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Authors Meng F, Peng K, Yang JP, Ji FH, Xia F, Meng XW
Received 22 March 2018
Accepted for publication 24 July 2018
Published 12 October 2018 Volume 2018:11 Pages 2343—2351
DOI https://doi.org/10.2147/JPR.S168650
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Colin Mak
Peer reviewer comments 3
Editor who approved publication: Dr Katherine Hanlon
Aim: This meta-analysis was performed to evaluate the efficacy and
safety of botulinum toxin-A (BTX-A) for the treatment of neuralgia.
Methods: We searched PubMed, EMBASE, and Cochrane databases to identify randomized
controlled trials (RCTs) comparing BTX-A treatment with saline for alleviating
neuropathic pain. Primary outcome measures were pain scores up to 24 weeks
after treatment. Secondary outcomes were hours of sleep, Short Form-36 (SF-36)
life quality questionnaire, and adverse events. We used Review Manager 5.3 for
the data analyses.
Results: Twelve RCTs were included (n=495). Pain scores in the BTX-A group
were significantly lower compared to the saline group at 4 weeks (mean
difference [MD] =–1.64, 95% CI [–3.21, –0.07], P =0.04),
12 weeks (MD =–1.49, 95% CI [−2.05, –0.93], P <0.00001),
and 24 weeks (MD =–1.61, 95% CI [−2.81, –0.40], P =0.009). There were no
significant differences in hours of sleep, SF-36 questionnaire, or the
incidence of injection pain or hematoma between the two groups. No serious
adverse events associated with BTX-A were noted. Fourteen out of 108 patients
(12.9%) with trigeminal neuralgia experienced mild facial asymmetry after the
BTX-A treatment.
Conclusion: Based on the current evidence, BTX-A may be an effective and safe
option for the treatment of neuralgia. Due to the limited number of patients
included in this meta-analysis, more trials are still needed to confirm these
results.
Keywords: botulinum toxin, neuralgia, neuropathic pain, meta-analysis