Bianchi Francesca, Nelson Mariana, Wissel Jörg, Kim Heakyung, Traut Alexandra, Shah Darshini, Musacchio Tiziana, Jabbari Bahman
Neurology and Stroke Unit, Department of Neuroscience, Bufalini Hospital, 47521 Cesena, Italy.
AbbVie, 1 North Waukegan Road, North Chicago, IL 60064, USA.
Toxins (Basel). 2025 Aug 18;17(8):418. doi: 10.3390/toxins17080418.
Many patients with spasticity report pain which can be debilitating. Numerous studies have shown onabotulinumtoxinA (onabotA) is efficacious in the management of spasticity but comprehensive data on its impact on spasticity-associated pain is limited. This systematic review aimed to assess the published evidence on the efficacy of onabotA in the management of pain in adults with spasticity. Search strategies were conducted from 1990 to 2023 for journal publications and from 2020 to 2023 for congress proceedings to identify relevant studies on onabotA in adults with spasticity where pain was a reported outcome. Of 665 records identified, 31 unique studies from 33 publications were included (2740 patients). Twenty-seven studies demonstrated a reduction in pain compared to baseline following treatment with onabotA in adults with spasticity (n = 2740). Of these, 12 studies reported a statistically significant reduction in pain with onabotA versus baseline. Sixteen studies reported a clinically meaningful reduction in pain (≥30% reduction). The reduction in pain with onabotA was consistent across etiologies and a range of pain measures. There was a high level of heterogeneity in the design and quality of the studies identified, which limited statistical analysis; however, the published evidence overall shows a consistent positive trend for the use of onabotA in reducing spasticity-related pain in adults.
许多痉挛患者报告有疼痛症状，这种疼痛可能使人衰弱。大量研究表明，A型肉毒毒素（onabotA）在治疗痉挛方面有效，但关于其对痉挛相关疼痛影响的全面数据有限。本系统评价旨在评估已发表的关于onabotA治疗成人痉挛性疼痛疗效的证据。检索策略涵盖1990年至2023年的期刊出版物以及2020年至2023年的会议论文集，以确定关于onabotA在报告有疼痛结果的成人痉挛患者中的相关研究。在识别出的665条记录中，纳入了来自33篇出版物的31项独特研究（2740名患者）。27项研究表明，与基线相比，onabotA治疗成人痉挛患者后疼痛减轻（n = 2740）。其中，12项研究报告onabotA治疗后疼痛较基线有统计学显著降低。16项研究报告疼痛有临床意义的减轻（减轻≥30%）。onabotA导致的疼痛减轻在不同病因和一系列疼痛测量指标中是一致的。所识别研究的设计和质量存在高度异质性，这限制了统计分析；然而，总体已发表证据显示，使用onabotA在减轻成人痉挛相关疼痛方面呈现出一致的积极趋势。
