Abstract | BACKGROUND: AIMS: To evaluate the efficacy and safety of BoNT-A in the treatment of hand tremor. METHODS: We searched the MEDLINE, EMBASE, PsycINFO and Cochrane Library databases for relevant randomised controlled trials of the effects of BoNT-A injections on tremors, up to 20 February 2020. A meta-analysis of comparative effects was performed using R studio software, and publication bias was examined using Egger's test. RESULTS: Six studies examining a total of 245 participants with tremor were included in the meta-analysis. The primary outcome of meta-analysis showed no difference in clinical tremor scale scores between the BoNT-A group versus the placebo group (standardised mean difference (SMD): -0.42, 95% confidence interval (CI): -1.94 to 1.10; I2 = 96%). For clinical tremor scale scores, subgroup analyses suggested that the BoNT-A group may differ in terms of multiple sclerosis (MS) related tremor (SMD: -1.10; 95% CI: -2.17 to -0.04; I2 = 79%) compared to a placebo, but the difference did not exist in the outcome of essential tremor (ET) or hand tremor (MD: -1.31; 95% CI: -3.39; 1.31; I2 = 97%). Grip strength (MD: -1.25, 95% CI: -5.99 to 3.50, I2 = 97%) was slightly lower in the BoNT-A group, but the difference was not significant. The incidence of adverse events (AEs), including hand weakness (RR: 2.96, 95% CI: 1.40 to 6.24, I2 = 37%), was significantly greater in the BoNT-A group than in the placebo group. Two studies were assessed as having an overall low risk of bias. CONCLUSIONS: Our study confirms that BoNT-A injections are unlikely to have an impact on patients with hand tremors. However, subgroup analysis suggested that BoNT-A injections could have possible benefits in MS-related tremor. While moderate to severe hand weakness AEs often limits their use in clinical practice, additional well-designed double-blind, placebo-controlled trials are needed to provide more robust conclusions.
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Authors | Xiaoyan Zheng, Wenjing Wei, Peidong Liu, Chunxiao Wu, Liming Lu, Chunzhi Tang |
Journal | Neurologia i neurochirurgia polska
(Neurol Neurochir Pol)
Vol. 54
Issue 6
Pg. 561-567
( 2020)
ISSN: 0028-3843 [Print] Poland |
PMID | 33047784
(Publication Type: Journal Article, Meta-Analysis, Systematic Review)
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Chemical References |
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Topics |
- Botulinum Toxins, Type A
(therapeutic use)
- Hand
(innervation)
- Humans
- Muscle Weakness
- Tremor
(drug therapy)
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