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Clin J Pain. 2013 Oct;29(10):857-64. doi: 10.1097/AJP.0b013e31827a72d2.

Botulinum toxin A in postherpetic neuralgia: a parallel, randomized, double-blind, single-dose, placebo-controlled trial.

Author information

1
*State Hospital for Dermatologic and Venereologic Diseases †First Department of Dermatology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Abstract

OBJECTIVES:

Cumulative evidence support a beneficial effect of botulinum toxin A (BTX-A) in postherpetic neuralgia (PHN). We aimed to assess efficacy, safety, and tolerability of BTX-A in the management of PHN, performing a randomized, double-blind, single-dose, placebo-controlled trial.

METHODS:

Thirty adults with PHN were randomized either to BTX-A or placebo. Severity of pain was evaluated by patients using a visual analogue scale (VAS) and quality of sleep was assessed using a 5-item questionnaire. Primary outcome was reduction in VAS score, with a greater than 50% reduction being considered clinically significant. Secondary outcomes were reduction in sleep score and maintenance of VAS score after treatment, with over 50% maintenance considered clinically meaningful.

RESULTS:

Thirteen patients from the experimental arm achieved an at least 50% reduction in VAS score, compared with none of the placebo patients (NNT=1.2, 95% CI, 2-1; ARR=0.87, 95% CI, 055-096; P<0.001). BTX-A patients showed significant reduction in VAS pain scores between baseline and week 2, which persisted for a median period of 16 weeks. BTX-A patients showed significant reduction in sleep scores between baseline and week 2, which remained unchanged until 16th week (P<0.001). Treatment was well tolerated.

DISCUSSION:

Data confirm that BTX-A is effective and well tolerated in the treatment of PHN.

PMID:
23370074
DOI:
10.1097/AJP.0b013e31827a72d2
[Indexed for MEDLINE]

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