Abstract | OBJECTIVE: METHODS: We included clinical trials of adults with shoulder pain (population), comparing botulinum toxin (intervention) to placebo or other therapies (comparison), and reporting benefits or harms (outcomes). We calculated relative risk (RR) for categorical outcomes and mean differences (MD) for continuous outcomes. RESULTS: Six randomized controlled trials (RCT) with 164 patients all comparing single botulinum toxin type A injections to placebo were included. Five RCT in patients with post- stroke shoulder pain found that an intramuscular injection of botulinum toxin type A significantly reduced pain at 3-6 months (MD -1.2 points on 0-10 scale, 95% CI -2.4 to -0.07) and improved shoulder external rotation at 1 month (MD 9.8°, 95% CI 0.2° to 19.4°). Number of adverse events did not differ between groups (RR 1.46, 95% CI 0.6 to 24.3). One RCT in arthritis-related shoulder pain showed that single intraarticular botulinum toxin type A injection reduced pain (MD -2.0 on 0-10 scale, 95% CI -3.7 to -0.3) and shoulder disability (MD -13.4 on 0-100 scale, 95% CI -24.9 to -1.9) and improved shoulder abduction (MD 13.8°, 95% CI 3.2° to 44.0°) at 1 month, compared with placebo. Serious adverse events did not differ between groups (RR 0.35, 95% CI 0.11, 1.12). CONCLUSION:
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Authors | Jasvinder A Singh, Patrick M Fitzgerald |
Journal | The Journal of rheumatology
(J Rheumatol)
Vol. 38
Issue 3
Pg. 409-18
(Mar 2011)
ISSN: 0315-162X [Print] Canada |
PMID | 21285169
(Publication Type: Journal Article, Research Support, N.I.H., Extramural, Review, Systematic Review)
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Chemical References |
- Placebos
- Botulinum Toxins
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Topics |
- Botulinum Toxins
(therapeutic use)
- Databases, Factual
- Humans
- Pain Measurement
- Placebos
- Randomized Controlled Trials as Topic
- Shoulder Pain
(drug therapy)
- Treatment Outcome
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