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The Use of Botulinum Toxin A as an Adjunctive Therapy in the Management of Chronic Musculoskeletal Pain : A Systematic Review with Meta-Analysis

Battista, Simone LU orcid ; Buzzatti, Luca ; Gandolfi, Marialuisa ; Finocchi, Cinzia ; Falsiroli Maistrello, Luca ; Viceconti, Antonello ; Giardulli, Benedetto and Testa, Marco (2021) In Toxins 13(9). p.1-17
Abstract

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... (More)

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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author
; ; ; ; ; ; and
publishing date
type
Contribution to journal
publication status
published
in
Toxins
volume
13
issue
9
article number
640
pages
1 - 17
publisher
MDPI AG
external identifiers
  • pmid:34564644
  • scopus:85115269802
ISSN
2072-6651
DOI
10.3390/toxins13090640
language
English
LU publication?
no
id
3f641855-15ff-4f14-8738-27f6a02c3972
date added to LUP
2021-11-15 12:50:10
date last changed
2024-04-20 16:32:30
@article{3f641855-15ff-4f14-8738-27f6a02c3972,
  abstract     = {{<p>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 &lt; 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.</p>}},
  author       = {{Battista, Simone and Buzzatti, Luca and Gandolfi, Marialuisa and Finocchi, Cinzia and Falsiroli Maistrello, Luca and Viceconti, Antonello and Giardulli, Benedetto and Testa, Marco}},
  issn         = {{2072-6651}},
  language     = {{eng}},
  number       = {{9}},
  pages        = {{1--17}},
  publisher    = {{MDPI AG}},
  series       = {{Toxins}},
  title        = {{The Use of Botulinum Toxin A as an Adjunctive Therapy in the Management of Chronic Musculoskeletal Pain : A Systematic Review with Meta-Analysis}},
  url          = {{http://dx.doi.org/10.3390/toxins13090640}},
  doi          = {{10.3390/toxins13090640}},
  volume       = {{13}},
  year         = {{2021}},
}