Cochrane · systematic review · CD006981
Treatment for sialorrhea (excessive saliva) in people with motor neuron disease/amyotrophic lateral sclerosis
James, E, Ellis, C, Brassington, R, et al. · Cochrane Database of Systematic Reviews · 2022 · Cochrane Library
NeuromuscularAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
16
current version
GRADE rated
12
No studies
4
Included studies
NR
No studies 4 · 25%Ungraded 0 · 0%Very low 6 · 37.5%Low 3 · 18.8%Moderate 3 · 18.8%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Botulinum toxin injection versus placebo for sialorrhea (excessive saliva) in people with motor neuron disease/amyotrophic lateral sclerosis
Population: sialorrhea (excessive saliva) in people with motor neuron disease/amyotrophic lateral sclerosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Participant‐reported improvement in sialorrhea in the short term number of participants reporting improvement Botulinum toxin injection vs placebo | RR 3 [0.81, 11.08] | 1 study · 18 participants | Low Downgraded: risk of bias, imprecision |
Reduction in the amount of saliva production in the short term using an objective measure: volume of saliva mL in 5 min (final values) Botulinum toxin injection vs placebo | no estimate extracted | 1 study · 18 participants | Moderate Downgraded: risk of bias, imprecision |
Quality of life: SEIQOL‐DW (0 to 100; with higher scores indicating better quality of life) (final values) Botulinum toxin injection vs placebo | no estimate extracted | 1 study · 17 participants | Low Downgraded: risk of bias, imprecision |
Adverse effects Botulinum toxin injection vs placebo | no estimate extracted | 1 study · 20 participants | Low Downgraded: risk of bias, imprecision |
Radiotherapy versus botulinum toxin for sialorrhea (excessive saliva) in people with motor neuron disease/amyotrophic lateral sclerosis
Population: people with motor neuron disease/amyotrophic lateral sclerosis with excessive saliva
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Participant‐reported improvement in sialorrhea in the short term, measured using the Drool Rating Scale (DRS) (range 8 to 39; higher scores indicate worse drooling) Radiotherapy vs botulinum toxin | no estimate extracted | 1 study · 16 participants | Very low Downgraded: risk of bias |
Reduction in the amount of saliva production in the short term using an objective measure Radiotherapy vs botulinum toxin | no estimate extracted | NR | No studies |
Quality of life Radiotherapy vs botulinum toxin | no estimate extracted | NR | No studies |
Adverse events, reported as "negative experiences" Radiotherapy vs botulinum toxin | RR 7 [1.04, 46.95] | 1 study · 20 participants | Very low Downgraded: risk of bias |
Dextromethorphan and quinidine sulfate combination (DMQ) versus placebo for sialorrhea (excessive saliva) in people with motor neuron disease/amyotrophic lateral sclerosis
Population: sialorrhea (excessive saliva) in people with motor neuron disease/amyotrophic lateral sclerosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Participant‐reported improvement in sialorrhea in the short term Dextromethorphan and quinidine sulfate combination (DMQ) vs placebo | no estimate extracted | 1 participants | Moderate Downgraded: risk of bias |
Reduction in the amount of saliva production in the short term using an objective measure Dextromethorphan and quinidine sulfate combination (DMQ) vs placebo | no estimate extracted | 1 participants | Very low Downgraded: risk of bias |
Quality of life Dextromethorphan and quinidine sulfate combination (DMQ) vs placebo | no estimate extracted | NR | No studies |
Adverse events Dextromethorphan and quinidine sulfate combination (DMQ) vs placebo | no estimate extracted | 1 participants | Moderate Downgraded: risk of bias |
Scopolamine (hyoscine) patches versus placebo for (excessive saliva) in people with motor neuron disease/amyotrophic lateral sclerosis
Population: people with motor neuron disease/amyotrophic lateral sclerosis with sialorrhea (excessive saliva) (all fed via gastrostomy and most receiving tracheostomy positive pressure ventilation)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Participant‐reported improvement in sialorrhea in the short term Various measures: two 100 mm VAS, for severity and difficulty, anchors unstated, and response based on the ALSFRS‐R (no change or better vs worse) Scopolamine (hyoscine) patches vs placebo | no estimate extracted | 8 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Reduction in the amount of saliva production in the short term using an objective measure Mean volume of daily oral suction Scopolamine (hyoscine) patches vs placebo | no estimate extracted | 8 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Quality of life Scopolamine (hyoscine) patches vs placebo | no estimate extracted | NR | No studies |
Adverse events Scopolamine (hyoscine) patches vs placebo | no estimate extracted | 10 participants | Very low Downgraded: risk of bias, imprecision, indirectness |