University, Taipei, Taiwan.
AD  - Department of Neurology, Taipei Medical University Shuang Ho Hospital, New Taipei 
      City, Taiwan.
AD  - Department of Neurology, School of Medicine, College of Medicine, Taipei Medical 
      University, Taipei, Taiwan.
FAU - Tu, Yu-Kang
AU  - Tu YK
AD  - Institute of Epidemiology and Preventive Medicine, College of Public Health, 
      National Taiwan University, Taipei, Taiwan.
FAU - Hong, Chien-Tai
AU  - Hong CT
AD  - Taipei Neuroscience Institute, Taipei Medical University, Taipei, Taiwan.
AD  - Department of Neurology, Taipei Medical University Shuang Ho Hospital, New Taipei 
      City, Taiwan.
AD  - Department of Neurology, School of Medicine, College of Medicine, Taipei Medical 
      University, Taipei, Taiwan.
FAU - Chen, Kee-Hsin
AU  - Chen KH
AD  - Postbaccalaureate Program in Nursing, College of Nursing, Taipei Medical 
      University, Taipei, Taiwan.
AD  - Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan.
AD  - Center for Nursing and Health Care Research in Clinical Practice Application, Wan 
      Fang Hospital, Taipei Medical University, Taipei, Taiwan.
AD  - Evidence-Based Knowledge Translation Center, Wan Fang Hospital, Taipei, Taiwan.
FAU - Tam, Ka-Wai
AU  - Tam KW
AD  - Evidence-Based Knowledge Translation Center, Wan Fang Hospital, Taipei, Taiwan.
AD  - Center for Evidence-Based Health Care, Taipei Medical University Shuang Ho 
      Hospital, New Taipei City, Taiwan.
AD  - Division of General Surgery, Department of Surgery, School of Medicine, College 
      of Medicine, Taipei Medical University, Taipei, Taiwan.
AD  - Division of General Surgery, Department of Surgery, Taipei Medical University 
      Shuang Ho Hospital, New Taipei City, Taiwan.
FAU - Kuan, Yi-Chun
AU  - Kuan YC
AUID- ORCID: 0000-0001-9316-4976
AD  - Taipei Neuroscience Institute, Taipei Medical University, Taipei, Taiwan.
AD  - Department of Neurology, Taipei Medical University Shuang Ho Hospital, New Taipei 
      City, Taiwan.
AD  - Department of Neurology, School of Medicine, College of Medicine, Taipei Medical 
      University, Taipei, Taiwan.
AD  - Institute of Epidemiology and Preventive Medicine, College of Public Health, 
      National Taiwan University, Taipei, Taiwan.
AD  - Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan.
AD  - Center for Evidence-Based Health Care, Taipei Medical University Shuang Ho 
      Hospital, New Taipei City, Taiwan.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Systematic Review
DEP - 20210912
PL  - England
TA  - Eur J Neurol
JT  - European journal of neurology
JID - 9506311
RN  - 0 (Neuromuscular Agents)
RN  - EC 3.4.24.69 (Botulinum Toxins, Type A)
SB  - IM
MH  - *Botulinum Toxins, Type A/adverse effects
MH  - Child
MH  - Humans
MH  - *Neuromuscular Agents/therapeutic use
MH  - *Sialorrhea/chemically induced/etiology
MH  - Treatment Outcome
OTO - NOTNLM
OT  - botulinum toxin
OT  - meta-analysis
OT  - movement disorders
OT  - randomized clinical trial
EDAT- 2021/08/28 06:00
MHDA- 2022/04/05 06:00
CRDT- 2021/08/27 17:43
PHST- 2021/08/12 00:00 [revised]
PHST- 2021/06/07 00:00 [received]
PHST- 2021/08/19 00:00 [accepted]
PHST- 2021/08/28 06:00 [pubmed]
PHST- 2022/04/05 06:00 [medline]
PHST- 2021/08/27 17:43 [entrez]
AID - 10.1111/ene.15083 [doi]
PST - ppublish
SO  - Eur J Neurol. 2022 Jan;29(1):69-80. doi: 10.1111/ene.15083. Epub 2021 Sep 12.