Botulinum toxin A versus B in sialorrhea: A prospective, randomized, double‐blind, crossover pilot study in patients with amyotrophic lateral sclerosis or Parkinson's disease
Identifieur interne : 001783 ( Main/Exploration ); précédent : 001782; suivant : 001784Botulinum toxin A versus B in sialorrhea: A prospective, randomized, double‐blind, crossover pilot study in patients with amyotrophic lateral sclerosis or Parkinson's disease
Auteurs : Arianna Guidubaldi [Italie] ; Alfonso Fasano [Italie] ; Tamara Ialongo [Italie] ; Carla Piano [Italie] ; Maurizio Pompili [Italie] ; Roberta Mascianà [Italie] ; Luisa Siciliani [Italie] ; Mario Sabatelli [Italie] ; Anna Rita Bentivoglio [Italie]Source :
- Movement Disorders [ 0885-3185 ] ; 2011-02-01.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Homme, Prospective.
English descriptors
- KwdEn :
- Aged, Aged, 80 and over, Amyotrophic Lateral Sclerosis (complications), Amyotrophic lateral sclerosis, Bontoxilysin, Botulinum Toxins (therapeutic use), Botulinum Toxins, Type A (therapeutic use), Comparative study, Cross-Over Studies, Double blind study, Double-Blind Method, Female, Guidance, Human, Humans, Male, Middle Aged, Nervous system diseases, Parkinson Disease (complications), Parkinson disease, Parkinson's disease, Pilot Projects, Prospective, Prospective Studies, Sialorrhea, Sialorrhea (complications), Sialorrhea (therapy), Treatment Outcome, Ultrasound, amyotrophic lateral sclerosis, botulinum toxin A, botulinum toxin B, sialorrhea, ultrasound guidance.
- MESH :
- chemical , therapeutic use : Botulinum Toxins, Botulinum Toxins, Type A.
- complications : Amyotrophic Lateral Sclerosis, Parkinson Disease, Sialorrhea.
- therapy : Sialorrhea.
- Aged, Aged, 80 and over, Cross-Over Studies, Double-Blind Method, Female, Humans, Male, Middle Aged, Pilot Projects, Prospective Studies, Treatment Outcome.
Abstract
Background: Either botulinum toxins (BoNTs) A and B have been used for improving drooling in different neurological conditions. Methods: Consecutive patients affected by Amyotrophic Lateral Sclerosis (ALS) or Parkinson's Disease (PD) accompanied by severe drooling were randomized to receive botulinum neurotoxin type A (BoNT‐A) or B (BoNT‐B) injections into the salivary glands. Following the first treatment, when sialorrhea returned to baseline (at least three months after the first injection), subjects were re‐treated with the other serotype. Ultrasound‐guided injections into parotid and submandibular glands were bilaterally performed: total doses were 250 U BoNT‐A (Dysport) and 2500 U BoNT‐B (Neurobloc). Objective (cotton roll weight) and subjective (ad hoc clinical scales) evaluations were performed at baseline, after 1 and 4 weeks, and every 4 weeks until drooling returned to baseline. Results: Twenty‐seven patients (15 ALS and 12 PD) were enrolled, fourteen completed the study. BoNT‐A and BoNT‐B treatments gave both subjective and objective improvements in all patients. The latency was significantly shorter after BoNT‐B treatments (3.2 ± 3.7 days) compared to BoNT‐A (6.6 ± 4.1 days; P = 0.002). The mean benefit duration was similar at 75 and 90 days for BoNT‐A and BoNT‐B, respectively (P = NS). The only toxin‐related side effect was a change to saliva thickness. Conclusions: Either 250 U Dysport or 2500 U Neurobloc have similar effectiveness and safety in controlling sialorrhea. BoNT‐B has a shorter latency and comparable duration. Cost analysis, considering the doses used in this study protocol favored BoNT‐B treatment. © 2011 Movement Disorder Society
Url:
DOI: 10.1002/mds.23473
Affiliations:
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last="Fasano">Alfonso Fasano</name><affiliation wicri:level="3"><country xml:lang="fr">Italie</country><wicri:regionArea>Istituto di Neurologia, Università Cattolica del Sacro Cuore, Roma</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Ialongo, Tamara" sort="Ialongo, Tamara" uniqKey="Ialongo T" first="Tamara" last="Ialongo">Tamara Ialongo</name><affiliation wicri:level="3"><country xml:lang="fr">Italie</country><wicri:regionArea>Istituto di Neurologia, Università Cattolica del Sacro Cuore, Roma</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Piano, Carla" sort="Piano, Carla" uniqKey="Piano C" first="Carla" last="Piano">Carla Piano</name><affiliation wicri:level="3"><country xml:lang="fr">Italie</country><wicri:regionArea>Istituto di Neurologia, Università Cattolica del Sacro Cuore, Roma</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Pompili, Maurizio" sort="Pompili, Maurizio" uniqKey="Pompili M" first="Maurizio" last="Pompili">Maurizio Pompili</name><affiliation wicri:level="3"><country xml:lang="fr">Italie</country><wicri:regionArea>Istituto di Medicina Interna e Geriatria, Università Cattolica del Sacro Cuore, Roma</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Masciana, Roberta" sort="Masciana, Roberta" uniqKey="Masciana R" first="Roberta" last="Mascianà">Roberta Mascianà</name><affiliation wicri:level="3"><country xml:lang="fr">Italie</country><wicri:regionArea>Istituto di Medicina Interna e Geriatria, Università Cattolica del Sacro Cuore, Roma</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region 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sort="Bentivoglio, Anna Rita" uniqKey="Bentivoglio A" first="Anna Rita" last="Bentivoglio">Anna Rita Bentivoglio</name><affiliation wicri:level="3"><country xml:lang="fr">Italie</country><wicri:regionArea>Istituto di Neurologia, Università Cattolica del Sacro Cuore, Roma</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author></analytic><monogr></monogr><series><title level="j">Movement