OnabotulinumtoxinA improves oral aperture in patients with scleroderma: A small clinical trial

Cristian D Gonzalez; Jarod John Pamatmat; Kevin M Burningham; Michelle Yang; Heather W Goff

doi:10.1016/j.jaad.2023.04.069

OnabotulinumtoxinA improves oral aperture in patients with scleroderma: A small clinical trial

J Am Acad Dermatol. 2023 Nov;89(5):952-958. doi: 10.1016/j.jaad.2023.04.069. Epub 2023 Jun 8.

Authors

Cristian D Gonzalez¹, Jarod John Pamatmat², Kevin M Burningham², Michelle Yang¹, Heather W Goff³

Affiliations

¹ Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas.
² University of Texas Southwestern Medical School, Dallas, Texas.
³ Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas. Electronic address: heather.goff@utsouthwestern.edu.

PMID: 37301288
DOI: 10.1016/j.jaad.2023.04.069

Abstract

Background: Reduced oral aperture (ROA), resulting from systemic sclerosis (SSc), is a debilitating condition with limited treatment options. Improvement in oral function has been reported with perioral administration of botulinum toxin type A.

Objective: To prospectively evaluate the efficacy of onabotulinumtoxinA (onabotA) injection in improving oral opening and quality of life in SSc patients with ROA.

Methods: Seventeen women with SSc and ROA were treated with 16 units of onabotA in 8 different sites around the cutaneous lips. Measurements of maximum mouth opening were taken before treatment, at 2 weeks posttreatment, and at 3 months posttreatment. Function and quality of life were also assessed via surveys.

Results: Interincisor and interlabial distances were significantly increased 2 weeks after treatment with onabotA (P < .001) but not 3 months after. Subjective improvement in quality of life was noted.

Limitations: This single-institution study enrolled 17 patients and did not have a placebo control group.

Conclusion: OnabotA appears to have a strong short-term symptomatic benefit in patients with ROA due to SSc, with possible benefit to quality of life.

Keywords: diffuse scleroderma; limited mouth opening; microstomia; neuromodulator; onabotulinumtoxinA; reduced oral aperture; scleroderma; systemic sclerosis.