Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

217 questions · 259 findings · 23 reviews

No studies found 55 · 21.2%GRADE not reported 17 · 6.6%Very low 50 · 19.3%Low 40 · 15.4%Moderate 69 · 26.6%High 28 · 10.8%

Intraglandular botulinum neurotoxin (BoNT) injection vs placebo injection

Reduction in frequency and severity of drooling · Adults with Parkinson's disease and sialorrhea (drooling)

Type A botulinum toxin significantly reduced DSFS scores versus placebo (SMD -0.80, 95% CI -1.25 to -0.36; ungraded subgroup).

3 findings from 1 review

Intraglandular botulinum neurotoxin (BoNT) injection vs placebo injection

Adverse events (participants with >=1 adverse event) · Adults with Parkinson's disease and sialorrhea (drooling)

Type A botulinum toxin showed a borderline, non-significant increase in adverse events versus placebo (RD 0.10, 95% CI 0.00 to 0.21; ungraded subgroup).

3 findings from 1 review

Botulinum toxin vs placebo

Participant‐reported improvement in sialorrhea in the short term · sialorrhea (excessive saliva) in people with motor neuron disease/amyotrophic lateral sclerosis

Botulinum toxin injection showed no clear difference in participant‐reported improvement in sialorrhea in the short term… compared with placebo (low certainty).

1 finding from 1 review

Summary of Findings Table ‐ AbobotulinumtoxinA 50U vs OnabotulinumtoxinA 20U

Participant assessment of success by analysing scores and scales ‐ 4 weeks · glabellar lines

Summary of Findings Table ‐ AbobotulinumtoxinA 50U showed no clear difference in participant assessment success by analysing scores and scales ‐ 4… compared with onabotulinumtoxinA 20U (high certainty).

1 finding from 1 review

Summary of Findings Table ‐ AbobotulinumtoxinA 50U vs OnabotulinumtoxinA 20U

Major adverse events (eyelid ptosis, eyelid sensory disorder, strabismus) · glabellar lines

Summary of Findings Table ‐ AbobotulinumtoxinA 50U showed no clear difference in major adverse events ‐ Any major adverse events (eyelid ptosis,… compared with onabotulinumtoxinA 20U (moderate certainty).

1 finding from 1 review

Summary of Findings Table ‐ AbobotulinumtoxinA 50U vs OnabotulinumtoxinA 20U

Physician assessment of success by analysing scores and scales ‐ 4 weeks (Validated tools, wrinkles and lines at maximum contraction) · glabellar lines

Summary of Findings Table ‐ AbobotulinumtoxinA 50U showed no clear difference in physician assessment of success by analysing scores and scales ‐ 4… compared with onabotulinumtoxinA 20U (high certainty).

1 finding from 1 review

Summary of Findings Table ‐ IncobotulinumtoxinA 24U vs OnabotulinumtoxinA 24U

Physician assessment of success by analysing scores and scales ‐ 4 weeks (Validated tools, wrinkles and lines at maximum contraction) · glabellar lines

Summary of Findings Table ‐ IncobotulinumtoxinA 24U showed no clear difference in physician assessment of success by analysing scores and scales ‐ 4… compared with onabotulinumtoxinA 24U (low certainty).

1 finding from 1 review

Botulinum toxin plus conservative treatment vs conservative treatment

Improvement (greater than 50% of time spent) heel‐toe walking Measured by parents' perception of toe walking frequency more than 50% of the time. · children with ITW gait

It is very uncertain whether botulinum toxin plus conservative treatment changes improvement (greater than 50% of time spent) heel‐toe walking… compared with conservative treatment only (very low certainty).

1 finding from 1 review