{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T19:47:27Z","timestamp":1790970447092,"version":"4.1.0"},"reference-count":41,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,9,12]],"date-time":"2021-09-12T00:00:00Z","timestamp":1631404800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>Sialorrhea often happens in patients with neurologic disorders, and botulinum toxin (BoNT), which inhibits acetylcholine activation, may be an effective treatment for drooling. This systematic review and meta\u2010analysis of randomized control trials aims to evaluate the efficacy and safety of BoNT in adults and children with sialorrhea due to neurological disorders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The PubMed, Embase, and Cochrane databases were searched for relevant studies published before August 2021. The pooled estimate of outcomes was calculated using a random effect model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The review included 17 studies involving 981 patients. Compared with placebo, both BoNT type A (BoNT\u2010A) and BoNT type B (BoNT\u2010B) alleviated drooling frequency and severity (mean difference, 95% CI; BoNT\u2010A: \u22121.20, \u22121.89 to \u22120.51; BoNT\u2010B: \u22121.62, \u22122.07 to \u22121.17), reduced saliva weight (BoNT\u2010A: \u22121.70, \u22122.30 to \u22121.10; BoNT\u2010B: \u22121.12, \u22121.97 to \u22120.27), and improved global impression of change (BoNT\u2010A: \u22121.30, \u22121.73 to \u22120.86; BoNT\u2010B: \u22121.58, \u22121.95 to \u22121.21) in adults 4\u00a0weeks postinjection. BoNT\u2010B remained effective at 12\u00a0weeks. In children, BoNT\u2010A and BoNT\u2010B alleviated sialorrhea symptoms (BoNT\u2010A: \u22121.63, \u22122.42 to \u22120.85; BoNT\u2010B: \u22125.20, \u22126.03 to \u22124.37) and BoNT\u2010A reduced saliva weight (\u22120.77, \u22121.54 to 0.00) at 4\u00a0weeks postinjection. After 12\u00a0weeks, BoNT\u2010B remained efficacious. Most adverse effects (AEs) were mild to moderate and self\u2010limited.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There is moderate certainty of evidence (COE) that either BoNT\u2010A or BoNT\u2010B could relieve sialorrhea after 4 and 12\u00a0weeks of follow\u2010up without significantly more severe AEs in adults. However, the COE is very low to low in children.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.15083","type":"journal-article","created":{"date-parts":[[2021,8,27]],"date-time":"2021-08-27T18:10:34Z","timestamp":1630087834000},"page":"69-80","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Efficacy and safety of botulinum toxin for treating sialorrhea: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"29","author":[{"given":"Ya\u2010Chien","family":"Yu","sequence":"first","affiliation":[{"name":"School of Medicine College of Medicine Taipei Medical University Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6743-6667","authenticated-orcid":false,"given":"Chen\u2010Chih","family":"Chung","sequence":"additional","affiliation":[{"name":"Taipei Neuroscience Institute Taipei Medical University Taipei Taiwan"},{"name":"Department of 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