Botulinum toxin – neuropathic pain: Safety and efficacy of repeated injections of botulinum toxin A in peripheral neuropathic pain (BOTNEP): a randomised, double-blind, placebo-controlled trial

Key Points

• A selection of abstracts of clinically relevant papers from other journals.

• The abstracts on this page have been chosen and edited by John R. Radford.

Abstract

When treated with botulinum toxin A, those patients with peripheral neuropathic pain and allodynia (triggering of pain from stimuli which do not normally provoke pain) at baseline, would appear to have a better outcome.

Main

Attal N, de Andrade DC et al. Lancet Neurol 2016;15: 555–565

As background, the quality of evidence for the efficacy of botulinum toxin for the treatment of peripheral neuropathic pain is low. In this randomised double-blind, placebo-controlled trial, 68 patients (66 completed trial) with peripheral neuropathic pain were allocated to either an intervention group who received two subcutaneous administrations of botulinum toxin A into the painful area of skin, or a placebo group (saline). Those with facial pain were excluded because of the potential for 'unmasking' caused by facial palsy. Botulinum toxin A reduced pain intensity over 24 weeks compared with placebo (adjusted effect estimate/size of the treatment effects was 0·77, 95% CI −0·95 to −0·59; p <0·0001).