{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T02:58:25Z","timestamp":1793761105814,"version":"4.6.1"},"reference-count":20,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T00:00:00Z","timestamp":1757462400000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Neuropathic pain (NP) is frequently resistant to conventional treatments. Botulinum toxin type A (BT\u2010A) is a recommended option for focal peripheral NP, but the dynamics of its effect in real\u2010life conditions remain poorly characterized.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess BT\u2010A efficacy in a real\u2010world study of patients with focal peripheral NP, over a 1\u2010year follow\u2010up period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this prospective, observational study, adult patients with chronic focal peripheral NP refractory to standard therapies were treated with BT\u2010A in two French pain centers. Injections were individualized and administered at approximately 3\u2010month intervals. The primary outcome was the patient\u2010reported percentage of improvement since the first injection, assessed at each follow\u2010up visit (Cycles 2\u20135). Secondary outcomes included the Patient Global Impression of Change (PGIC), average pain intensity over the previous 8\u2009days, and exploratory analysis of response trajectories distinguishing early (\u2265\u200930% improvement at Cycle 3) from late responders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighty\u2010two patients received \u2265\u20092 BT\u2010A cycles. Mean self\u2010reported improvement increased from 30.7% at Cycle 2 to 51.0% at Cycle 5 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). PGIC and pain intensity also showed significant improvements. Among 59 patients evaluable at Cycle 3, 66% were early responders; late responders showed significant benefit after the third injection. BT\u2010A was well tolerated: 63.6% reported end\u2010of\u2010dose effects, and 25.8% experienced only mild, transient adverse events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This real\u2010life study over 1\u2009year suggests that BT\u2010A provides progressive and sustained benefit in focal peripheral NP, supporting continued treatment beyond two cycles.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.70362","type":"journal-article","created":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T04:44:33Z","timestamp":1757565873000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Real\u2010World Evaluation of Botulinum Toxin A in Focal Peripheral Neuropathic Pain: Longitudinal Outcomes"],"prefix":"10.1111","volume":"32","author":[{"given":"Eva","family":"Sole\u2010Cruz","sequence":"first","affiliation":[{"name":"Pain Treatment and Evaluation Center, CHU Timone, Assistance Publique des 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