Evidence map›Paper›PMID 41366746›Full record

SynthesisBMC neurology2025

Safety and efficacy of botulinum toxin injection for sialorrhea in amyotrophic lateral sclerosis: a systematic review and meta-analysis.

Ju Huang, Yanjun Liu, Min Li, Ruyang He, Zhuojuan Tang, Yanping Lei, Yunhong Zha, Jun Wei

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

8 authors.

Ju HuangDepartment of Neurology, The First College of Clinical Medical Science, China Three Gorges University, Yichang Central People's Hospital, Yichang, 443000, China.
Yanjun LiuDepartment of Cardiovascular, Xiantao First People's Hospital, Xiantao, Hubei, 433000, China.
Min LiDepartment of Central Lab, The First College of Clinical Medical Science, China Three Gorges University, Yichang Central People's Hospital, Hubei Province Clinical Medical Research Center for Rare Diseases of Nervous System, Yichang, 443000, China.
Ruyang HeDepartment of Neurology, The First College of Clinical Medical Science, China Three Gorges University, Yichang Central People's Hospital, Yichang, 443000, China.
Zhuojuan TangDepartment of Neurology, The First College of Clinical Medical Science, China Three Gorges University, Yichang Central People's Hospital, Yichang, 443000, China.
Yanping LeiDepartment of Neurology, The First College of Clinical Medical Science, China Three Gorges University, Yichang Central People's Hospital, Yichang, 443000, China.
Yunhong ZhaDepartment of Neurology, The First Affiliated Hospital of Ningbo University, Ningbo, 315020, China.
Jun WeiDepartment of Neurology, The First College of Clinical Medical Science, China Three Gorges University, Yichang Central People's Hospital, Hubei Province Clinical Medical Research Center for Rare Diseases of Nervous System, Yichang, 443002, China. junwei@ctgu.edu.cn.ORCID http://orcid.org/0009-0001-6023-0081

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionAmyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease, with 80% of ALS patients experiencing bulbar weakness at some stage of the disease. ALS patients with bulbar weakness often suffer from troublesome sialorrhea. Botulinum toxin injection, as a neuromuscular blocker, has been widely used in the treatment of sialorrhea. This paper evaluates the safety and efficacy of botulinum toxin injections for the treatment of sialorrhea in ALS patients through a systematic review and meta-analysis.

methodsA systematic review and meta-analysis was conducted by searching eight databases, including PubMed, EMBASE, and CNKI, up to April 13, 2025. Eligible randomized controlled trials and quasi-experimental studies were analyzed using Review Manager 5.4 and Stata software.

resultsThirteen studies (2 RCTs, 11 quasi-experimental studies) with 130 ALS patients were included. Botulinum toxin significantly reduced sialorrhea and improved quality of life (Z = 10.98, p < 0.00001; RD = 0.82, 95% CI: 0.67–0.97). The treatment effect was independent of toxin type (p = 0.48), injection site (p = 0.17), and ultrasound guidance use (p = 0.44).

conclusionBotulinum toxin appears to be a safe and effective option for managing sialorrhea in ALS patients, regardless of injection technique. However, given that most included studies were observational, further validation through high-quality RCTs is warranted.

trial registrationThis meta-analysis has been registered with Prospero, and the registration number is CRD420251029441. The registration period is April 9, 2025.

Indexed as

Amyotrophic Lateral SclerosisBotulinum ToxinsNeuromuscular AgentsSialorrheaHumansTreatment OutcomeBotulinum ToxinsNeuromuscular AgentsAmyotrophic lateral sclerosis (ALS)Botulinum toxinMeta-AnalysisSialorrheaSystematic review

Identifiers

PMID41366746
PMCPMC12690843

What OpenQuestion holds

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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.