SynthesisEuropean journal of clinical pharmacology2026
Efficacy of botulinum toxin type a for treating chronic low back pain: a systematic review and metanalysis.
Synthesis in European journal of clinical pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Authors and funding
6 authors.
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Abstract
backgroundChronic low back pain (CLBP) is a leading cause of pain and disability worldwide. Most cases are nonspecific, lacking a clear pathological cause, and management remains challenging. Botulinum toxin type A (BoNT-A), a neurotoxin that blocks acetylcholine release and reduces muscle hyperactivity, has been studied in CLBP with inconsistent results. This meta-analysis aimed to determine the efficacy of BoNT-A compared with placebo or saline in the management of nonspecific CLBP.
methodsA comprehensive search of PubMed, Embase, Cochrane Library, and the WHO ICTRP databases was conducted for randomized controlled trials (RCTs) involving adults with nonspecific CLBP who received BoNT-A or placebo injections and were registered in PROSPERO (CRD42024559735). The primary outcome was pain response, defined as a ≥ 50% reduction in VAS score, while the secondary outcome was functional improvement. A random-effects model was used to calculate pooled risk ratios (RR) with 95% confidence intervals (CI).
resultsFive eligible RCTs involving 177 participants were analyzed. BoNT-A improved pain response compared with placebo [RR = 2.09, 95% CI: 1.11-3.95; p = 0.02; I
conclusionBoNT-A may improve pain and functional outcomes in nonspecific CLBP, although the certainty of evidence is low. Exploratory analyses suggested a possible decline in pain benefit over time, and safety data are limited. Larger, high-quality RCTs are needed to confirm these findings.
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