Evidence map›Paper›PMID 40771035›Full record

Trial reportMovement disorders clinical practice2026

Efficacy and Safety of IncobotulinumtoxinA for Treatment of Sialorrhea: A Multicenter, Phase 3 Study in Japan.

Nobutaka Hattori, Yohei Mukai, Noriko Nishikawa, Kazuko Hasegawa, Masahiko Tomiyama, Yasuyoshi Kimura, Yoshio Tsuboi, Ryosuke Takahashi, Ryota Nakamura, Yuishin Izumi and 6 more

Abstract readClinical Trial, Phase IIIMulticenter Study
In one paragraph

Trial report in Movement disorders clinical practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
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

16 authors.

Nobutaka HattoriDepartment of Neurology, Juntendo University Faculty of Medicine, Tokyo, Japan.ORCID https://orcid.org/0000-0002-2034-2556
Yohei MukaiDepartment of Neurology, National Center of Neurology and Psychiatry, Tokyo, Japan.ORCID https://orcid.org/0000-0003-2930-5003
Noriko NishikawaDepartment of Neurology, Juntendo University Faculty of Medicine, Tokyo, Japan.ORCID https://orcid.org/0000-0001-7762-3597
Kazuko HasegawaDepartment of Neurology, National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan.ORCID https://orcid.org/0000-0002-0142-4839
Masahiko TomiyamaDepartment of Neurology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
Yasuyoshi KimuraDepartment of Neurology, Osaka University Graduate School of Medicine, Osaka, Japan.ORCID https://orcid.org/0000-0001-9147-8058
Yoshio TsuboiDepartment of Neurology, Fukuoka University, Fukuoka, Japan.ORCID https://orcid.org/0000-0002-6758-0981
Ryosuke TakahashiDepartment of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan.ORCID https://orcid.org/0000-0002-1407-9640
Ryota NakamuraDepartment of Neurology, Juntendo University Urayasu Hospital, Urayasu, Japan.ORCID https://orcid.org/0000-0003-2975-1265
Yuishin IzumiDepartment of Neurology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan.ORCID https://orcid.org/0000-0002-3048-9041
Hirohisa WatanabeDepartment of Neurology, Fujita Health University School of Medicine, Toyoake, Japan.ORCID https://orcid.org/0000-0001-8553-8536
Morinobu SekiDepartment of Neurology, Keio University School of Medicine, Tokyo, Japan.ORCID https://orcid.org/0000-0002-6726-6781
Kenji SekiguchiDivision of Neurology, Kobe University Graduate School of Medicine, Kobe, Japan.ORCID https://orcid.org/0000-0003-4100-7316
Shohei TateishiClinical Development Control Department, Teijin Pharma Limited, Tokyo, Japan.
Yusaku MatsushitaClinical Development Department, Teijin Pharma Limited, Tokyo, Japan.
Yusaku NakamuraDepartment of Neurology, Rinku General Medical Center, Osaka, Japan.

Funding

Teijin Pharma
6 · The paper itself

Abstract

backgroundSialorrhea, caused by various neurological diseases, impairs patient health and quality of life. After the results of a randomized controlled trial, incobotulinumtoxinA was approved for the treatment of chronic sialorrhea in the United States and Europe; however, no pharmacotherapy has been approved in Japan.

objectiveThe aim was to evaluate the efficacy and safety of incobotulinumtoxinA treatment for chronic sialorrhea in a single-arm phase 3 study in Japan.

methodsPatients with chronic sialorrhea caused by neurological diseases (Parkinson's disease, atypical parkinsonism, and stroke, group A) and broader diseases (eg, muscular dystrophy and amyotrophic lateral sclerosis, group B) were enrolled. IncobotulinumtoxinA 100 U was injected into the salivary glands once every 16 weeks for 48 weeks. A primary endpoint was assessed in group A, whereas secondary endpoints and safety were assessed in both groups.

resultsFrom November 2021 to August 2023, 92 patients (58 and 34 in groups A and B, respectively) received incobotulinumtoxinA at 28 institutions. The primary endpoint, the least square mean (standard error) of change in unstimulated salivary flow rate from baseline to 4 weeks, was -0.08 (0.009, 95% confidence interval [CI]: -0.10, -0.06) g/min, achieving the prespecified efficacy criteria (upper limit of the 95% CI <-0.04). The secondary endpoints were consistent across efficacy measures, indicating that reduced salivary secretion and improved drooling symptoms persisted for 48 weeks. The most common adverse events were dry mouth and dysphagia.

conclusionsThe first study in Japan confirmed the efficacy of incobotulinumtoxinA treatment for chronic sialorrhea with good patient tolerability and no new safety concerns.

Indexed as

Botulinum Toxins, Type ANeuromuscular AgentsSialorrheaAdultAgedFemaleHumansJapanMaleMiddle AgedTreatment OutcomeBotulinum Toxins, Type AincobotulinumtoxinANeuromuscular Agentsbotulinum toxinsdroolinghypersalivationParkinson's diseasesalivary gland

Identifiers

PMID40771035
PMCPMC12839494

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Registered trials

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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.