Comment on the Efficacy and Safety of Botulinum Toxin Injections in Preventing Postoperative Scars and Improving Scar Quality: A Systematic Review and Meta-Analysis—Is the Observed Effect due to Botulinum Neurotoxicity?

Objective:Botulinum Toxin (BTX) has become a widely used treatment in several dystonic conditions, but the evidence for its efficacy has largely come from open trials and expert opinion. This systematic review examined the efficacy and safety of BTX in the treatment of Focal Hand Dystonia (FHD) in Randomized Controlled Trials (RCTs).Methods:We searched Ovid MEDLINE, EMBASE, Cochrane Database of Systematic Reviews (CDSR), Database of Abstracts of Reviews of Effects (DARE), Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, SPORT Discus, SCOPUS, Web of Science, PEDro, ClinicalTrials.gov, and the International Clinical Trials Registry Platform (ICTRP) for randomized, placebo-controlled trials on the use of BTX for FHD.Results:Of 1,116 publications retrieved from the databases searched, three publications were included. The evidence identified pertains to focal task-specific hand dystonias. Sixty-nine participants were involved in the three RCTs with a mean duration of symptoms of 7.5 years. Participants were assessed using a combination of self-reported and functional performance outcome measures following injections of BTX subtype A (BTX-A) or placebo. The Oxford Quality Scale was used to assess the included studies, and the three studies each scored 3/5 or above. The included studies reported no adverse events with BTX-A use, other than muscle weakness and pain at the injection sites.Conclusion:The number of participants included in these three trials is too small to draw dependable conclusions about the efficacy and safety of BTX-A for FHD. There is currently not enough evidence to recommend the routine use of BTX-A for FHD.

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The efficacy and safety of Botulinum Toxin Type A in painful knee osteoarthritis: a systematic review and meta-analysis

Journal of International Medical Research ◽

10.1177/0300060519895868 ◽

2019 ◽

Vol 48 (4) ◽

pp. 030006051989586 ◽

Cited By ~ 1

Author(s):

Shuchao Zhai ◽

Botao Huang ◽

Kai Yu

Keyword(s):

Systematic Review ◽

Botulinum Toxin ◽

Knee Osteoarthritis ◽

Meta Analysis ◽

Botulinum Toxin Type A ◽

Type A ◽

Botulinum Toxin Type ◽

Efficacy And Safety ◽

Randomized Controlled ◽

Painful Knee

Objective A systematic review and meta-analysis was carried out to evaluate the efficacy and safety of Botulinum Toxin Type A in painful knee osteoarthritis. Methods The EMBASE and MEDLINE databases were searched to identify randomized controlled trials (RCTs) of Botulinum Toxin Type A in the treatment of painful knee osteoarthritis. The references of included literature were also searched. Results Five articles involving 5 RCTs including 314 patients were included in this analysis. There was a significant difference between Botulinum Toxin Type A and placebo in the visual analog scale (VAS) pain scale and Western Ontario & McMaster Universities Osteoarthritis Index (WOMAC) questionnaire score in both the short-term (≤4 weeks) and long-term (≥8 weeks) treatment period. There were no serious adverse events in the Botulinum Toxin Type A groups. Conclusions This meta-analysis suggests that Botulinum Toxin Type A is effective and safe in the painful knee OA treatment. However, high-quality randomized controlled studies are still needed to further confirm our findings.

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Efficacy and safety of botulinum toxin type A for postoperative scar prevention and wound healing improvement: A systematic review and meta‐analysis

Journal of Cosmetic Dermatology ◽

10.1111/jocd.14617 ◽

2021 ◽

Author(s):

Ziyao Fu ◽

Hanzi Huang ◽

Jiuzuo Huang

Keyword(s):

Systematic Review ◽

Wound Healing ◽

Botulinum Toxin ◽

Meta Analysis ◽

Botulinum Toxin Type A ◽

Type A ◽

Botulinum Toxin Type ◽

Efficacy And Safety ◽

Postoperative Scar ◽

Scar Prevention

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Botulinum toxin injections after surgery for Hirschsprung disease: Systematic review and meta-analysis

World Journal of Gastroenterology ◽

10.3748/wjg.v25.i25.3268 ◽

2019 ◽

Vol 25 (25) ◽

pp. 3268-3280 ◽

Cited By ~ 3

Author(s):

