Assessment: Botulinum neurotoxin in the treatment of autonomic disorders and pain (an evidence-based review): report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology.

Details

Serval ID
serval:BIB_A0A0358505E4
Type
Article: article from journal or magazin.
Collection
Publications
Title
Assessment: Botulinum neurotoxin in the treatment of autonomic disorders and pain (an evidence-based review): report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology.
Journal
Neurology
Author(s)
Naumann M., So Y., Argoff C.E., Childers M.K., Dykstra D.D., Gronseth G.S., Jabbari B., Kaufmann H.C., Schurch B., Silberstein S.D., Simpson D.M., Therapeutics 
Working group(s)
Technology Assessment Subcommittee of the American Academy of Neurology
Contributor(s)
Therapeutics 
ISSN
1526-632X (Electronic)
ISSN-L
0028-3878
Publication state
Published
Issued date
2008
Volume
70
Number
19
Pages
1707-1714
Language
english
Notes
Publication types: Journal Article ; Meta-AnalysisPublication Status: ppublish
Abstract
OBJECTIVE: To perform an evidence-based review of the safety and efficacy of botulinum neurotoxin (BoNT) in the treatment of autonomic and urologic disorders and low back and head pain.
METHODS: A literature search was performed including MEDLINE and Current Contents for therapeutic articles relevant to BoNT and the selected indications. Authors reviewed, abstracted, and classified articles based on the quality of the study (Class I-IV). Conclusions and recommendations were developed based on the highest level of evidence and put into current clinical context.
RESULTS: The highest quality literature available for the respective indications was as follows: axillary hyperhidrosis (two Class I studies); palmar hyperhidrosis (two Class II studies); drooling (four Class II studies); gustatory sweating (five Class III studies); neurogenic detrusor overactivity (two Class I studies); sphincter detrusor dyssynergia in spinal cord injury (two Class II studies); chronic low back pain (one Class II study); episodic migraine (two Class I and two Class II studies); chronic daily headache (four Class II studies); and chronic tension-type headache (two Class I studies).
RECOMMENDATIONS: Botulinum neurotoxin (BoNT) should be offered as a treatment option for the treatment of axillary hyperhidrosis and detrusor overactivity (Level A), should be considered for palmar hyperhidrosis, drooling, and detrusor sphincter dyssynergia after spinal cord injury (Level B), and may be considered for gustatory sweating and low back pain (Level C). BoNT is probably ineffective in episodic migraine and chronic tension-type headache (Level B). There is presently no consistent or strong evidence to permit drawing conclusions on the efficacy of BoNT in chronic daily headache (mainly transformed migraine) (Level U). While clinicians' practice may suggest stronger recommendations in some of these indications, evidence-based conclusions are limited by the availability of data.
Keywords
Autonomic Nervous System Diseases/drug therapy, Autonomic Nervous System Diseases/physiopathology, Botulinum Toxins/administration & dosage, Clinical Trials as Topic/statistics & numerical data, Evidence-Based Medicine, Humans, Hyperhidrosis/drug therapy, Low Back Pain/drug therapy, Neuromuscular Blocking Agents/administration & dosage, Pain/drug therapy, Pain/physiopathology, Urinary Bladder, Neurogenic/drug therapy
Pubmed
Web of science
Open Access
Yes
Create date
05/11/2014 12:12
Last modification date
20/08/2019 15:06
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