Long-term incobotulinumtoxinA treatment for chronic sialorrhea: Efficacy and safety over 64 weeks.


Journal

Parkinsonism & related disorders
ISSN: 1873-5126
Titre abrégé: Parkinsonism Relat Disord
Pays: England
ID NLM: 9513583

Informations de publication

Date de publication:
01 2020
Historique:
received: 27 08 2019
revised: 15 11 2019
accepted: 26 11 2019
pubmed: 4 12 2019
medline: 18 12 2020
entrez: 4 12 2019
Statut: ppublish

Résumé

Botulinum neurotoxin (BoNT) is an effective treatment for chronic sialorrhea; however, reliable and robust evidence supporting long-term efficacy and safety is lacking. This study investigated the efficacy and safety of repeated incobotulinumtoxinA injections for chronic sialorrhea over 64 weeks. Adults with sialorrhea were randomized (2:2:1) to incobotulinumtoxinA 75 U, incobotulinumtoxinA 100 U (n = 74 each), or placebo (n = 36) in the double-blind, placebo-controlled main period (NCT02091739). Eligible subjects entered the extension period and received dose-blinded incobotulinumtoxinA 75 or 100 U in three further 16±2-week injection cycles. Efficacy and safety assessments in subjects who received incobotulinumtoxinA throughout the study included unstimulated salivary flow rate (uSFR), subjects' Global Impression of Change Scale (GICS), Drooling Severity and Frequency Scale (DSFS), modified Radboud Oral Motor Inventory for Parkinson's Disease (mROMP) drooling, speech, and swallowing symptom scores, and incidence of adverse events (AEs). In total, 173/184 subjects (94%) completed the main period and entered the extension period; 141 subjects received incobotulinumtoxinA 75 U (n = 69) or 100 U (n = 72) in both periods. Mean uSFR decreased consistently with repeated incobotulinumtoxinA 75 and 100 U treatment and by -0.16 and -0.17, respectively, at the end-of-study visit. Subjects' GICS, DSFS, and mROMP drooling scores also improved at all assessments. mROMP speech and swallowing scores remained stable. The most common treatment-related AEs during the extension period were dry mouth (4.4% and 11.1%) and dysphagia (1.5% and 4.2%). Data support long-term efficacy and safety of repeated incobotulinumtoxinA treatment for sialorrhea, with no additional safety concerns reported over 64 weeks.

Sections du résumé

BACKGROUND
Botulinum neurotoxin (BoNT) is an effective treatment for chronic sialorrhea; however, reliable and robust evidence supporting long-term efficacy and safety is lacking. This study investigated the efficacy and safety of repeated incobotulinumtoxinA injections for chronic sialorrhea over 64 weeks.
METHODS
Adults with sialorrhea were randomized (2:2:1) to incobotulinumtoxinA 75 U, incobotulinumtoxinA 100 U (n = 74 each), or placebo (n = 36) in the double-blind, placebo-controlled main period (NCT02091739). Eligible subjects entered the extension period and received dose-blinded incobotulinumtoxinA 75 or 100 U in three further 16±2-week injection cycles. Efficacy and safety assessments in subjects who received incobotulinumtoxinA throughout the study included unstimulated salivary flow rate (uSFR), subjects' Global Impression of Change Scale (GICS), Drooling Severity and Frequency Scale (DSFS), modified Radboud Oral Motor Inventory for Parkinson's Disease (mROMP) drooling, speech, and swallowing symptom scores, and incidence of adverse events (AEs).
RESULTS
In total, 173/184 subjects (94%) completed the main period and entered the extension period; 141 subjects received incobotulinumtoxinA 75 U (n = 69) or 100 U (n = 72) in both periods. Mean uSFR decreased consistently with repeated incobotulinumtoxinA 75 and 100 U treatment and by -0.16 and -0.17, respectively, at the end-of-study visit. Subjects' GICS, DSFS, and mROMP drooling scores also improved at all assessments. mROMP speech and swallowing scores remained stable. The most common treatment-related AEs during the extension period were dry mouth (4.4% and 11.1%) and dysphagia (1.5% and 4.2%).
CONCLUSIONS
Data support long-term efficacy and safety of repeated incobotulinumtoxinA treatment for sialorrhea, with no additional safety concerns reported over 64 weeks.

Identifiants

pubmed: 31794936
pii: S1353-8020(19)30518-8
doi: 10.1016/j.parkreldis.2019.11.024
pii:
doi:

Substances chimiques

Neuromuscular Agents 0
Botulinum Toxins, Type A EC 3.4.24.69
incobotulinumtoxinA EC 3.4.24.69

Banques de données

ClinicalTrials.gov
['NCT02091739']

Types de publication

Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

23-30

Informations de copyright

Copyright © 2019. Published by Elsevier Ltd.

Auteurs

Wolfgang H Jost (WH)

Parkinson-Klinik Ortenau, Wolfach, Germany. Electronic address: w.jost@parkinson-klinik.de.

Andrzej Friedman (A)

Department of Neurology, Faculty of Health Science, Medical University of Warsaw, Warsaw, Poland. Electronic address: andrzej.friedman@wum.edu.pl.

Olaf Michel (O)

Department of Otorhinolaryngology, University Hospital Brussels, Vrije Universiteit Brussel, Brussels, Belgium. Electronic address: omichel@uzbrussel.be.

Christian Oehlwein (C)

Neurological Outpatient Clinic for Parkinson's Disease and Deep Brain Stimulation, Gera, Germany. Electronic address: parkinson@oehlwein.com.

Jaroslaw Slawek (J)

Department of Neurological-Psychiatric Nursing, Medical University of Gdansk, Gdansk, Poland; Neurology Department, St Adalbert Hospital, Gdansk, Poland. Electronic address: jaroslaw.slawek@gumed.edu.pl.

Andrzej Bogucki (A)

Department of Extrapyramidal Diseases, Medical University of Łódź, Łódź, Poland. Electronic address: andrzej.bogucki@umed.lodz.pl.

Stanislaw Ochudlo (S)

Department of Neurology and Stroke Unit, Medical University of Silesia, Katowice, Poland. Electronic address: stanislaw.ochudlo@op.pl.

Marta Banach (M)

Department of Neurology, Collegium Medicum, Jagiellonian University Medical College, Krakow, Poland. Electronic address: martabanach@yahoo.com.

Fernando Pagan (F)

Department of Neurology, Georgetown University Hospital, Washington DC, USA. Electronic address: FPOGAN01@gunet.georgetown.edu.

Birgit Flatau-Baqué (B)

Merz Pharmaceuticals GmbH, Frankfurt am Main, Germany. Electronic address: Birgit.Flatau-Baque@merz.de.

Ulrike Dorsch (U)

Merz Pharmaceuticals GmbH, Frankfurt am Main, Germany. Electronic address: Ulrike.Dorsch@merz.de.

János Csikós (J)

Formerly of Merz Pharmaceuticals GmbH, Frankfurt am Main, Germany. Electronic address: janoscsikos@gmx.at.

Andrew Blitzer (A)

Department of Otolaryngology/Head and Neck Surgery, Columbia University College of Physicians and Surgeons, New York, NY, USA; Department of Neurology, Icahn School of Medicine at Mt. Sinai, New York, NY, USA; NY Center for Voice and Swallowing Disorders, New York, NY, USA. Electronic address: ab1136@aol.com.

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