Abstract Details

Title Botulinum toxin for Sialorrhea in Patients with Parkinson’s disease & Atypical Parkinsonism: A Single Center Real-World Study

Topic Neuromuscular and Clinical Neurophysiology (EMG)

Presentation(s) P8 - Poster Session 8 (11:45 AM-12:45 PM)

Poster/Presentation
Number 4-008

Objective

To determine the safety and efficacy of botulinum toxin treatment (BTX) for medically refractory sialorrhea in patients with Parkinson’s Disease (PD) and Atypical Parkinsonism (AP).

Background

RimabotulinumtoxinB and IncobotulinumtoxinA are FDA approved for the treatment of medically refractory sialorrhea. However, there is paucity of studies that show their use in a ‘real-world’ setting.

Design/Methods A retrospective chart review was completed at a tertiary care movement disorder clinic. All patients with PD or AP who were treated with BTX were included. Patients with PD who had Deep Brain Stimulation (DBS) were also included. All injections were given by a fellowship trained movement disorder neurologist. Efficacy was measured by the patient reported Clinical Global Impression Scale (CGI) after each injection.

Results 111 Patients (76 male, 35 female) were included. 99 (89%) patients had PD and 12 (11%) patients had AP. Disease duration was 3.93 ± 2.6 years. Type of BTX injected was, rimabotulinumtoxinB 78 (70%), incobotulinumtoxinA 16 (14%), onobotulinumtoxinA 7 (6%). Ten patients received both rimabotulinumtoxinB and incobotulinumtoxinA at different times when they were switched from one BTX type to the other. Improvement was noted by mean CGI of 2.06 ± 0.09 for rimabotulinumtoxinB, 2.32 ± 0.19 for incobotulinumtoxinA, and 2.38 ± 0.35 for onobotulinumtoxinA respectively. This correlates to “much improved” on the CGI scale. No significant difference in efficacy was noted between the three BTX types (p= 0.42). 36 (33%) patients had preexisting dysphagia at the time of injection. 103 (92%) of patients reported no dysphagia or worsening of preexisting dysphagia after injections while 8 (8%) reported mild dysphagia after injection which resolved in a few weeks.

Conclusions

In this large ‘real world’ study of patients with PD, with and without DBS, AP, BTX was well tolerated and resulted in patient reported “much improvement” of medically refractory sialorrhea.

Authors/Disclosures
Danyaal Buttar PRESENTER	Mr. Buttar has nothing to disclose.
Mustafa S. Siddiqui, MD, FAAN	Dr. Siddiqui has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Boston Scientific Neuromodulation. Dr. Siddiqui has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Medtronic. The institution of Dr. Siddiqui has received research support from Boston Scientific Neuromodulation. The institution of Dr. Siddiqui has received research support from Abbvie. The institution of Dr. Siddiqui has received research support from National Institute of Health .

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