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Dr. Joseph Delano Fule Robles, 5 days ago

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Botulinum toxin-A a potential treatment for painful joint disease

17 Aug 2017

Intra-articular injections of botulinum toxin-A (BT) deliver substantial short-term benefits in terms of pain reduction in patients with refractory joint pain, according to a meta-analysis.

Researchers searched multiple electronic databases, as well as grey literature, for studies evaluating the effect of BT intra-articular injections in the treatment of painful osteoarticular disease.

A total of six studies involving 382 patients were included in the meta-analysis, which was performed by comparing the numeric rating scale (NRS; from 0 to 10) at baseline and at 1 or 2 months and 6 months after treatment between the BT and control groups. A separate comparison was made between low- and high-dose BT at a follow-up of 1 or 2 months.

Of the five trials comparing NRS at 1 or 2 months regardless of the dose of BT, four reported that BT had a positive effect on the NRS compared with the control treatment, whereas the remaining study found no effect. The overall weighted mean difference was -1.10 (95 percent CI, -1.62 to -0.58; p<0.0001; I2=63 percent).

Of the four trials evaluating the effect of low-dose BT (100 units) on the NRS at 1 or 2 months, three showed positive results when compared with the control treatment; the fourth study failed to find any effect. The overall weighted mean difference was -0.95 (-0.02 to -1.88; p=0.05; I2=67 percent).

Data from the two trials evaluating the effect of high-dose BT (200 units) indicated that the agent had an almost zero effect on the NRS at 1 or 2 months, with an overall weighted mean difference of 0.13 (-0.55 to 0.81; p=0.71; I2=0 percent).

Data from the three trials evaluating NRS at 6 months reported an overall weighted mean difference of -0.57 (-1.98 to 0.83; p=0.42; I2=73 percent).

Researchers attributed the efficacy of BT-A in reducing pain in painful joint diseases to the ability of BT-A to block the release of neuropeptides, such as substance P and calcitonin gene-related peptide, which are key mediators of neurogenic inflammation and pain. This particular effect of the agent has been demonstrated in previous studies. [Pain 2013;154:2547–53; Chin J Plast Surg 2009;25:50–3; BJU Int 2008;101:366–70; J Urol 2006;175:1138–42]

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Most Read Articles
Dr. Joseph Delano Fule Robles, 5 days ago

A recent study conducted by The University of Hong Kong (HKU) revealed that long-term use of proton pump inhibitors (PPIs) is associated with a significantly increased risk of gastric cancer even in patients who have had Helicobacter pylori eradicated. 

01 Aug 2017
New drug applications approved by US FDA as of 1 - 15 June 2017 which includes New Molecular Entities (NMEs) and new biologics. It does not include Tentative Approvals. Supplemental approvals may have occurred since the original approval date.
27 May 2016
TRIPLIXAM – Perindopril arginine, Indapamide, Amlodipine FC tab – Servier
01 Jul 2016
Get access to disease management charts, dosage guidelines and much more.