{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T17:02:31Z","timestamp":1791997351046,"version":"4.4.0"},"reference-count":41,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,3,23]],"date-time":"2022-03-23T00:00:00Z","timestamp":1647993600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Objective<\/jats:title><jats:p>Botulinum toxin type A (BTX\u2010A)\u00a0is a recently developed treatment for the management of peripheral neuropathic pain. The objective of this study was to\u202fprovide a synthesis of the\u202fevidence concerning the efficacy and safety of subcutaneous botulinum toxin type A injections.<\/jats:p><\/jats:sec><jats:sec><jats:title>Databases and Data Treatment<\/jats:title><jats:p>We searched the MEDLINE, EMBASE, LILACS, Cochrane, and Clinical Trial Register databases for randomized controlled trials comparing\u00a0subcutaneous\u00a0BTX\u2010A to placebo injections for treating chronic peripheral neuropathic pain. The primary endpoint was the assessment of pain 1\u00a0month after the injection. The secondary outcomes were the assessment of pain at 3\u00a0months, neuropathic pain intensity and\u00a0quality of life\u00a0at 1 and 3\u00a0months, and adverse effects. A random\u2010effect meta\u2010analysis was performed on the combined data. Evidence quality was rated by the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) method.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ten randomized controlled trials including 505 patients were included in this review (registration number CRD42021239108). At 1 and 3\u00a0months after injection,\u00a0the\u00a0BTX\u2010A groups had a lower mean difference (MD) in pain score (MD \u22121.87 (confidence intervals [CIs] \u22122.91; \u22120.83) and \u22121.38 (CI \u22121.95; \u22120.81), respectively).\u00a0Subgroup analysis showed greater efficacy for diabetic polyneuropathy (MD \u22122.48, [\u22123.22; \u22121.74]).\u00a0We found no impact of\u00a0BTX\u2010A on\u00a0quality of life and no difference in adverse effect between\u00a0BTX\u2010A and\u00a0placebo.\u00a0The evidence\u00a0was\u00a0considered\u00a0of moderate quality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The pooled data suggest that subcutaneous\u00a0BTX\u2010A injections have a\u00a0clinically\u00a0significant effect, decreasing pain for three\u00a0months after the injection, but no\u00a0benefit in terms of quality of life has yet been demonstrated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ejp.1941","type":"journal-article","created":{"date-parts":[[2022,3,16]],"date-time":"2022-03-16T08:09:56Z","timestamp":1647418196000},"page":"980-990","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Efficacy and safety\u202fof\u202fbotulinum\u00a0A toxin\u202ffor the treatment of chronic peripheral neuropathic\u202fpain: A systematic review of randomized controlled trials and meta\u2010analysis"],"prefix":"10.1002","volume":"26","author":[{"given":"Vincent","family":"Hary","sequence":"first","affiliation":[{"name":"Faculty of medecine Universit\u00e9 de Paris  Paris France"},{"name":"Pain Unit H\u00f4pital\u202fRaymond\u202fPoincar\u00e9 APHP  Garches France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastien","family":"Schitter","sequence":"additional","affiliation":[{"name":"Pain Unit H\u00f4pital\u202fRaymond\u202fPoincar\u00e9 APHP  Garches France"},{"name":"Faculty de medecine Universit\u00e9 Versailles Saint Quentin  Versailles France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Martinez","sequence":"additional","affiliation":[{"name":"Pain Unit H\u00f4pital\u202fRaymond\u202fPoincar\u00e9 APHP  Garches France"},{"name":"Faculty de medecine Universit\u00e9 Versailles Saint Quentin  Versailles France"},{"name":"INSERM U 987 CETD H\u00f4pital\u202fAmbroise\u202fPar\u00e9 APHP  Boulogne\u2010Billancourt France"},{"name":"Department of Anesthesiology H\u00f4pital\u202fRaymond\u202fPoincar\u00e9 APHP  Garches France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,3,23]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"The Cochrane Collaboration. (2020). Review Manager (RevMan) [Computer program]."},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0b013e31827a72d2"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(16)00017-X"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2011.09.014"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2010.07.015"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.13950"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2017.2"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2003.10.008"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0106907"},{"key":"e_1_2_7_11_1","first-page":"CD007393","article-title":"Topical capsaicin (high concentration) for chronic neuropathic pain in adults","volume":"1","author":"Derry S.","year":"2017","journal-title":"Cochrane Database Systematic Review"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1159\/000083259"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7109.629"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(14)70251-0"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000000492"},{"key":"e_1_2_7_16_1","first-page":"106","article-title":"The effects of intradermal botulinum toxin type A injections on pain symptoms of patients with diabetic neuropathy","volume":"19","author":"Ghasemi M.","year":"2014","journal-title":"Journal of Research in Medical Sciences"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-5-13"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/pme.12728"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.3111\/13696998.2012.729548"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1497.2002.11111.x"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.3390\/toxins11080459"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.2147\/JPR.S168650"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1242\/jcs.012211"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurol.2020.01.361"},{"key":"e_1_2_7_25_1","first-page":"27","article-title":"Efficacy and safety of 0.625% and 1.25% capsaicin patch in peripheral neuropathic pain: Multi\u2010center, randomized, and semi\u2010double blind controlled study","volume":"20","author":"Moon J.\u2010Y.","year":"2017","journal-title":"Pain Physician"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.21427"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpain.2003.09.004"},{"key":"e_1_2_7_29_1","first-page":"99","article-title":"The effects of botulinum toxin type A injection on pain symptoms, quality of life, and sleep quality of patients with diabetic neuropathy: A randomized double\u2010blind clinical trial","volume":"18","author":"Salehi H.","year":"2019","journal-title":"Iranian Journal of Neurology"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.3390\/toxins8030065"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oooo.2016.03.003"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1254\/jphs.11060FP"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2016.09.008"},{"key":"e_1_2_7_34_1","first-page":"168","article-title":"Botulinum toxin injection for facial wrinkles","volume":"90","author":"Small R.","year":"2014","journal-title":"American Family Physician"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1155\/2019\/8329306"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dsx.2020.09.019"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2013.11.013"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1002\/brb3.1409"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2020.00104"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4637.2010.01003.x"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1159\/000370245"},{"key":"e_1_2_7_42_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000345968.05959.cf"}],"container-title":["European Journal of Pain"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ejp.1941","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ejp.1941","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ejp.1941","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,25]],"date-time":"2023-08-25T14:04:36Z","timestamp":1692972276000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ejp.1941"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,23]]},"references-count":41,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2022,5]]}},"alternative-id":["10.1002\/ejp.1941"],"URL":"https:\/\/doi.org\/10.1002\/ejp.1941","archive":["Portico"],"relation":{},"ISSN":["1090-3801","1532-2149"],"issn-type":[{"value":"1090-3801","type":"print"},{"value":"1532-2149","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,23]]},"assertion":[{"value":"2022-03-23","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}