Botulinum toxin A treatment for post‑herpetic neuralgia: A systematic review and meta‑analysis

Li,Xin‑Long; Zeng,Xu; Zeng,Shan; He,Hai‑Ping; Zeng,Zhen; Peng,Li‑Lei; Chen,Li‑Gang

doi:10.3892/etm.2019.8301

Botulinum toxin A treatment for post‑herpetic neuralgia: A systematic review and meta‑analysis

Authors:
- Xin‑Long Li
- Xu Zeng
- Shan Zeng
- Hai‑Ping He
- Zhen Zeng
- Li‑Lei Peng
- Li‑Gang Chen
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Affiliations: Department of Neurosurgery, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China, Department of Ultrasound, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
Published online on: December 9, 2019 https://doi.org/10.3892/etm.2019.8301
Pages: 1058-1064
Copyright: © Li et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY_NC 4.0].

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Abstract

The present meta‑analysis study aimed to investigate the safety and efficacy of local administration of botulinum toxin (BTX‑A) vs. lidocaine in the treatment of post‑herpetic neuralgia. A systematic search of the Cochrane Library, PubMed, Embase, Chinese National Knowledge Infrastructure, Wanfang, Chongqing VIP Information Co. and Chinese Biomedical Literature Database was performed to identify randomized controlled trials (RCTs) comparing BTX‑A and lidocaine in the treatment of post‑herpetic neuralgia. The primary outcomes were Visual Analogue Scale (VAS) pain scores at 1, 2 and 3 months after treatment and the effective rate. Secondary outcomes were scores on the McGill pain questionnaire and adverse event rate. A total of 7 RCTs comprising 752 patients were included. The VAS pain score was significantly lower at 1 month [mean difference (MD)=‑2.31; 95% CI: ‑3.06, ‑1.56; P<0.00001)], 2 months (MD=‑2.18; 95% CI: ‑2.24, ‑2.11; P<0.00001) and 3 months (MD=‑1.93; 95% CI: ‑3.05, ‑0.82; P=0.0007) after treatment, the effective rate was significantly higher (odds ratio=2.9; 95% CI: 1.71, 4.13; P<0.0001) and scores on the McGill pain questionnaire were significantly lower (MD=‑10.93; 95% CI: ‑21.02, ‑0.83; Z=2.12; P=0.03) in patients who received BTX‑A for post‑herpetic neuralgia compared to those who received lidocaine. There was no difference in the adverse event rate between treatments. In conclusion, BTX‑A has potential as a safe and effective treatment option for post‑herpetic neuralgia. Further large and well‑designed RCTs are required to confirm this conclusion.

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