scholarly journals A Systematic Review and Meta-Analysis of Efficacy of Botulinum Toxin A for Neuropathic Pain

Toxins ◽  
2022 ◽  
Vol 14 (1) ◽  
pp. 36
Author(s):  
Anupam Datta Gupta ◽  
Suzanne Edwards ◽  
Jessica Smith ◽  
John Snow ◽  
Renuka Visvanathan ◽  
...  

We performed a systematic review and meta-analysis of randomised controlled trials (RCTs) conducted from January 2005 to June 2021 to update the evidence of Botulinum toxin A (BoNT-A) in neuropathic pain (NP) in addition to quality of life (QOL), mental health, and sleep outcomes. We conducted a Cochrane Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria analysis of RCTs from the following data sources: EMBASE, CINAHL, WHO International Clinical Trial Registry Platform, ClinicalTrials.gov, Cochrane database, Cochrane Clinical Trial Register, Australia New Zealand Clinical Trials Registry, and EU Clinical Trials Register. Meta-analysis of 17 studies showed a mean final VAS reduction in pain in the intervention group of 2.59 units (95% confidence interval: 1.79, 3.38) greater than the mean for the placebo group. The overall mean difference for sleep, Hospital Anxiety and Depression Scale (HADS) anxiety, HADS depression, and QOL mental and physical sub-scales were, respectively, 1.10 (95% CI: −1.71, 3.90), 1.41 (95% CI: −0.61, 3.43), −0.16 (95% CI: −1.95, 1.63), 0.85 (95% CI: −1.85, 3.56), and −0.71 (95% CI: −3.39, 1.97), indicating no significance. BoNT-A is effective for NP; however, small-scale RCTs to date have been limited in evidence. The reasons for this are discussed, and methods for future RCTs are developed to establish BoNT-A as the first-line agent.

Surgery ◽  
2021 ◽  
Author(s):  
Mathilde Maria Johanna van Rooijen ◽  
Yagmur Yurtkap ◽  
Mathias Allaeys ◽  
Nabeel Ibrahim ◽  
Frederik Berrevoet ◽  
...  

2018 ◽  
Vol Volume 11 ◽  
pp. 2343-2351 ◽  
Author(s):  
Fan Meng ◽  
Ke Peng ◽  
Jian-Ping Yang ◽  
Fu-Hai Ji ◽  
Fan Xia ◽  
...  

Toxins ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 640
Author(s):  
Simone Battista ◽  
Luca Buzzatti ◽  
Marialuisa Gandolfi ◽  
Cinzia Finocchi ◽  
Luca Falsiroli Maistrello ◽  
...  

Several studies have investigated the effect of botulinum toxin A (BoNT-A) for managing chronic musculoskeletal pain, bringing contrasting results to the forefront. Thus far, however, there has been no synthesis of evidence on the effect of BoNT-A as an adjunctive treatment within a multimodal approach. Hence, Medline via PubMed, EMBASE, and the Cochrane Library-CENTRAL were searched until November 2020 for randomised controlled trials (RCTs) that investigated the use of BoNT-A as an adjunctive therapy for chronic musculoskeletal pain. The risk of bias (RoB) and the overall quality of the studies were assessed through RoB 2.0 and the GRADE approach, respectively. Meta-analysis was conducted to analyse the pooled results of the six included RCTs. Four were at a low RoB, while two were at a high RoB. The meta-analysis showed that BoNT-A as an adjunctive therapy did not significantly decrease pain compared to the sole use of traditional treatment (SDM −0.89; 95% CI −1.91; 0.12; p = 0.08). Caution should be used when interpreting such results, since the studies displayed very high heterogeneity (I = 94%, p < 0.001). The overall certainty of the evidence was very low. The data retrieved from this systematic review do not support the use of BoNT-A as an adjunctive therapy in treating chronic musculoskeletal pain.


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