OnabotulinumtoxinA (BTX-A) has demonstrated effectiveness in alleviating pain associated with trigeminal neuralgia (TN) in patients with multiple sclerosis (MS), according to a recent retrospective study. The research, which reviewed the medical records of 53 patients, suggests that BTX-A could offer a valuable treatment option for this challenging condition.
The study, published recently, aimed to evaluate the efficacy of BTX-A in patients with TN secondary to MS (TN-MS) and compare it to its effectiveness in primary TN (TN-P). Trigeminal neuralgia is characterized by intense, stabbing facial pain, and its occurrence in MS patients can significantly impact their quality of life.
The researchers retrospectively analyzed data from patients who received BTX-A injections for TN. The cohort included 31 patients with TN-MS and 22 with TN-P. BTX-A was administered subcutaneously and/or submucosally into the painful areas by the same physician using consistent methods. Therapeutic efficacy was defined as a ≥50% reduction in pain severity and/or frequency two weeks post-injection.
The results indicated that BTX-A treatment was effective in 52% (16 out of 31) of patients with TN-MS and 45% (10 out of 22) of those with TN-P. This suggests that BTX-A's efficacy is comparable between the two groups. Notably, the study identified factors that may predict treatment response.
"Our findings suggest that BTX-A can be a valuable tool in managing TN-MS, particularly in patients experiencing continuous pain," the authors noted. The study found that patients with concomitant continuous pain experienced greater benefit from BTX-A treatment (p = 0.047; OR: 0.046-0.98). Conversely, patients with a history of interventional treatments to the trigeminal nerve or ganglion showed reduced efficacy (p = 0.007; OR: 0.020-0.53).
These results highlight the importance of considering patient history and pain characteristics when determining the suitability of BTX-A treatment for TN-MS. While the study is limited by its retrospective nature, it provides valuable insights into the potential of BTX-A for managing this debilitating condition in MS patients. Further prospective studies are warranted to confirm these findings and optimize treatment protocols.
