Glycopyrrolate for sialorrhea in Parkinson disease: a randomized, double-blind, crossover trial.

Translated title of the contribution: Glycopyrrolate for sialorrhea in Parkinson disease: a randomized, double-blind, crossover trial.

M.E.L. Arbouw, K.L.L. Movig, M. Koopmann, P.J.E. Poels, H.J. Guchelaar, A.C.G. Egberts, C. Neef, J.P.P. van Vugt

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND: Sialorrhea affects approximately 75% of patients with Parkinson disease (PD). Sialorrhea is often treated with anticholinergics, but central side effects limit their usefulness. Glycopyrrolate (glycopyrronium bromide) is an anticholinergic drug with a quaternary ammonium structure not able to cross the blood-brain barrier in considerable amounts. Therefore, glycopyrrolate exhibits minimal central side effects, which may be an advantage in patients with PD, of whom a significant portion already experience cognitive deficits. OBJECTIVE: To determine the efficacy and safety of glycopyrrolate in the treatment of sialorrhea in patients with PD. METHODS: We conducted a 4-week, randomized, double-blind, placebo-controlled, crossover trial with oral glycopyrrolate 1 mg 3 times daily in 23 patients with PD. The severity of the sialorrhea was scored on a daily basis by the patients or a caregiver with a sialorrhea scoring scale ranging from 1 (no sialorrhea) to 9 (profuse sialorrhea). RESULTS: The mean (SD) sialorrhea score improved from 4.6 (1.7) with placebo to 3.8 (1.6) with glycopyrrolate (p = 0.011). Nine patients (39.1%) with glycopyrrolate had a clinically relevant improvement of at least 30% vs 1 patient (4.3%) with placebo (p = 0.021). There were no significant differences in adverse events between glycopyrrolate and placebo treatment. CONCLUSIONS: Oral glycopyrrolate 1 mg 3 times daily is an effective and safe therapy for sialorrhea in Parkinson disease. Classification of evidence: This study provides Class I evidence that glycopyrrolate 1 mg 3 times daily is more effective than placebo in reducing sialorrhea in patients with Parkinson disease during a 4-week study.
Translated title of the contributionGlycopyrrolate for sialorrhea in Parkinson disease: a randomized, double-blind, crossover trial.
Original languageUndefined/Unknown
Pages (from-to)1203-7
Number of pages5
JournalNeurology
Volume74
Issue number15
Publication statusPublished - 2010

Keywords

  • Farmacie/Biofarmaceutische wetenschappen (FARM)
  • Epidemiology
  • Farmacie(FARM)
  • Biomedische technologie en medicijnen
  • Ziekenhuisstructuur en organisatie van de gezondheidszorg
  • Public Health

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