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Glycopyrrolate for Drooling in Children With Neurodisability: Multicenter Study
Pinar Ozbudak1, Habibe Koc Ucar2, Leman Tekin Orgun3
1Department of Pediatric Neurology, Ankara Etlik City Hospital, Ankara, Turkiye.
Insights
Oral glycopyrrolate effectively reduces drooling in children with neurodisabilities, including autism spectrum disorder and epileptic encephalopathy. This treatment is well-tolerated and improves quality of life.
Area of Science:
- Pediatric Neurology
- Pharmacology
- Clinical Trials
Background:
- Drooling (sialorrhea) is a common challenge in children with neurodevelopmental disorders.
- Existing treatments for drooling may have limited efficacy or significant side effects.
Purpose of the Study:
- To assess the efficacy and safety of oral glycopyrrolate for treating moderate-to-severe drooling in children with neurodisabilities.
- To evaluate the impact of glycopyrrolate on quality of life in this pediatric population.
Main Methods:
- A multicenter study involving 159 children with cerebral palsy, epileptic encephalopathy, or autism spectrum disorder.
- Utilized validated scales (Drooling Impact Scale, Drooling Severity and Frequency Scale) and quality of life measures.
- Employed a dose titration protocol and systematically recorded adverse events.
Main Results:
- Significant improvements in drooling severity, impact, and quality of life were observed (P < .001).
- Glycopyrrolate was well-tolerated, with predominantly mild adverse effects, most commonly constipation.
- Cerebral palsy patients showed greater variability in response compared to other groups.
Conclusions:
- Oral glycopyrrolate is an effective and safe pharmacologic option for managing drooling in children with neurodisabilities.
- The medication demonstrates potential for improving salivary control and enhancing the quality of life for affected children and their families.
Abstract:
ObjectiveThis multicenter study aimed to evaluate the efficacy and safety of oral glycopyrrolate in children with neurodisabilities experiencing moderate-to-severe drooling.MethodsA total of 159 children diagnosed with cerebral palsy, epileptic encephalopathy, or autism spectrum disorder were assessed using the Drooling Impact Scale, Drooling Severity and Frequency Scale, and quality of life measures at baseline, week 4, and week 12. A structured dose titration protocol was followed, and adverse events were systematically recorded.ResultsOf the 159 children enrolled, 130 completed the study. Significant improvements were observed in Drooling Impact Scale, Drooling Severity and Frequency Scale, and quality of life scores across all groups (P < .001). Cerebral palsy patients exhibited greater variability in Drooling Impact Scale scores than epileptic encephalopathy and autism spectrum disorder groups at weeks 4 and 12 (P < .01). Adverse effects were predominantly mild, with constipation being the most common.ConclusionGlycopyrrolate is an effective and well-tolerated treatment for drooling in children with neurodisabilities, including autism spectrum disorder and epileptic encephalopathy. It presents a viable pharmacologic option for improving salivary control and quality of life.
