Evaluating the efficacy of botulinum toxin in treating complex regional pain syndrome: A systematic review.

Autor: Almeida BO; Federal University of Bahia, Salvador, Bahia State, Brazil., Barreto ESR; Federal University of Bahia, Salvador, Bahia State, Brazil. Electronic address: eduardosrb@ufba.br., Antunes Júnior CR; Federal University of Bahia, Salvador, Bahia State, Brazil., Alencar VB; Federal University of Bahia, Salvador, Bahia State, Brazil., Souza AKDN; Federal University of Bahia, Salvador, Bahia State, Brazil., Azi LMTA; Federal University of Bahia, Salvador, Bahia State, Brazil., Lins-Kusterer LEF; Federal University of Bahia, Salvador, Bahia State, Brazil., Kraychete DC; Federal University of Bahia, Salvador, Bahia State, Brazil.
Jazyk: angličtina
Zdroj: Toxicon : official journal of the International Society on Toxinology [Toxicon] 2024 Nov 06; Vol. 250, pp. 108100. Date of Electronic Publication: 2024 Sep 17.
DOI: 10.1016/j.toxicon.2024.108100
Abstrakt: Complex Regional Pain Syndrome (CRPS) is characterized by pain, swelling, limited range of motion, skin changes, vasomotor instability, and bone demineralization. This study aims to assess the efficacy of botulinum toxin type A (BoNT-A) in the treatment of CRPS. We conducted a systematic literature review following the PRISMA guidelines, using the PICO strategy (Patient, Intervention, Comparison and Outcome) with the following criteria: P = Patients with CRPS; I = Botulinum toxin; C = Placebo or active drug; and O = Pain relief. Three randomized controlled trials with placebo controls were included, involving a total of 64 patients, 36 of whom received BoNT-A in doses ranging from 40U to 200U. The studies examined both lumbar sympathetic block and local application methods. Botulinum toxin shows promise in alleviating pain associated with CRPS, particularly when used as an adjunct to lumbar sympathetic blockade. However, the limited number of studies and small sample sizes impede reaching definitive conclusions regarding its efficacy and safety. Notably, local applications (intradermal or subcutaneous) require further investigation, as current evidence is insufficient and reports indicate patient discomfort. While preliminary findings suggest potential benefits of BoNT-A in managing CRPS, larger randomized trials are necessary to confirm its efficacy and safety.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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