Daniëlle Roorda ◽

Zarah AM Abeln ◽

Jaap Oosterlaan ◽

Lodewijk WE van Heurn ◽

Joep PM Derikx

Keyword(s):

Systematic Review ◽

Botulinum Toxin ◽

Meta Analysis ◽

Hirschsprung Disease ◽

Botulinum Toxin Injections

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Efficacy and Safety of Botulinum Toxin vs. Placebo in Depression: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Frontiers in Psychiatry ◽

10.3389/fpsyt.2020.603087 ◽

2020 ◽

Vol 11 ◽

Author(s):

Huan Qian ◽

Fangjie Shao ◽

Cameron Lenahan ◽

Anwen Shao ◽

Yingjun Li

Keyword(s):

Systematic Review ◽

Depressive Symptoms ◽

Botulinum Toxin ◽

Randomized Controlled Trials ◽

Clinical Diagnosis ◽

Effect Size ◽

Meta Analysis ◽

Controlled Trials ◽

Efficacy And Safety ◽

Randomized Controlled

Background: Major depressive disorder (MDD) is a serious mental disorder that represents a substantial public health problem. Several trials have been undertaken to investigate the role of botulinum toxin type A (BTX-A) in the treatment of MDD, but the conclusions were controversial. To examine the efficacy and safety of BTX-A vs. placebo on patients with a clinical diagnosis of MDD, we conducted this systematic review and meta-analysis.Methods: A systematic search was conducted for all relevant randomized controlled trials (RCTs) in PubMed and Web of Science from inception to June 17, 2020. All published studies that investigated the efficacy and safety of BTX-A injections on patients with a clinical diagnosis of MDD were included. The overall effect size was summarized using a random-effects meta-analysis model. The primary outcomes of the present meta-analysis were the changes in depressive rating scale at week 6 after BTX-A injection compared with placebo. The safety of BTX-A injections also was assessed.Results: Five RCTs with a total of 417 participants (189 patients in the BTX-A group, 228 patients in placebo group) were eligible in this meta-analysis. The results indicated an overall positive effect of BTX-A injections for reducing the depressive symptoms of patients with MDD (Hedges' g, −0.82; 95% CI, −1.38 to −0.27) with large effect size. Differences are likely explained by the dose of BTX-As and the gender of the participants. Our findings also highlighted that BTX-A injections were generally well-tolerated, with only mild and temporary adverse events reported.Conclusions: The present meta-analysis provides evidence that BTX-A injections are associated with a statistically significant improvement in depressive symptoms. BTX-A injections are generally safe and may provide a new, alternative option for the treatment of depression.

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Use of Botulinum Toxin for Androgenic Alopecia: A Systematic Review

Skin Appendage Disorders ◽

10.1159/000518574 ◽

2021 ◽

pp. 1-8

Author(s):

Robert S. English Jr. ◽

Sophia Ruiz

Keyword(s):

Systematic Review ◽

Botulinum Toxin ◽

Hair Loss ◽

Response Rates ◽

Efficacy And Safety ◽

Control Groups ◽

Androgenic Alopecia ◽

Serious Adverse Events ◽

Prospective Cohorts ◽

Botulinum Toxin Injections

In this systematic review, we summarize the efficacy and safety of intradermal and intramuscular botulinum toxin injections for androgenic alopecia (AGA). Using PubMed, we conducted a literature search up to February 2021 using the following keyword combinations: “botulinum toxin” or “botox” and “androgenetic alopecia,” “hair loss,” or “alopecia.” Five clinical studies met our inclusion criteria: 4 prospective cohorts and 1 randomized clinical trial (RCT). Study durations ranged from 24 to 60 weeks. No studies included control groups or compared botulinum toxin injections against approved treatments. A total of 165 participants were identified – all of whom were males with AGA. Of the 4 studies measuring response rates (i.e., subjects with >0% hair changes), response rates ranged from 75 to 79.1%. Within studies measuring hair count changes from intramuscular injections, changes ranged from 18 to 20.9%. No serious adverse events were reported. Studies on botulinum toxin injections have produced favorable outcomes for AGA subjects. However, results should be interpreted with caution due to the absence of control groups, small numbers of participants, and relatively low Jadad quality scores. Large RCTs are recommended to confirm efficacy and safety, explore the effects of botulinum toxin on females with pattern hair loss, and establish best practices for intradermal and intramuscular injection methodologies.

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