TY - JOUR
T1 - Efficacy and safety of botulinum toxin type a on persistentmyofascial pain
T2 - A randomized clinical trial
AU - De La Torre Canales, Giancarlo
AU - Alvarez-Pinzon, Natalia
AU - Muñoz-Lora, Victor Ricardo Manuel
AU - Peroni, Leonardo Vieira
AU - Gomes, Amanda Farias
AU - Sánchez-Ayala, Alfonso
AU - Haiter-Neto, Francisco
AU - Manfredini, Daniele
AU - Rizzatti-Barbosa, Célia Marisa
N1 - Publisher Copyright:
© 2020 by the authors.
PY - 2020/6
Y1 - 2020/6
N2 - This study assessed the safety and efficacy of three different doses of BoNT-A for persistent myofascial pain (MFP). One hundred female subjects were randomly assigned into five groups (n = 20): oral appliance (OA), saline solution (SS) and three BoNT-A groups with different doses. Pain intensity and pressure pain threshold were evaluated up to 24 weeks after treatment. Adverse effects related to muscle contraction, masticatory performance, muscle thickness and mandibular bone volume were also assessed. Changes over time were compared within and between groups. The "nparLD" package and Wilcoxon signed-rank test were used to analyze the data. BoNT-A reduced pain intensity (p < 0.0001) and increased pressure pain threshold (p < 0.0001) for up to 24 weeks compared to the placebo. No differenceswere found between BoNT-A and OA at the last follow-up. A transient decline inmasticatory performance (p < 0.05) and muscle contraction (p < 0.0001), and a decrease in muscle thickness (p < 0.05) and coronoid and condylar process bone volume (p < 0.05) were found as dose-related adverse effects of BoNT-A. Regardless of the dose, BoNT-A was as effective as OA on MFP. Notwithstanding, due to BoNT-A dose-related adverse effects, we suggest the use of low doses of BoNT-A in MFP patients that do not benefit from conservative treatments.
AB - This study assessed the safety and efficacy of three different doses of BoNT-A for persistent myofascial pain (MFP). One hundred female subjects were randomly assigned into five groups (n = 20): oral appliance (OA), saline solution (SS) and three BoNT-A groups with different doses. Pain intensity and pressure pain threshold were evaluated up to 24 weeks after treatment. Adverse effects related to muscle contraction, masticatory performance, muscle thickness and mandibular bone volume were also assessed. Changes over time were compared within and between groups. The "nparLD" package and Wilcoxon signed-rank test were used to analyze the data. BoNT-A reduced pain intensity (p < 0.0001) and increased pressure pain threshold (p < 0.0001) for up to 24 weeks compared to the placebo. No differenceswere found between BoNT-A and OA at the last follow-up. A transient decline inmasticatory performance (p < 0.05) and muscle contraction (p < 0.0001), and a decrease in muscle thickness (p < 0.05) and coronoid and condylar process bone volume (p < 0.05) were found as dose-related adverse effects of BoNT-A. Regardless of the dose, BoNT-A was as effective as OA on MFP. Notwithstanding, due to BoNT-A dose-related adverse effects, we suggest the use of low doses of BoNT-A in MFP patients that do not benefit from conservative treatments.
KW - Bone loss
KW - Botulinum toxin type A
KW - Chronic pain
KW - Myofascial pain
KW - Temporomandibular disorders
UR - http://www.scopus.com/inward/record.url?scp=85086685746&partnerID=8YFLogxK
U2 - 10.3390/toxins12060395
DO - 10.3390/toxins12060395
M3 - Article
C2 - 32549196
AN - SCOPUS:85086685746
SN - 2072-6651
VL - 12
JO - Toxins
JF - Toxins
IS - 6
M1 - 395
ER -