Botulinum Toxin A (BTA) for pain and function improvement in osteoarthritis: a systematic review and meta-analysis of clinical efficacy evidence from randomized controlled trials

IF 2.4 4区医学 Q2 PHARMACOLOGY & PHARMACY

Toxicon Pub Date : 2025-09-16 DOI:10.1016/j.toxicon.2025.108582

Beibei Lei , Weisheng Zhuang , Yage Wang , Shenhong Ma , Heling Wang , Di Zhang , Qiaohua Han , Xu Wang , Qixin Ding , Yuefang Li

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引用次数: 0

Abstract

Objective

To evaluate the effectiveness of botulinum toxin A injections in improving pain and function in patients with osteoarthritis.

Design

This study systematically searched the PubMed, Web of Science, Embase, Medline, Cochrane Library, CNKI, and Wanfang databases. The primary outcome was the Visual Analogue Scale (VAS), while secondary outcomes included the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and the occurrence of adverse events.

Results

A total of eight randomized controlled trials (RCTs) were included. Seven studies compared VAS scores between the experimental and control groups, while three studies compared WOMAC scores. Both VAS and WOMAC scores were significantly lower in the experimental group than in the control group (P < 0.00001). In addition, different sites of OA (P = 0.99), different doses of botulinum toxin A injection (P = 0.52), and different times of outcome assessment (P = 0.58) had similar effects in reducing VAS scores.

Conclusions

BTA injections effectively relieve overall pain perception and resting pain, but their efficacy for pain associated with specific functional activities remains uncertain. The effects of low- and high-dose regimens on reducing VAS scores are comparable, supporting the preferential use of the low-dose regimen; however, the efficacy of BTA in improving joint function remains highly uncertain.

查看原文本刊更多论文

肉毒毒素A （BTA）用于骨关节炎疼痛和功能改善：随机对照试验临床疗效证据的系统回顾和荟萃分析。

目的：评价A型肉毒毒素注射对骨关节炎患者疼痛和功能的改善效果。设计：本研究系统检索PubMed、Web of Science、Embase、Medline、Cochrane Library、CNKI、万方等数据库。主要结果是视觉模拟量表（VAS），次要结果包括西安大略省和麦克马斯特大学关节炎指数（WOMAC）和不良事件的发生。结果：共纳入8项随机对照试验（RCTs）。7项研究比较了实验组和对照组的VAS评分，3项研究比较了WOMAC评分。试验组VAS评分、WOMAC评分均显著低于对照组（P < 0.00001）。此外，不同部位OA （P = 0.99）、不同剂量A型肉毒毒素注射（P = 0.52）、不同结局评估时间（P = 0.58）对VAS评分的降低效果相似。结论：BTA注射可有效缓解整体疼痛感觉和静息疼痛，但其对特定功能活动相关疼痛的疗效尚不确定。低剂量方案和高剂量方案对降低VAS评分的影响具有可比性，支持优先使用低剂量方案；然而，BTA在改善关节功能方面的功效仍然高度不确定。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Toxicon 医学-毒理学

CiteScore

4.80

自引率

10.70%

发文量

358

审稿时长

68 days

期刊介绍： Toxicon has an open access mirror Toxicon: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. An introductory offer Toxicon: X - full waiver of the Open Access fee. Toxicon''s "aims and scope" are to publish: -articles containing the results of original research on problems related to toxins derived from animals, plants and microorganisms -papers on novel findings related to the chemical, pharmacological, toxicological, and immunological properties of natural toxins -molecular biological studies of toxins and other genes from poisonous and venomous organisms that advance understanding of the role or function of toxins -clinical observations on poisoning and envenoming where a new therapeutic principle has been proposed or a decidedly superior clinical result has been obtained. -material on the use of toxins as tools in studying biological processes and material on subjects related to venom and antivenom problems. -articles on the translational application of toxins, for example as drugs and insecticides -epidemiological studies on envenoming or poisoning, so long as they highlight a previously unrecognised medical problem or provide insight into the prevention or medical treatment of envenoming or poisoning. Retrospective surveys of hospital records, especially those lacking species identification, will not be considered for publication. Properly designed prospective community-based surveys are strongly encouraged. -articles describing well-known activities of venoms, such as antibacterial, anticancer, and analgesic activities of arachnid venoms, without any attempt to define the mechanism of action or purify the active component, will not be considered for publication in Toxicon. -review articles on problems related to toxinology. To encourage the exchange of ideas, sections of the journal may be devoted to Short Communications, Letters to the Editor and activities of the affiliated societies.