Evidence map›Paper›PMID 40498248›Full record

ArticleNeurology and therapy2025

Long-Term Safety and Efficacy of Repeated Cycles of RimabotulinumtoxinB in the Treatment of Chronic Sialorrhea: Results of the OPTIMYST Trial.

Rajesh Pahwa, Eric Molho, Mark Lew, Khashayar Dashtipour, Ramon A Gil, Fredy J Revilla, Thomas Clinch, Peibing Qin, Stuart H Isaacson, OPen Label Trial of Intraglandular MYobloc injections for Sialorrhea Treatment (OPTIMYST) study group

Registry-linked trialAbstract read
In one paragraph

Article in Neurology and therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02610868 (A Phase 3, Long-Term, Open-Label and Single-Arm Study of MYOBLOC® in the Treatment of Troublesome Sialorrhea in Adult Subjects), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02610868 phase3completednot on this map

A Phase 3, Long-Term, Open-Label and Single-Arm Study of MYOBLOC® in the Treatment of Troublesome Sialorrhea in Adult Subjects

TypeinterventionalSponsorSolstice Neurosciences, LLC, a subsidiary of US WorldMeds, LLCRan2015 to 2017Enrolled187ConditionsSialorrheaArmsMYOBLOC
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Rajesh PahwaUniversity of Kansas Medical Center, 3599 Rainbow Blvd, Kansas City, KS, 66103, USA. rpahwa@kumc.edu.ORCID http://orcid.org/0000-0003-3176-6466
Eric MolhoParkinson's Disease and Movement Disorders Center, Albany Medical Center, Albany, NY, USA.
Mark LewUSC School of Medicine, Los Angeles, CA, USA.
Khashayar DashtipourSchools of Medicine, Loma Linda University Health System, Loma Linda, CA, USA.
Ramon A GilParkinson's Disease Treatment Center of SW Florida, Port Charlotte, FL, USA.
Fredy J RevillaDivision of Neurology, University of South Carolina School of Medicine Greenville, Greenville, SC, USA.
Thomas ClinchMDD US Operations, LLC, a Subsidiary of Supernus Pharmaceuticals, Inc., Rockville, MD, USA.
Peibing QinSupernus Pharmaceuticals Inc., Rockville, MD, USA.
Stuart H IsaacsonParkinson's Disease and Movement Disorder Center of Boca Raton, Boca Raton, FL, USA.
OPen Label Trial of Intraglandular MYobloc injections for Sialorrhea Treatment (OPTIMYST) study group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionBotulinum toxin injections into the salivary glands inhibit saliva production by reducing the release of acetylcholine at the parasympathetic nerve terminals within the salivary gland. The phase 3 study reported here assessed the safety, tolerability, and effectiveness of repeated cycles of rimabotulinumtoxinB (RIMA) injections in adults with troublesome sialorrhea.

methodsIn this phase 3, open-label multicenter study, 187 adult participants with troublesome sialorrhea due to Parkinson disease (65.8%), amyotrophic lateral sclerosis (13.9%), and other etiologies (20.3%) received up to 4 cycles of RIMA treatment (3500 U every 11-15 weeks).

resultsParticipants (69% male, 31% female; mean age 64.1 years) had sialorrhea for a mean of 3.2 years at baseline with a mean Unstimulated Salivary Flow Rate (USFR) of 0.63 ± 0.49 g/min. During the first treatment cycle, RIMA significantly reduced the mean±standard deviation (SD) USFR from baseline to week 4 by - 0.34 ± 0.37 g/min (p < 0.0001), and efficacy was maintained through week 13 (- 0.14 ± 0.29 g/min; p < 0.0001). Reductions were maintained at subsequent injection cycles 2-4, with mean absolute USFRs at weeks 4 and 13 of each cycle similar to those of cycle 1. Most adverse events (AEs) were mild, and the most commonly reported AEs in each cycle that were considered to be treatment-related were dry mouth (≤ 15.5% participants/cycle) and dental caries (≤ 6.0% participants/cycle).

conclusionThis study demonstrates that RIMA 3500 U safely reduces saliva production over repeated treatment cycles through 1 year, thereby supporting its utility in the management of troublesome sialorrhea in adults. CLINICALTRIALS: GOV IDENTIFIER: NCT02610868.

Indexed as

Amyotrophic lateral sclerosisBotulinum toxin type BDroolingParkinson’s diseaseRimabotulinumtoxinBSialorrhea

Identifiers

PMID40498248
PMCPMC12255616

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.