Disorders</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2011-02-01">2011-02-01</date><biblScope unit="vol">26</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="313">313</biblScope><biblScope unit="page" to="319">319</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">5D912AC4261466CBB0EDFC6A19729816B9EF020D</idno><idno type="DOI">10.1002/mds.23473</idno><idno type="ArticleID">MDS23473</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Amyotrophic Lateral Sclerosis (complications)</term><term>Amyotrophic lateral sclerosis</term><term>Bontoxilysin</term><term>Botulinum Toxins (therapeutic use)</term><term>Botulinum Toxins, Type A (therapeutic use)</term><term>Comparative study</term><term>Cross-Over Studies</term><term>Double blind study</term><term>Double-Blind Method</term><term>Female</term><term>Guidance</term><term>Human</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Nervous system diseases</term><term>Parkinson Disease (complications)</term><term>Parkinson disease</term><term>Parkinson's disease</term><term>Pilot Projects</term><term>Prospective</term><term>Prospective Studies</term><term>Sialorrhea</term><term>Sialorrhea (complications)</term><term>Sialorrhea (therapy)</term><term>Treatment Outcome</term><term>Ultrasound</term><term>amyotrophic lateral sclerosis</term><term>botulinum toxin A</term><term>botulinum toxin B</term><term>sialorrhea</term><term>ultrasound guidance</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Botulinum Toxins</term><term>Botulinum Toxins, Type A</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Amyotrophic Lateral Sclerosis</term><term>Parkinson Disease</term><term>Sialorrhea</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Sialorrhea</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Cross-Over Studies</term><term>Double-Blind Method</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Pilot Projects</term><term>Prospective Studies</term><term>Treatment Outcome</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Bontoxilysin</term><term>Etude comparative</term><term>Etude double insu</term><term>Guidage</term><term>Homme</term><term>Maladie de Parkinson</term><term>Pathologie du système nerveux</term><term>Prospective</term><term>Sclérose latérale amyotrophique</term><term>Sialorrhée</term><term>Ultrason</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term><term>Prospective</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background: Either botulinum toxins (BoNTs) A and B have been used for improving drooling in different neurological conditions. Methods: Consecutive patients affected by Amyotrophic Lateral Sclerosis (ALS) or Parkinson's Disease (PD) accompanied by severe drooling were randomized to receive botulinum neurotoxin type A (BoNT‐A) or B (BoNT‐B) injections into the salivary glands. Following the first treatment, when sialorrhea returned to baseline (at least three months after the first injection), subjects were re‐treated with the other serotype. Ultrasound‐guided injections into parotid and submandibular glands were bilaterally performed: total doses were 250 U BoNT‐A (Dysport) and 2500 U BoNT‐B (Neurobloc). Objective (cotton roll weight) and subjective (ad hoc clinical scales) evaluations were performed at baseline, after 1 and 4 weeks, and every 4 weeks until drooling returned to baseline. Results: Twenty‐seven patients (15 ALS and 12 PD) were enrolled, fourteen completed the study. BoNT‐A and BoNT‐B treatments gave both subjective and objective improvements in all patients. The latency was significantly shorter after BoNT‐B treatments (3.2 ± 3.7 days) compared to BoNT‐A (6.6 ± 4.1 days; P = 0.002). The mean benefit duration was similar at 75 and 90 days for BoNT‐A and BoNT‐B, respectively (P = NS). The only toxin‐related side effect was a change to saliva thickness. Conclusions: Either 250 U Dysport or 2500 U Neurobloc have similar effectiveness and safety in controlling sialorrhea. BoNT‐B has a shorter latency and comparable duration. Cost analysis, considering the doses used in this study protocol favored BoNT‐B treatment. © 2011 Movement Disorder Society</div></front></TEI><affiliations><list><country><li>Italie</li></country><region><li>Latium</li></region><settlement><li>Rome</li></settlement></list><tree><country name="Italie"><region name="Latium"><name sortKey="Guidubaldi, Arianna" sort="Guidubaldi, Arianna" uniqKey="Guidubaldi A" first="Arianna" last="Guidubaldi">Arianna Guidubaldi</name></region><name sortKey="Bentivoglio, Anna Rita" sort="Bentivoglio, Anna Rita" uniqKey="Bentivoglio A" first="Anna Rita" last="Bentivoglio">Anna Rita Bentivoglio</name><name sortKey="Fasano, Alfonso" sort="Fasano, Alfonso" uniqKey="Fasano A" first="Alfonso" last="Fasano">Alfonso Fasano</name><name sortKey="Ialongo, Tamara" sort="Ialongo, Tamara" uniqKey="Ialongo T" first="Tamara" last="Ialongo">Tamara Ialongo</name><name sortKey="Masciana, Roberta" sort="Masciana, Roberta" uniqKey="Masciana R" first="Roberta" last="Mascianà">Roberta Mascianà</name><name sortKey="Piano, Carla" sort="Piano, Carla" uniqKey="Piano C" first="Carla" last="Piano">Carla Piano</name><name sortKey="Pompili, Maurizio" sort="Pompili, Maurizio" uniqKey="Pompili M" first="Maurizio" last="Pompili">Maurizio Pompili</name><name sortKey="Sabatelli, Mario" sort="Sabatelli, Mario" uniqKey="Sabatelli M" first="Mario" last="Sabatelli">Mario Sabatelli</name><name sortKey="Siciliani, Luisa" sort="Siciliani, Luisa" uniqKey="Siciliani L" first="Luisa" last="Siciliani">Luisa Siciliani</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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