Intra-articular botulinum toxin type A for treatment of knee osteoarthritis: Clinical trial

Najafi, Sharif; Sanati, Ehsan; Khademi, Mahsa; Abdorrazaghi, Fateme; Mofrad, Reza Kazempoor; Rezasoltani, Zahra

doi:10.1016/j.toxicon.2019.04.003

Cited by 22 publications

(9 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therefore, in the last two decades, a large body of work has been performed to develop non-operative or minimally invasive interventions to alleviate OA symptoms or slow down OA progression. However, no consensus has been reached yet regarding the standard management strategies [7][8][9][10][11]. Among the minimally invasive methods recommended for knee OA management is intra-articular injections for which a large array of products have been used such as corticosteroids, dextrose, hyaluronic acid (HA), plasma derivatives including platelet-rich plasma (PRP) and plasma rich in growth factors (PRGF), and ozone [12,13].…”

Section: Introductionmentioning

confidence: 99%

The comparison effects of intra-articular injection of Platelet Rich Plasma (PRP), Plasma Rich in Growth Factor (PRGF), Hyaluronic Acid (HA), and ozone in knee osteoarthritis; a one year randomized clinical trial

Raeissadat

Hosseini

Bahrami

et al. 2021

BMC Musculoskelet Disord

View full text Add to dashboard Cite

Background Our study compare the short and long-term efficacy of the intra articular injections (IAIs) of hyaluronic acid (HA), platelet-rich plasma (PRP), plasma rich in growth factors (PRGF), and ozone in patients with knee osteoarthritis (OA). Methods In this randomized clinical trial, 238 patients with mild to moderate knee OA were randomized into 4 groups of IAIs: HA (3 doses weekly), PRP (2 doses with 3 weeks interval), PRGF (2 doses with 3 weeks interval), and Ozone (3 doses weekly). Our outcome measures were the mean changes from baseline (immediately from the first injections) until 2,6, and 12 months post intervention in scores of visual analog scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Lequesne index. Results A total of 200 patients enrolled in the final analysis. The mean age of patients was 56.9 ± 6.3 years, and 69.5% were women. In 2 months follow up, significant improvement of pain, stiffness, and function were seen in all groups compared to the baseline, but the ozone group had the best results (P < 0.05). In 6 month follow up HA, PRP, and PRGF groups demonstrated better therapeutic effects in all scores in comparison with ozone (P < 0.05). At the end of the 12th month, only PRGF and PRP groups had better results versus HA and ozone groups in all scores (P < 0.05). Despite the fact that ozone showed better early results, its effects begin to wear off earlier than other products and ultimately disappear in 12 months. Conclusions Ozone injection had rapid effects and better short-term results after 2 months, but its therapeutic effects did not persist after 6 months and at the 6-month follow up, PRP,PRGF and HA were superior to ozone. Only patients in PRP and PRGF groups improved symptoms persisted for 12 months. Therefore, these products could be the preferable choices for long-term management. Trial registration Registered in the Iranian Center of Clinical Trials (www.irct.ir) in 11/11/2017 with the following code: IRCT2017082013442N17.

show abstract

Section: Introductionmentioning

confidence: 99%

The comparison effects of intra-articular injection of Platelet Rich Plasma (PRP), Plasma Rich in Growth Factor (PRGF), Hyaluronic Acid (HA), and ozone in knee osteoarthritis; a one year randomized clinical trial

Raeissadat

Hosseini

Bahrami

et al. 2021

BMC Musculoskelet Disord

View full text Add to dashboard Cite

show abstract

“…However, intramuscular injection of Botulinum toxin has limitations such as exacerbating muscle atrophy [13][14][15] , dose degradation 17 , and unsuitable for patients with low muscle tension 18 . On the other hand, intra-articular drug injections has shown its simplicity, e cacy, safety and ease of acceptance by patients 19,20 . The mechanism of joint injection is mainly thought to block the conduction of pain receptors 21 in the shoulder joint cavity, reduce neurogenic in ammation by inhibiting neuropathic pain-inducing substances, prevent peripheral and central sensitizing factors 22 .…”

Section: Background and Rationale {6a}mentioning

confidence: 99%

Effect of ultrasound-guided injection of botulinum toxin type A into shoulder joint cavity on shoulder pain in poststroke patients: Study Protocol for a Randomized Controlled Trial

