Botulinum neurotoxin type A in the interdisciplinary treatment of sialorrhea in adults and children-update and practice recommendations.

Jost, Wolfgang H; Bäumer, Tobias; Bevot, Andrea; Birkmann, Ulrich; Buhmann, Carsten; Grosheva, Maria; Guntinas-Lichius, Orlando; Laskawi, Rainer; Paus, Sebastian; Pflug, Christina; Schroeder, A Sebastian; Spittau, Björn; Steffen, Armin; Wilken, Bernd; Winterholler, Martin; Berweck, Steffen

Jost, Wolfgang H; Bäumer, Tobias; Bevot, Andrea; Birkmann, Ulrich; Buhmann, Carsten; Grosheva, Maria; Guntinas-Lichius, Orlando; Laskawi, Rainer; Paus, Sebastian; Pflug, Christina; Schroeder, A Sebastian; Spittau, Björn; Steffen, Armin; Wilken, Bernd; Winterholler, Martin; Berweck, Steffen.

Jost WH; Parkinson-Klinik Ortenau, Wolfach, Germany.
Bäumer T; Institute of Systemic Motor Science, CBBM, University of Lübeck, Lübeck, Germany.
Bevot A; Department of Neuropediatrics and Developmental Medicine, University Children's Hospital Tübingen, Tübingen, Germany.
Birkmann U; Department of Neurology, Schluckambulanz, GFO Clinics Troisdorf, Troisdorf, Germany.
Buhmann C; Department of Neurology, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
Grosheva M; Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany.
Guntinas-Lichius O; Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany.
Laskawi R; Department of Otorhinolaryngology, University Hospital Göttingen, Göttingen, Germany.
Paus S; Department of Neurology, GFO Clinics Troisdorf, Troisdorf, Germany.
Pflug C; Department of Voice, Speech and Hearing Disorders, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
Schroeder AS; Clinic for Child Neurology and Social Pediatrics, Child Center Maulbronn, Maulbronn, Germany.
Spittau B; Anatomy and Cell Biology, Medical School OWL, Bielefeld University, Bielefeld, Germany.
Steffen A; Department for Otorhinolaryngology, University of Lübeck, Lübeck, Germany.
Wilken B; Department of Pediatric Neurology, Klinikum Kassel, Kassel, Germany.
Winterholler M; Department of Neurology, Sana Hospital Rummelsberg, Nuremberg/Schwarzenbruck, Germany.
Berweck S; Specialist Center for Pediatric Neurology, Neurorehabilitation and Epileptology, Schön Clinic, Vogtareuth, Germany.

Front Neurol ; 14: 1275807, 2023.

Article en En | MEDLINE | ID: mdl-38162447

ABSTRACT

ABSTRACT

Sialorrhea is defined as a chronic excessive flow of saliva from the mouth, often with adverse consequences for health and quality of life of patients. In addition to currently used non-drug treatment and systemic drugs, intraglandular Botulinum Neurotoxin A (BoNT/A) injections have been examined in case studies, controlled trials and clinical practice. Two pivotal Phase III trials recently led to market approval in the USA and EU for IncobotulinumtoxinA [Xeomin®, IncoBoNT/A, Clostridium botulinum neurotoxin type A (150 kD), free from complexing proteins, Merz Pharmaceuticals GmbH] for treatment of chronic sialorrhea in adults and pediatric patients. This review provides a multidisciplinary approach to discuss the current state of sialorrhea therapy as well as benefits and current limitations of BoNT/A injections. A consensus regarding treatment recommendations made available to physicians in Germany in 2022 has now been updated here for presentation to an international audience. This review provides a framework including a flow chart for patient selection, recommendations for dosing and the injection process, as well as a discussion of therapeutic goals, long-term benefits and safety aspects. This review is aimed at supporting physicians in developing multidisciplinary and individualized treatment approaches to achieve optimal benefits for patients.

Palabras clave

BoNT/A; IncobotulinumtoxinA; botulinum neurotoxin type A; botulinum toxin; hypersalivation; practice recommendations; quality of life; sialorrhea

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