Effects of Ultrasound-Guided Administration of Botulinum Toxin (IncobotulinumtoxinA) in Patients with Lateral Epicondylitis

• Published in: Toxins 2019-01, Vol.11 (1), p.46
• Main Authors: Galván Ruiz, Antonio, Vergara Díaz, Gloria, Rendón Fernández, Beatriz, Echevarría Ruiz De Vargas, Carmen
• Format: Article
• Language: English
• Subjects: Adult; Botulinum toxin; botulinum toxin A; Botulinum Toxins, Type A - administration & dosage; Botulinum Toxins, Type A - adverse effects; Elbow; Female; Females; Humans; incobotulinumtoxinA; lateral epicondylitis; Male; Mean; Middle Aged; Muscle Weakness - chemically induced; Muscle, Skeletal - drug effects; Muscles; Neuromuscular Agents - administration & dosage; Neuromuscular Agents - adverse effects; Pain; Pain - drug therapy; Patients; rehabilitation; Skeletal muscle; tennis elbow; Tennis Elbow - drug therapy; Toxins; Treatment Outcome; Ultrasonic imaging; Ultrasonography; Ultrasound; Variance analysis
• ISSN: 2072-6651; 2072-6651
• DOI: 10.3390/toxins11010046

How effective and safe are incobotulinumtoxinA injections in adult patients with lateral epicondylitis refractory to other treatments? In this experimental study, ultrasound-guided incobotulinumtoxinA 10⁻30 U/muscle was injected into extensor carpi ulnaris, extensor digiti minimi, extensor digitorum longus and extensor carpi radialis brevis muscles. Pain (visual analogue scale [VAS], 0 to 10 [no pain to severe pain]) and upper-limb functionality (QuickDASH scale, 0 to 100 [best to worst]), assessed at baseline, 1, 3 and 6 months post-treatment, were analysed using repeated-measures analysis of variance (ANOVA) and Tukey post-hoc tests. Secondary analyses stratifying patient population by sex and baseline VAS were performed. Adverse events were reported. Twenty-four patients (mean [standard deviation] age 46.8 years) were included. Compared with baseline, mean VAS and QuickDASH scores improved at all follow-ups ( < 0.001 and = 0.001, respectively; repeated-measures ANOVA). Secondary analyses revealed significant differences between baseline and all follow-ups in the group with baseline VAS ≥ 6 and in males and females (all < 0.05, Tukey post-hoc test). No adverse events, except for the expected third finger weakness, were reported. In conclusion, ultrasound-guided incobotulinumtoxinA injections may be an effective treatment for lateral epicondylitis in the appropriate patient population.