PMID- 37828600
OWN - NLM
STAT- MEDLINE
DCOM- 20231102
LR  - 20231119
IS  - 2050-6511 (Electronic)
IS  - 2050-6511 (Linking)
VI  - 24
IP  - 1
DP  - 2023 Oct 12
TI  - The effectiveness and safety of botulinum toxin injections for the treatment of 
      sialorrhea with Parkinson's disease: a systematic review and meta-analysis.
PG  - 52
LID - 10.1186/s40360-023-00694-7 [doi]
LID - 52
AB  - BACKGROUND: Botulinum toxin (BoNT) injection is an important adjunctive method to 
      treat sialorrhea. The purpose of this systematic review was to analyze the effect 
      and safety of BoNT injections in the intervention of sialorrhea with Parkinson's 
      disease (PD). METHODS: We searched PubMed, Web Of Science (WOS), Scopus, Cochrane 
      CENTRAL, and Embase from inception until April 2022. Randomized controlled trials 
      or randomized crossover trials comparing BoNT with placebo in sialorrhea with PD 
      were eligible. PRISMA guidelines were used to carry out the meta-analysis. The 
      Drooling Severity Frequency Scale (DSFS) score and the number of adverse events 
      (AEs) were the primary and secondary outcomes, respectively. Standardized mean 
      differences (SMDs) and risk differences (RDs) are used to express continuous and 
      categorical outcomes, respectively. Heterogeneity among these studies was 
      evaluated using I(2) tests. We used the GRADE tool to assess the certainty of 
      evidence (COE). RESULTS: Eight articles involving 259 patients compared BoNT 
      injections with a placebo for PD with sialorrhea. This meta-analysis showed a 
      significant reduction in DSFS scores between BoNT injections and placebo 
      (SMD=-0.98; 95% CI, -1.27 to 0.70, p<0.001; COE: high). This meta-analysis showed 
      a significant difference in AEs between BoNT injections and placebo (RD=0.15; 95% 
      CI, 0.05 to 0.24, p=0.002; COE: low). CONCLUSIONS: The pooled results suggest 
      that BoNT injections have some effect on DSFS scores with sialorrhea caused by 
      PD. There are also mild adverse events, which generally recover within a week or 
      so. The results indicate that BoNT injection is one of the treatments for 
      sialorrhea caused by PD, but we need to pay attention to adverse events. In 
      addition, the follow-up time was extended to observe oral hygiene, ulceration or 
      dental caries, and digestive function. TRIAL REGISTRATION: Our review protocol 
      was registered on PROSPERO (42021288334).
CI  - (c) 2023. BioMed Central Ltd., part of Springer Nature.
FAU - Yang, Chun-Lan
AU  - Yang CL
AUID- ORCID: 0000-0002-1637-7131
AD  - Department of Rehabilitation Medicine, West China Hospital, Sichuan University, 
      Chengdu, Sichuan, 610041, PR China.
AD  - Minda Hospital of Hubei Minzu University, Enshi, Hubei, 445000, PR China.
AD  - Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China 
      Hospital, Sichuan University, Chengdu, Sichuan, 610041, PR China.
FAU - Huang, Jia-Peng
AU  - Huang JP
AUID- ORCID: 0000-0002-5574-677X
AD  - Department of Rehabilitation Medicine, West China Hospital, Sichuan University, 
      Chengdu, Sichuan, 610041, PR China.
AD  - Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China 
      Hospital, Sichuan University, Chengdu, Sichuan, 610041, PR China.
FAU - Tan, Ying-Chao
AU  - Tan YC
AD  - Enshi Prefecture Central Hospital, Enshi, Hubei, 445000, PR China.
FAU - Wang, Ting-Ting
AU  - Wang TT
AD  - Department of Rehabilitation Medicine, West China Hospital, Sichuan University, 
      Chengdu, Sichuan, 610041, PR China.
AD  - Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China 
      Hospital, Sichuan University, Chengdu, Sichuan, 610041, PR China.
FAU - Zhang, Han
AU  - Zhang H
AD  - Department of Rehabilitation Medicine, West China Hospital, Sichuan University, 
      Chengdu, Sichuan, 610041, PR China.
AD  - Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China 
      Hospital, Sichuan University, Chengdu, Sichuan, 610041, PR China.
FAU - Qu, Yun
AU  - Qu Y
AUID- ORCID: 0000-0002-1197-4164
AD  - Department of Rehabilitation Medicine, West China Hospital, Sichuan University, 
      Chengdu, Sichuan, 610041, PR China. dr_yunqu@163.com.
AD  - Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China 
      Hospital, Sichuan University, Chengdu, Sichuan, 610041, PR China. 
      dr_yunqu@163.com.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Systematic Review
DEP - 20231012
PL  - England
TA  - BMC Pharmacol Toxicol
JT  - BMC pharmacology & toxicology
JID - 101590449
RN  - EC 3.4.24.69 (Botulinum Toxins, Type A)
SB  - IM
MH  - Humans
MH  - *Botulinum Toxins, Type A/adverse effects
MH  - *Sialorrhea/etiology/complications
MH  - *Parkinson Disease/complications/drug therapy
MH  - *Dental Caries/chemically induced/complications/drug therapy
MH  - Treatment Outcome
PMC - PMC10571401
OTO - NOTNLM
OT  - Botulinum toxins
OT  - Parkinson disease
OT  - Safety
OT  - Sialorrhea
COIS- The authors declare no competing interests.
EDAT- 2023/10/13 00:43
MHDA- 2023/11/02 12:45
PMCR- 2023/10/12
CRDT- 2023/10/12 23:52
PHST- 2022/08/29 00:00 [received]
PHST- 2023/10/03 00:00 [accepted]
PHST- 2023/11/02 12:45 [medline]
PHST- 2023/10/13 00:43 [pubmed]
PHST- 2023/10/12 23:52 [entrez]
PHST- 2023/10/12 00:00 [pmc-release]
AID - 10.1186/s40360-023-00694-7 [pii]
AID - 694 [pii]
AID - 10.1186/s40360-023-00694-7 [doi]
PST - epublish
SO  - BMC Pharmacol Toxicol. 2023 Oct 12;24(1):52. doi: 10.1186/s40360-023-00694-7.