The Effect of Intradermal Botulinum Toxin a injections on painful diabetic polyneuropathy

Taheri, Mohammad; Sedaghat, Meghdad; Solhpour, Ali; Rostami, Pooya; Lima, Behnam Safarpour

doi:10.1016/j.dsx.2020.09.019

Cited by 19 publications

(47 citation statements)

References 25 publications

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“… 19 Only one study used proper allocation concealment to ensure that the trial investigators and participants were masked to treatment allocation. 22 The funnel plot and Egger’s test ( p = 0.277) suggested that the studies had no significant publication bias ( Figure 3 ). The overall risk of bias across all included studies was low.…”

Section: Resultsmentioning

confidence: 97%

“… 19–21 One study used a 5×4 grid in the sole of the foot. 22 All included studies used BTX-A for the injections. The dosage range of BTX-A was between 50 and 150 units in each foot.…”

Section: Resultsmentioning

confidence: 99%

“… A grid distribution pattern of 12 (3 × 4) points on the foot surface. VAS, NPS, PSQI, and SF-36 1, 4, 8, and 12 weeks after injection Taheri et al (2020) 22 Iran 55.2 ± 7.4, 55/86 (141) Double-blind multi-arm RCT BTX-A vs placebo Intradermal D1: 150 units of BTX-A in 2 mL 0.9% saline into the right foot. D2: 150 units of BTX-A in 4 mL 0.9% saline into both feet.…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Botulinum Toxin Type A for Diabetic Peripheral Neuropathy Pain: A Systematic Review and Meta-Analysis

Wang¹,

Zhang²,

Wang³

et al. 2021

JPR

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Purpose Botulinum toxin type A (BTX-A) has been proposed as a treatment for painful diabetic peripheral neuropathy (DPN). This systematic review and meta-analysis aimed to assess the effect and safety of BTX-A for treating DPN pain. Methods PubMed, Embase, and Cochrane Library were searched for relevant articles published up to July 7, 2021. Randomized clinical trials (RCTs) were included if they were related to the treatment of DPN pain with BTX-A. The primary outcome was the change in intensity of pain and secondary outcomes were adverse effects and changes in sleep and life quality. Results A total of four studies, comprising 231 patients, were included in our systematic review. BTX-A treatment induced a greater reduction in the visual analog scale score (mean difference = −2.52, 95% confidence interval [CI] [−3.06, −1.99], p < 0.001) than did the placebo treatment, with no significant heterogeneity between studies (I 2 = 0). BTX-A treatment improved several neuropathy pain scale items (eg, hot sensation, sensitive sensation, unpleasant sensation, deep pain, and surface pain) significantly more than with placebo treatment ( p < 0.05 for all). There was no significant difference in adverse effect (relative risk = 1.00, 95% CI [0.97, 1.03], p = 0.89). Conclusion Intradermal BTX-A injection was shown to be effective and safe in relieving DPN pain. Further larger scale and well-designed RCTs are needed.

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Section: Resultsmentioning

confidence: 97%

“… 19–21 One study used a 5×4 grid in the sole of the foot. 22 All included studies used BTX-A for the injections. The dosage range of BTX-A was between 50 and 150 units in each foot.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Botulinum Toxin Type A for Diabetic Peripheral Neuropathy Pain: A Systematic Review and Meta-Analysis

Wang¹,

Zhang²,

Wang³

et al. 2021

JPR

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“…Another prospective trial looked at the efficacy of BTX-A for diabetic polyneuropathy, which randomized 141 patients aged 40 to 70 years into three groups: the first group was injected with 150U BTX-A on one side of the foot and 0.9% saline on the other side; the second group was injected with 150U BTX-A in both feet; the third group was injected with 0.9% physiological saline, using VAS and NPS for comparison. The results showed a significant improvement in VAS and NPS (except dull and cold sensation) scores in the BTX-A group compared with the saline group, indicating that intradermal injection of BTX-A was effective in treating good diabetic polyneuropathy (Taheri et al, 2020). All of the above results demonstrate that BTX-A effectively improves neuropathic pain in diabetic patients, although different results were shown on NPS, which may be related to sample size and BTX-A dose.…”

Section: Diabe C Neuropathy Painmentioning

confidence: 84%

“…There was a significant improvement in VAS in the BTX-A group versus the placebo group, while VAS scores did not differ significantly between the BTX-A groups (Taheri et al, 2020) revealed that after single and continuous injections of BTX-A, the severity of pain in patients was significantly reduced, the efficiency of pain relief was 100% in both cases, and there was no significant difference in the mean duration of pain relief. No significant adverse effects were seen in either case, suggesting that repeated injections of BTX-A are safe and effective (Gorimanipalli et al, 2019).…”

