title: Abobotulinum Toxin A in the Treatment of Chronic Low Back Pain.
abstract: Chronic low back pain is a debilitating condition with a complex and multifactorial pathophysiology. Botulinum neurotoxins (BoNTs) have strong analgesic effects, as shown in both animal models of pain and in human beings. A randomized, double-blind, placebo-controlled, parallel format study to investigate the efficacy of abobotulinum toxin A (aboA) in chronic low back pain was conducted. The study cohort consisted of 18 patients who received 100 units of aboA into each of the five lumbar extensor spinae muscles unilaterally or bilaterally (total dose 500 to 1000 units), and 19 who received normal saline of the same volume. The level of pain and quality of life were assessed using the visual analogue scale (VAS) and three questionnaires including the Oswestry Low Back Pain Disability Questionnaire (OLBPDQ). Patients' perception of improvement was recorded via patient global impression of change (PGIC). The primary outcome measure, the proportion of responders with VAS of <4 at 6 weeks, was not met, but the data was significantly in favor of aboA at 4 weeks (p= 0.008). The total Oswestry score representing quality of life improved in the aboA group compared to the placebo group (p= 0.0448). Moreover, significantly more patients reported their low back pain as "much improved" in the abobotulinum toxin A group (0.0293).
authors.affiliation: Department of Neurology, Yale University School of Medicine, New Haven, CT 06510, USA. duarte.machado@yale.edu.
authors.forename: Duarte
authors.initials: D
authors.lastname: Machado
authors.affiliation: Department of Neurology, Yale University School of Medicine, New Haven, CT 06510, USA. aditya.kumar@yale.edu.
authors.forename: Aditya
authors.initials: A
authors.lastname: Kumar
authors.affiliation: Department of Neurology, Yale University School of Medicine, New Haven, CT 06510, USA. bahman.jabbari@yale.edu.
authors.forename: Bahman
authors.initials: B
authors.lastname: Jabbari
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use*; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D002908:Chronic Disease; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D017116:Low Back Pain / Q000188:drug therapy*; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal; D055815:Young Adult
chemical_list: D018712:Analgesics, Non-Narcotic; D019274:Botulinum Toxins, Type A; C542869:abobotulinumtoxinA
keywords: abobotulinum toxin A; botulinum neurotoxin; low back pain; randomized controlled trial