Cochrane · systematic review · CD003633
Botulinum toxin type A therapy for cervical dystonia
Rodrigues, FB, Duarte, GS, Marques, RE, et al. · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
7
current version
GRADE rated
7
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 1 · 14.3%Low 0 · 0%Moderate 4 · 57.1%High 2 · 28.6%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyBotulinum toxin type A compared to placebo for cervical dystonia
Population: cervical dystonia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Cervical dystonia‐specific improvement Botulinum toxin type A vs placebo | no estimate extracted | NR | Moderate Downgraded: risk of bias |
Adverse events at 4 weeks; 1085 participants (8 RCTs) Botulinum toxin type A vs placebo | RR 1.23 [1.05, 1.43] | NR | Moderate Downgraded: risk of bias |
Subjective participant assessment at 4 weeks; 755 participants(6 RCTs) Botulinum toxin type A vs placebo | RR 2.19 [1.78, 2.7] | NR | High |
Cervical dystonia‐specific pain Botulinum toxin type A vs placebo | no estimate extracted | NR | Moderate Downgraded: risk of bias |
Tolerability assessed as dropouts at 4 to 6 weeks: 705 participants (5 RCTs) Botulinum toxin type A vs placebo | RR 0.48 [0.32, 0.73] | NR | High |
Health‐related quality of life Botulinum toxin type A vs placebo | no estimate extracted | NR | Moderate Downgraded: risk of bias |
Duration of effect 618 participants (5 RCTs) Botulinum toxin type A vs placebo | no estimate extracted | NR | Very low Downgraded: risk of bias |
Botulinum toxin type A compared to placebo for cervical dystonia
Population: adults with cervical dystonia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Cervical dystonia‐specific impairment Number of participants: 522 (4 RCTs) Assessed 3 to 6 weeks post‐injection using TWSTRS total score Botulinum toxin type A vs placebo | no estimate extracted | NR | Moderate Downgraded: risk of bias |
Adverse events Number of participants: 952 (7 RCTs) Assessed at any point during Botulinum toxin type A vs placebo | RR 1.19 [1.03, 1.36] | NR | Moderate Downgraded: risk of bias |
Subjective participant assessment Number of participants: 624 (5 RCTs) Assessed 3 to 6 weeks post‐injection Botulinum toxin type A vs placebo | RR 2.3 [1.83, 2.9] | NR | Moderate Downgraded: risk of bias |
Pain relief Number of participants: 429 (3 RCTs) Assessed 3 to 6 weeks post‐injection using TWSTRS pain subscore Botulinum toxin type A vs placebo | no estimate extracted | NR | Moderate Downgraded: risk of bias |
Tolerability Number of participants: 574 (4 RCTs) Assessed at any point during Botulinum toxin type A vs placebo | RR 0.38 [0.23, 0.62] | NR | Moderate Downgraded: risk of bias |
Dysphagia Number of participants: 1007 (8 RCTs) Assessed at any point during Botulinum toxin type A vs placebo | RR 3.04 [1.68, 5.5] | NR | Moderate Downgraded: risk of bias |
Diffuse weakness/tiredness Number of participants: 823 (6 RCTs) Assessed at any point during Botulinum toxin type A vs placebo | RR 1.78 [1.08, 2.94] | NR | Moderate Downgraded: risk of bias |