Abobotulinumtoxin A injections for the chronic sialorrhea correction in children: Russian retrospective multicenter study

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OBJECTIVE: Multicenter retrospective analysis of the Russian experience in the use of AbobotulinumtoxinA injections for the correction of chronic sialorrhea of various etiologies in children. MATERIAL AND METHODS: 608 injections (from 1 to 5 repeated injections) of the AbobotulinumtoxinA into the salivary glands for 226 patients aged 2.0 to 17.8 years (Me - 5.1 years) with various neurological diseases and neurodevelopmental disorders in 12 Russian centers. RESULTS: In 180 patients (79.6%), AbobotulinumtoxinA was the first drug used to correct drooling. 177 (78.3%) children received combined injections into the salivary glands and body muscles to correct spasticity. The total doses of AbobotulinumtoxinA administered into the salivary glands during the first injection were (Med; min-max; 25-75%):150 U (7.7 U/kg); 30-400 U (1.9-27.3); 100-200 units (4.8-15.3). Doses to both parotid glands - 80 units (4.1 units/kg); 18-250 U (0.8-15.4 U/kg); 60-120 U (2.7-8.5 U/kg); in both submandibular - 70 U (3.3 U/kg); 12-160 U (0.5-13.6 U/kg); 40-80 U (2.1-6.1 U/kg). After the first injection of AbobotulinumtoxinA, a significant decrease in salivation was observed in 212 cases (93.8%). The effect lasted for an average of 4.9 months (0.5 to 24 months). Changes in the Drooling Impact Scale and subjective duration of effect were not significantly different after repeated injections. Adverse events were noted in 30 (13.3%) cases and persisted up to 2-3 weeks after injection. CONCLUSION: AbobotulinumtoxinA injections have shown effectiveness and safety in the correction of chronic sialorrhea in children, also in combination with concomitant spasticity treatment. Further research is needed to determine the optimal dose and treatment protocols.

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