PT  - JOURNAL ARTICLE
AU  - Jeremy R Parr
AU  - Emma Todhunter
AU  - Lindsay Pennington
AU  - Deborah Stocken
AU  - Jill Cadwgan
AU  - Anne E O’Hare
AU  - Catherine Tuffrey
AU  - Jane Williams
AU  - Mike Cole
AU  - Allan F Colver
TI  - Drooling Reduction Intervention randomised trial (DRI): comparing the efficacy and acceptability of hyoscine patches and glycopyrronium liquid on drooling in children with neurodisability
AID  - 10.1136/archdischild-2017-313763
DP  - 2018 Apr 01
TA  - Archives of Disease in Childhood
PG  - 371--376
VI  - 103
IP  - 4
4099  - http://adc.bmj.com/content/103/4/371.short
4100  - http://adc.bmj.com/content/103/4/371.full
SO  - Arch Dis Child2018 Apr 01; 103
AB  - 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’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