@article {Parr371, author = {Jeremy R Parr and Emma Todhunter and Lindsay Pennington and Deborah Stocken and Jill Cadwgan and Anne E O{\textquoteright}Hare and Catherine Tuffrey and Jane Williams and Mike Cole and Allan F Colver}, title = {Drooling Reduction Intervention randomised trial (DRI): comparing the efficacy and acceptability of hyoscine patches and glycopyrronium liquid on drooling in children with neurodisability}, volume = {103}, number = {4}, pages = {371--376}, year = {2018}, doi = {10.1136/archdischild-2017-313763}, publisher = {BMJ Publishing Group Ltd}, abstract = {Objective Investigate whether hyoscine patch or glycopyrronium liquid is more effective and acceptable to treat drooling in children with neurodisability.Design Multicentre, single-blind, randomised controlled trial.Setting Recruitment through neurodisability teams; treatment by parents.Participants Ninety children with neurodisability who had never received medication for drooling (55 boys, 35 girls; median age 4 years). Exclusion criteria: medication contraindicated; in a trial that could affect drooling or management.Intervention Children were randomised to receive a hyoscine skin patch or glycopyrronium liquid. Dose was increased over 4 weeks to achieve optimum symptom control with minimal side-effects; steady dose then continued to 12 weeks.Primary and secondary outcomes Primary outcome: Drooling Impact Scale (DIS) score at week-4. Secondary outcomes: change in DIS scores over 12 weeks, Drooling Severity and Frequency Scale and Treatment Satisfaction Questionnaire for Medication; adverse events; children{\textquoteright}s perception about treatment.Results Both medications yielded clinically and statistically significant reductions in mean DIS at week-4 (25.0 (SD 22.2) for hyoscine and 26.6 (SD 16) for glycopyrronium). There was no significant difference in change in DIS scores between treatment groups. By week-12, 26/47 (55\%) children starting treatment were receiving hyoscine compared with 31/38 (82\%) on glycopyrronium. There was a 42\% increased chance of being on treatment at week-12 for children randomised to glycopyrronium relative to hyoscine (1.42, 95\% CI 1.04 to 1.95).Conclusions Hyoscine and glycopyrronium are clinically effective in treating drooling in children with neurodisability. Hyoscine produced more problematic side effects leading to a greater chance of treatment cessation.Trial registration numbers ISRCTN75287237; EUDRACT: 2013-000863-94; Medicines and Healthcare Products Regulatory Agency: 17136/0264/001-0003}, issn = {0003-9888}, URL = {https://adc.bmj.com/content/103/4/371}, eprint = {https://adc.bmj.com/content/103/4/371.full.pdf}, journal = {Archives of Disease in Childhood} }