SynthesisInternational journal of medical sciences2026
Beyond Conventional Analgesics: Updated Evidence Supporting Botulinum Toxin Type A for-Neuralgia Management.
Synthesis in International journal of medical sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
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Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Neuralgia is a chronic neuropathic pain condition characterized by recurrent paroxysms of severe pain that are often refractory to conventional pharmacological therapies. Botulinum toxin type A (BTX-A) has emerged as a promising adjunctive treatment due to its analgesic and neuromodulatory properties. Objective: Evidence from randomized controlled trials (RCTs) remains heterogeneous, with variability in dosage, injection protocols, and follow-up duration. In addition, prior meta-analyses lacked detailed subgroup analyses, and several RCTs combined BTX-A with concomitant long-term analgesics, obscuring its independent therapeutic effect. This study aimed to provide a comprehensive synthesis of the efficacy and safety of BTX-A monotherapy for neuralgia, while permitting the use of acute analgesics (PROSPERO registration: CRD420251042926). Methods: We systematically searched PubMed, Embase, the Cochrane Library, and Web of Science for RCTs published up to September 2025 that evaluated BTX-A monotherapy in adults with neuralgia. Study selection and data extraction adhered to PRISMA 2020 guidelines. Pooled effect sizes were calculated using random-effects models, and heterogeneity was quantified with the Results: Seven RCTs encompassing 368 participants were included. Compared with placebo or standard therapy, BTX-A significantly reduced pain intensity (VAS), attack frequency, and rescue analgesic use, while improving sleep quality, quality of life (QoL), and patient global impression of change (PGIC). Subgroup analysis revealed that low-dose regimens (<50 U) achieved comparable analgesic efficacy and durability to higher doses, with effects sustained for approximately three months. No serious adverse events were reported. Conclusions: BTX-A monotherapy provides clinically meaningful pain relief and functional improvement in patients with neuralgia, including trigeminal and postherpetic neuralgia. Its favorable safety profile and sustained efficacy support its role as an effective adjunct or alternative for refractory neuropathic pain. Future large-scale RCTs with standardized dosing and extended follow-up are warranted to optimize treatment protocols.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.