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

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 Coc...

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Autores principales: Datta Gupta, Anupam, Edwards, Suzanne, Smith, Jessica, Snow, John, Visvanathan, Renuka, Tucker, Graeme, Wilson, David
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8780616/
https://www.ncbi.nlm.nih.gov/pubmed/35051013
http://dx.doi.org/10.3390/toxins14010036
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author Datta Gupta, Anupam
Edwards, Suzanne
Smith, Jessica
Snow, John
Visvanathan, Renuka
Tucker, Graeme
Wilson, David
author_facet Datta Gupta, Anupam
Edwards, Suzanne
Smith, Jessica
Snow, John
Visvanathan, Renuka
Tucker, Graeme
Wilson, David
author_sort Datta Gupta, Anupam
collection PubMed
description 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.
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spelling pubmed-87806162022-01-22 A Systematic Review and Meta-Analysis of Efficacy of Botulinum Toxin A for Neuropathic Pain Datta Gupta, Anupam Edwards, Suzanne Smith, Jessica Snow, John Visvanathan, Renuka Tucker, Graeme Wilson, David Toxins (Basel) Review 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. MDPI 2022-01-03 /pmc/articles/PMC8780616/ /pubmed/35051013 http://dx.doi.org/10.3390/toxins14010036 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Datta Gupta, Anupam
Edwards, Suzanne
Smith, Jessica
Snow, John
Visvanathan, Renuka
Tucker, Graeme
Wilson, David
A Systematic Review and Meta-Analysis of Efficacy of Botulinum Toxin A for Neuropathic Pain
title A Systematic Review and Meta-Analysis of Efficacy of Botulinum Toxin A for Neuropathic Pain
title_full A Systematic Review and Meta-Analysis of Efficacy of Botulinum Toxin A for Neuropathic Pain
title_fullStr A Systematic Review and Meta-Analysis of Efficacy of Botulinum Toxin A for Neuropathic Pain
title_full_unstemmed A Systematic Review and Meta-Analysis of Efficacy of Botulinum Toxin A for Neuropathic Pain
title_short A Systematic Review and Meta-Analysis of Efficacy of Botulinum Toxin A for Neuropathic Pain
title_sort systematic review and meta-analysis of efficacy of botulinum toxin a for neuropathic pain
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8780616/
https://www.ncbi.nlm.nih.gov/pubmed/35051013
http://dx.doi.org/10.3390/toxins14010036
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