Efficacy and safety of botulinum toxin for treating sialorrhea: A systematic review and meta‐analysis

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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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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Efficacy and Safety of Botulinum Toxin Type A in Preventing Postoperative Scars and Improving the Cosmetic Appearance of Scars: A Systematic Review and Meta-Analysis

Journal of Cutaneous Medicine and Surgery ◽

10.1177/1203475420937963 ◽

2020 ◽

Vol 24 (6) ◽

pp. 608-618

Author(s):

Wei Zhang ◽

Xinyi Li ◽

Xiaojing Li

Keyword(s):

Systematic Review ◽

Botulinum Toxin ◽

Adverse Events ◽

Meta Analysis ◽

Botulinum Toxin Type A ◽

Botulinum Toxin Type ◽

Hypertrophic Scars ◽

Efficacy And Safety ◽

Cosmetic Appearance ◽

Scar Width

Background Scars with poor cosmesis that develop after wound healing may affect normal life. Objective To assess the efficacy and safety of botulinum toxin type A (BTXA) in preventing postoperative hypertrophic scars or keloids. Methods A systematic review was performed by searching the PubMed, Cochrane Library, and EMBASE databases from their inception date up to February 2020 for randomized controlled trials (RCTs) evaluating the efficacy of BTXA in preventing hypertrophic scars or keloids. The primary outcome measures included the Vancouver Scar Scale (VSS) score, Visual Analog Scale (VAS) score, scar width, patient satisfaction, and adverse events. Results Twelve RCTs involving 497 cases (372 patients) were included. The meta-analysis showed significant differences in the VAS score (weighted mean difference [WMD] = 1.31, 95% CI = 1.06 to 1.55, P < .00001), VSS score (WMD = −1.02, 95% CI = −1.72 to −0.32, P = .004), scar width (WMD = −0.18, 95% CI = −0.29 to −0.08, P = .0008), and patient satisfaction (relative risk = 1.25, 95% CI = 1.06-1.49, P = .01). Four studies reported trivial adverse events. Conclusions This meta-analysis showed that BTXA was more effective than the control treatment in preventing postoperative scars and improving the cosmetic appearance of facial scars for East Asians, and no serious adverse events were found during the follow-up period. However, there was insufficient evidence to support the use of BTXA for the prevention of scars in patients from other ethnic groups and regions or scars in non-facial areas.

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