Section: Trigeminal Neuralgiamentioning

confidence: 84%

Advances in botulinum toxin type A for the treatment of pain

Jiang¹,

Huang²,

Yang³

et al. 2021

NRFHH

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<i>Clostridium botulinum</i> (CB) is a Gram-positive anaerobic bacterium and a significant cause of food spoilage. Foodborne botulism occurs worldwide every year and even lead to death from respiratory distress in severe cases after eating botulism-contaminated food. The pathogenicity of CB lies in its ability to produce a potent neurotoxin, “botulinum toxin (BTX)”, for which eight different subtypes have already been isolated so far. Botulinum toxin type A (BTX-A) is widely used to treat critical clinical issues due to its good affinity and tolerability. Studies have shown that BTX-A injections effectively treat myofascial pain, inflammatory pain, and neuropathic pain. The current article mainly reviews the latest research progress using BTX-A in pain treatment during two years.

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Efficacy and safety of botulinum A toxin for the treatment of chronic peripheral neuropathic pain: A systematic review of randomized controlled trials and meta‐analysis

Hary

Schitter

Martinez

2022

European Journal of Pain

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Background and Objective: Botulinum toxin type A (BTX-A) is a recently developed treatment for the management of peripheral neuropathic pain. The objective of this study was to provide a synthesis of the evidence concerning the efficacy and safety of subcutaneous botulinum toxin type A injections. Databases and Data Treatment:We searched the MEDLINE, EMBASE, LILACS, Cochrane, and Clinical Trial Register databases for randomized controlled trials comparing subcutaneous BTX-A to placebo injections for treating chronic peripheral neuropathic pain. The primary endpoint was the assessment of pain 1 month after the injection. The secondary outcomes were the assessment of pain at 3 months, neuropathic pain intensity and quality of life at 1 and 3 months, and adverse effects. A random-effect meta-analysis was performed on the combined data. Evidence quality was rated by the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) method.Results: Ten randomized controlled trials including 505 patients were included in this review (registration number CRD42021239108). At 1 and 3 months after injection, the BTX-A groups had a lower mean difference (MD) in pain score (MD −1.87 (confidence intervals [CIs] −2.91; −0.83) and −1.38 (CI −1.95; −0.81), respectively). Subgroup analysis showed greater efficacy for diabetic polyneuropathy (MD −2.48, [−3.22; −1.74]). We found no impact of BTX-A on quality of life and no difference in adverse effect between BTX-A and placebo. The evidence was considered of moderate quality. Conclusion:The pooled data suggest that subcutaneous BTX-A injections have a clinically significant effect, decreasing pain for three months after the injection, but no benefit in terms of quality of life has yet been demonstrated. Significance:We found that botulinum toxin is efficient and safe for the treatment of neuropathic pain, especially for diabetic polyneuropathy. Botulinum toxin type A, used for years in neurology, rehabilitation and physical medicine, has proved innocuous and effective, and should be considered as a serious alternative for pain treatment.

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The Effect of Intradermal Botulinum Toxin a injections on painful diabetic polyneuropathy

Cited by 19 publications

References 25 publications

Botulinum Toxin Type A for Diabetic Peripheral Neuropathy Pain: A Systematic Review and Meta-Analysis

Botulinum Toxin Type A for Diabetic Peripheral Neuropathy Pain: A Systematic Review and Meta-Analysis

Advances in botulinum toxin type A for the treatment of pain

Efficacy and safety of botulinum A toxin for the treatment of chronic peripheral neuropathic pain: A systematic review of randomized controlled trials and meta‐analysis

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The Effect of Intradermal Botulinum Toxin a injections on painful diabetic polyneuropathy

Cited by 19 publications

References 25 publications

Botulinum Toxin Type A for Diabetic Peripheral Neuropathy Pain: A Systematic Review and Meta-Analysis

Botulinum Toxin Type A for Diabetic Peripheral Neuropathy Pain: A Systematic Review and Meta-Analysis

Advances in botulinum toxin type A for the treatment of pain

Efficacy and safety of botulinum A toxin for the treatment of chronic peripheral neuropathic pain: A systematic review of randomized controlled trials and meta‐analysis

Contact Info

Product

Resources

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Efficacy and safety of botulinum A toxin for the treatment of chronic peripheral neuropathic pain: A systematic review of randomized controlled trials and meta‐analysis