{"title":"A型肉毒毒素治疗带状疱疹后神经痛的预后模型和不良因素的临床评价:一项随机对照试验。","authors":"Mingfu Zheng, Lanrui Zeng, Li Ma","doi":"10.1097/WNF.0000000000000654","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to evaluate the efficacy of Botulinum toxin type A (BTX-A) in patients with postherpetic neuralgia (PHN) and to identify key prognostic factors associated with treatment response.</p><p><strong>Methods: </strong>This prospective, randomized controlled trial enrolled patients with PHN from November 2023 to January 2024. Sixty patients were randomized into 2 groups: the BTX-A group (standard care plus BTX-A injections) and the control group (standard care alone). The primary outcome was the change in pain intensity, assessed using the Visual Analog Scale (VAS) before and after treatment. Secondary outcomes included changes in inflammatory factor levels, the use of analgesics, and the occurrence of adverse events.</p><p><strong>Results: </strong>Compared with the control group, the BTX-A group showed significantly lower VAS scores and decreased inflammatory markers (P<0.001). After 1 month, the frequency of analgesic use decreased in both groups (P<0.001), but there was no difference between the groups. Multivariate logistic regression results showed that BTX-A was the only significant factor associated with pain reduction in PHN patients (P<0.001). Cox regression prognostic model results identified Gabapentin frequency, IL-6, and C-reactive protein as significant predictors of BTX-A treatment response (P<0.05). ROC analysis further showed that IL-6 was a strong predictor of BTX-A treatment response (AUC=0.804, P=0.034). Adverse events were rare and similar between groups.</p><p><strong>Conclusions: </strong>BTX-A may offer benefit in relieving pain and reducing inflammation in PHN patients compared with standard treatment, and IL-6 may be a strong predictor of efficacy.</p>","PeriodicalId":10449,"journal":{"name":"Clinical Neuropharmacology","volume":" ","pages":""},"PeriodicalIF":1.5000,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Prognostic Modeling and Clinical Evaluation of Adverse Factors in Postherpetic Neuralgia Treated With Botulinum Toxin Type A: A Randomized Controlled Trial.\",\"authors\":\"Mingfu Zheng, Lanrui Zeng, Li Ma\",\"doi\":\"10.1097/WNF.0000000000000654\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>This study aims to evaluate the efficacy of Botulinum toxin type A (BTX-A) in patients with postherpetic neuralgia (PHN) and to identify key prognostic factors associated with treatment response.</p><p><strong>Methods: </strong>This prospective, randomized controlled trial enrolled patients with PHN from November 2023 to January 2024. Sixty patients were randomized into 2 groups: the BTX-A group (standard care plus BTX-A injections) and the control group (standard care alone). The primary outcome was the change in pain intensity, assessed using the Visual Analog Scale (VAS) before and after treatment. Secondary outcomes included changes in inflammatory factor levels, the use of analgesics, and the occurrence of adverse events.</p><p><strong>Results: </strong>Compared with the control group, the BTX-A group showed significantly lower VAS scores and decreased inflammatory markers (P<0.001). After 1 month, the frequency of analgesic use decreased in both groups (P<0.001), but there was no difference between the groups. Multivariate logistic regression results showed that BTX-A was the only significant factor associated with pain reduction in PHN patients (P<0.001). Cox regression prognostic model results identified Gabapentin frequency, IL-6, and C-reactive protein as significant predictors of BTX-A treatment response (P<0.05). ROC analysis further showed that IL-6 was a strong predictor of BTX-A treatment response (AUC=0.804, P=0.034). Adverse events were rare and similar between groups.</p><p><strong>Conclusions: </strong>BTX-A may offer benefit in relieving pain and reducing inflammation in PHN patients compared with standard treatment, and IL-6 may be a strong predictor of efficacy.</p>\",\"PeriodicalId\":10449,\"journal\":{\"name\":\"Clinical Neuropharmacology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2025-09-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Neuropharmacology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/WNF.0000000000000654\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Neuropharmacology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/WNF.0000000000000654","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Prognostic Modeling and Clinical Evaluation of Adverse Factors in Postherpetic Neuralgia Treated With Botulinum Toxin Type A: A Randomized Controlled Trial.
Objectives: This study aims to evaluate the efficacy of Botulinum toxin type A (BTX-A) in patients with postherpetic neuralgia (PHN) and to identify key prognostic factors associated with treatment response.
Methods: This prospective, randomized controlled trial enrolled patients with PHN from November 2023 to January 2024. Sixty patients were randomized into 2 groups: the BTX-A group (standard care plus BTX-A injections) and the control group (standard care alone). The primary outcome was the change in pain intensity, assessed using the Visual Analog Scale (VAS) before and after treatment. Secondary outcomes included changes in inflammatory factor levels, the use of analgesics, and the occurrence of adverse events.
Results: Compared with the control group, the BTX-A group showed significantly lower VAS scores and decreased inflammatory markers (P<0.001). After 1 month, the frequency of analgesic use decreased in both groups (P<0.001), but there was no difference between the groups. Multivariate logistic regression results showed that BTX-A was the only significant factor associated with pain reduction in PHN patients (P<0.001). Cox regression prognostic model results identified Gabapentin frequency, IL-6, and C-reactive protein as significant predictors of BTX-A treatment response (P<0.05). ROC analysis further showed that IL-6 was a strong predictor of BTX-A treatment response (AUC=0.804, P=0.034). Adverse events were rare and similar between groups.
Conclusions: BTX-A may offer benefit in relieving pain and reducing inflammation in PHN patients compared with standard treatment, and IL-6 may be a strong predictor of efficacy.
期刊介绍:
Clinical Neuropharmacology is a peer-reviewed journal devoted to the pharmacology of the nervous system in its broadest sense. Coverage ranges from such basic aspects as mechanisms of action, structure-activity relationships, and drug metabolism and pharmacokinetics, to practical clinical problems such as drug interactions, drug toxicity, and therapy for specific syndromes and symptoms. The journal publishes original articles and brief reports, invited and submitted reviews, and letters to the editor. A regular feature is the Patient Management Series: in-depth case presentations with clinical questions and answers.