title: Intra-articular botulinum toxin A for the treatment of osteoarthritic joint pain in dogs: a randomized, double-blinded, placebo-controlled clinical trial.
abstract: The aim of this study was to investigate the efficacy of intra-articular (IA) botulinum toxin A (IA BoNT A) for the treatment of osteoarthritic joint pain in dogs. The study was a placebo-controlled, randomized, double-blinded clinical trial with parallel group design and 12-week follow-up. Thirty-six dogs with chronic lameness due to stifle, hip or elbow osteoarthritis were randomized to receive an IA injection of 30IU of BoNT A or placebo. The main outcome variables were vertical impulse (VI) and peak vertical force (PVF) measured with a force platform, and Helsinki chronic pain index (HCPI). Subjective pain score and the need for rescue analgesics were secondary variables. The response to treatment was assessed as the change from baseline to each examination week. The variables were analyzed by ANOVA with repeated measurements and results were considered statistically significant if P ⩽ 0.05. The improvement from baseline to 12 weeks after baseline was statistically significant in VI, PVF and HCPI in the treatment group (P=0.001, P=0.054 and P=0.053, respectively). Additionally, there were statistically significant improvements in VI in the treatment group at 2, 4 and 8 weeks after baseline (P=0.037, P=0.016 and P=0.016, respectively). The difference between groups in improvement in VI was statistically significant at 12weeks after baseline (P=0.005). There was no significant change in the subjective pain score or in the requirement for rescue analgesics in either group. No major adverse events thought to be related to trial protocol were detected. These results suggest that IA BoNT A has some efficacy in reducing osteoarthritic pain in dogs.
authors.affiliation: Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, P.O. Box 57, 00014 University of Helsinki, Finland. Electronic address: helka.heikkila@helsinki.fi.
authors.forename: H M
authors.initials: HM
authors.lastname: Heikkilä
authors.affiliation: Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, P.O. Box 57, 00014 University of Helsinki, Finland.
authors.forename: A K
authors.initials: AK
authors.lastname: Hielm-Björkman
authors.affiliation: Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, P.O. Box 57, 00014 University of Helsinki, Finland.
authors.forename: M
authors.initials: M
authors.lastname: Morelius
authors.affiliation: Centre for Epidemiology and Biostatistics, Norwegian School of Veterinary Science, P.O. Box 8146 Dep, 0033 Oslo, Norway.
authors.forename: S
authors.initials: S
authors.lastname: Larsen
authors.affiliation: Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, P.O. Box 57, 00014 University of Helsinki, Finland.
authors.forename: J
authors.initials: J
authors.lastname: Honkavaara
authors.affiliation: Department of Musculoskeletal Biology, Institute of Aging and Chronic Disease and School of Veterinary Science, University of Liverpool, Chester High Road, Neston CH64 7TE, UK.
authors.forename: J F
authors.initials: JF
authors.lastname: Innes
authors.affiliation: Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, P.O. Box 57, 00014 University of Helsinki, Finland.
authors.forename: O M
authors.initials: OM
authors.lastname: Laitinen-Vapaavuori
mesh_terms: D000700:Analgesics / Q000627:therapeutic use*; D000818:Animals; D018771:Arthralgia / Q000188:drug therapy / Q000209:etiology / Q000662:veterinary*; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D004283:Dog Diseases / Q000188:drug therapy* / Q000209:etiology; D004285:Dogs; D004311:Double-Blind Method; D005260:Female; D007270:Injections, Intra-Articular / Q000662:veterinary; D008297:Male; D010003:Osteoarthritis / Q000188:drug therapy / Q000209:etiology / Q000662:veterinary*; D059408:Pain Management / Q000662:veterinary*; D016896:Treatment Outcome
chemical_list: D000700:Analgesics; D019274:Botulinum Toxins, Type A
keywords: Botulinum toxin A; Dogs; Intra-articular; Osteoarthritis; Pain