Zheng,

Fan

2024

Preprint

View full text Add to dashboard Cite

Background Hemiplegic shoulder pain (HSP) is a common complication after stroke. It severely affects the recovery of upper limb motor function. Early shoulder pain in hemiplegic patients are mainly neuropathic caused by central nerve injury or neuroplasticity. Commonly used corticosteroid injections in the shoulder joint can reduce shoulder pain, however, the side effects also include soft tissue degeneration or increased tendon fragility, and the long-term effects remain controversial. Botulinum toxin injections are relatively new and are thought to block the transmission of pain receptors in the shoulder joint cavity, inhibit the production of neuropathogenic substances to reduce neurogenic inflammation. However, there is no conclusive evidence as to whether or not the amelioration of pain by botulinum toxin affects brain function. In previous studies of botulinum toxin versus glucocorticoids in the treatment of shoulder pain, there is a lack of observation of differences in changes in brain function. As the content of previous assessments of pain improvement was predominantly subjective, objective quantitative assessment indicators were lacking. Functional near-infrared imaging (fNIRS) can remedy this problem. Methods This study protocol was designed for a double-blind, randomized controlled clinical trial of patients with post-stroke HSP without biceps longus tenosynovitis or acromion bursitis. 78 patients will be randomly assigned to either the botulinum toxin type A or glucocorticoid group. At baseline, patients in each group will receive shoulder cavity injections of either botulinum toxin or glucocorticoids and will be followed for 1 and 4 weeks. The primary outcome is change in shoulder pain on the Visual Analog Scale (VAS). Secondary outcomes is the assessment of changes in oxyhemoglobin levels in the corresponding brain regions by fNIRS imaging, shoulder flexion, external rotation range of motion, upper extremity Fugl-Meyer, and modified Ashworth score. Discussion Ultrasound-guided botulinum toxin type A shoulder joint cavity injections may provide evidence of pain improvement in patients with HSP. The results of this trial are also help to analyse the correlation between changes in shoulder pain and changes in cerebral haemodynamics and shoulder joint motor function. Trial registration www.chictr.org.cn, identififier: ChiCTR2300070132 Trial registration: Chinese clinical Trial Registry, ChiCTR2300070132. Registered 03 April 2023, https://www.chictr.org.cn/showproj.html?proj=193722

show abstract

“…The analgesic effect of BTX-A was evaluated before and after treatment using the 100 mm visual analogue scale (VAS) and the knee injury and osteoarthritis outcome score (KOOS), respectively. The results showed that BTX-A reduced the subjective pain of KOA patients (Najafi et al, 2019). Another study compared the efficacy of physical therapy, hyaluronic acid intra-articular injections, intra-articular dextrose prolotherapy and BTX-A intra-articular injections for treating KOA in middle-aged and older adults.…”

Section: Knee Osteoarthri Smentioning

confidence: 99%

Advances in botulinum toxin type A for the treatment of pain

Jiang¹,

Huang²,

Yang³

et al. 2021

NRFHH

View full text Add to dashboard Cite

<i>Clostridium botulinum</i> (CB) is a Gram-positive anaerobic bacterium and a significant cause of food spoilage. Foodborne botulism occurs worldwide every year and even lead to death from respiratory distress in severe cases after eating botulism-contaminated food. The pathogenicity of CB lies in its ability to produce a potent neurotoxin, “botulinum toxin (BTX)”, for which eight different subtypes have already been isolated so far. Botulinum toxin type A (BTX-A) is widely used to treat critical clinical issues due to its good affinity and tolerability. Studies have shown that BTX-A injections effectively treat myofascial pain, inflammatory pain, and neuropathic pain. The current article mainly reviews the latest research progress using BTX-A in pain treatment during two years.

show abstract

Intra-articular botulinum toxin type A for treatment of knee osteoarthritis: Clinical trial

Cited by 22 publications

References 31 publications

The comparison effects of intra-articular injection of Platelet Rich Plasma (PRP), Plasma Rich in Growth Factor (PRGF), Hyaluronic Acid (HA), and ozone in knee osteoarthritis; a one year randomized clinical trial

The comparison effects of intra-articular injection of Platelet Rich Plasma (PRP), Plasma Rich in Growth Factor (PRGF), Hyaluronic Acid (HA), and ozone in knee osteoarthritis; a one year randomized clinical trial

Effect of ultrasound-guided injection of botulinum toxin type A into shoulder joint cavity on shoulder pain in poststroke patients: Study Protocol for a Randomized Controlled Trial

Advances in botulinum toxin type A for the treatment of pain

Contact Info

Product

Resources

About