Incobotulinumtoxin A in the treatment of excessive salivation in patients with neurological conditions

This study investigated the effectiveness and safety of incobotulinumtoxinA (IBTA) for the treatment of excessive salivation (sialorrhea) in patients with Parkinson's disease or stroke. Researchers suggested that IBTA might be a well-tolerated option for the treatment of these patients.

Sialorrhea (excessive salivation) can result from different causes such as swallowing problems (dysphagia). This condition is often associated with diseases involving the brain such as cerebral palsy, Parkinson's disease, stroke or brain injury. The effects of sialorrhea can include difficulty in eating and speaking, as well as skin breakdown and aspiration pneumonia (lung infection caused by the aspiration of food).

IncobotulinumtoxinA (IBTA; Xeomin) is a neurotoxin similar to Botox. It works by blocking nerve activity in the muscles it is injected in. Prior studies have shown the effectiveness and safety of Botox in the treatment of excessive salivation in patients with Parkinson's disease. However, it is still not clear how IBTA can affect the treatment of patients with brain conditions such as stroke or Parkinson's disease.

This study included information about 184 patients. They had excessive salivation from brain conditions. 70.7% had Parkinson disease and 19% had a stroke. These patients were randomly assigned to receive IBTA (75 U dose or 100 U dose) or a placebo). The main outcome was the change in saliva flow before treatment and after 4 weeks of treatment.

Both IBTA groups showed a reduction in saliva flow when compared to the placebo group. The reduction was even greater in patients treated with the higher dose of IBTA. A lasting effect was seen at week 16 after treatment.

In patients in the IBTA group, the most common treatment-related side effect was dry mouth (2.7%-5.4%) and problems in swallowing (0-2.7%). These were more common in the 75 U dose group.

The authors concluded that IBTA is an effective and safe treatment for excessive salivation in patients with Parkinson's disease or stroke.

This study had a limited number of patients with stroke. Larger studies are needed.