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Review
. 2023 Feb 28;10(4):558-568.
doi: 10.1002/mdc3.13688. eCollection 2023 Apr.

Pharmacological Interventions for Sialorrhoea in People with Parkinson's Disease: A Systematic Review and Meta-Analysis

Fariha Naeem  1 , James Reid  2 , Matthew Bailey  3 , Amanda Reid  4 , Clare Smyth  2 , Martin Taylor-Rowan  5 , Edward J Newman  6 , Terry Quinn  1   5
Affiliations
Review

Pharmacological Interventions for Sialorrhoea in People with Parkinson's Disease: A Systematic Review and Meta-Analysis

Fariha Naeem et al. Mov Disord Clin Pract. .

Abstract

Background/objectives: Sialorrhoea is a common non motor complication experienced by people with Parkinson's disease (PD). Despite its prevalence there is conflicting evidence on how to effectively treat it. Our aim was to establish the efficacy and safety outcomes of pharmacological interventions used to treat sialorrhoea in people with idiopathic PD.

Methods: We registered and conducted a systematic review and meta-analysis (PROSPERO: CRD42016042470). We searched seven electronic databases from inception until July 2022. Quantitative synthesis was performed where data allowed using random effects models.

Results: From 1374 records we included 13 studies (n = 405 participants). Studies were conducted in Europe, North America and China. There was marked heterogeneity in the interventions used, follow up times and outcome measures investigated. The main source of risk of bias identified was reporting bias. Five studies were included in the quantitative synthesis. Summary estimates showed administration of botulinum toxin significantly reduced saliva production, improved patient reported functional outcomes and was associated with an increase in adverse events.

Conclusion: Sialorrhoea in PD is an important condition, but current data does not allow for strong recommendations on optimal pharmacological treatments. There is significant heterogeneity in outcomes measures used to evaluate the burden of sialorrhoea with lack of consensus on what constitutes clinically meaningful change. More research is required to better understand the underlying mechanism and potential treatments of sialorrhoea in idiopathic PD.

Keywords: Parkinson's disease; botulinum toxin; sialorrhoea.

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Figures

FIG 1
FIG 1
Preferred Reporting of items in Systematic Reviews and Meta‐Analyses (PRISMA) flow diagram. A total of 13 studies were included in the systematic review and five studies in the meta‐analysis.
FIG 2
FIG 2
Summary of risk of bias of the included studies. Red circle with “cross” symbol indicates high risk of bias, yellow circle with “minus” symbol indicates unclear risk of bias and green circle with “plus” symbol indicates low risk of bias in that specific domain.
FIG 3
FIG 3
Meta‐analysis of outcomes of interest after Botulinum toxin administration in adults with sialorrhoea and Parkinson's Disease (PD). CI, confidence interval; St diff in means, standard difference in means. Panel A: Saliva production; Panel B: Functional Outcomes; Panel C: Adverse events.
See this image and copyright information in PMC

References

    1. Chou KL, Evatt M, Hinson V, Kompoliti K. Sialorrhea in Parkinson ’ s Disease: a review. Mov Disord 2007;22(16):2306–2313. - PubMed
    1. Srivanitchapoom P, Pandey S, Hallett M. Parkinsonism and related disorders drooling in Parkinson ’ s disease: a review. Parkinsonism Relat Disord 2016;20(11):1109–1118. 10.1016/j.parkreldis.2014.08.013. - DOI - PMC - PubMed
    1. Kalf JG, Scholten S, Hopman W. Saliva swallowing frequency measured using 24‐hours ambulatory impedance‐pH monitoring in patients with Parkinson's disease and drooling. Mov Disord 2016;31(suppl 2):S279. http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=emed17&NEWS=N&A....
    1. Proulx M, de Courval FP, Wiseman MA, Panisset M. Salivary production in Parkinson's disease. Mov Disord 2005;20(2):204–207. - PubMed
    1. Leibner J, Ramjit A, Sedig L, Dai Y, Wu SS, Jacobson C, et al. The impact of and the factors associated with drooling in Parkinsons disease. Parkinsonism Relat Disord 2010;16(7):475–477. 10.1016/j.parkreldis.2009.12.003. - DOI - PubMed

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