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. 2016 May 13;2016(5):CD004315. doi: 10.1002/14651858.CD004315.pub3

Comparison 1. Botulinum toxin type B vs Placebo.

Outcome or subgroup title No. of studies No. of participants Statistical method Effect size
1 Overall cervical dystonia improvement as assessed with TWSTRS: change from baseline to week 4 3   Mean Difference (Fixed, 95% CI) 6.78 [4.54, 9.01]
2 Overall cervical dystonia improvement as assessed with TWSTRS: change from baseline to week 4 ‐ Doses subgroup analysis 4   Mean Difference (Fixed, 95% CI) Subtotals only
2.1 2500 units 2   Mean Difference (Fixed, 95% CI) 6.95 [3.70, 10.21]
2.2 5000 units 3   Mean Difference (Fixed, 95% CI) 6.10 [3.40, 8.81]
2.3 10,000 units 4   Mean Difference (Fixed, 95% CI) 8.72 [6.35, 11.10]
3 Overall cervical dystonia improvement as assessed with TWSTRS: change from baseline to week 4 ‐ BtA‐responsive vs BtA‐non‐responsive subgroup analysis 2   Mean Difference (Fixed, 95% CI) 7.56 [4.41, 10.71]
3.1 BtA‐responsive 1   Mean Difference (Fixed, 95% CI) 9.0 [4.46, 13.54]
3.2 BtA‐non‐responsive 1   Mean Difference (Fixed, 95% CI) 6.22 [1.83, 10.60]
4 Proportion of participants with adverse events 2 186 Risk Ratio (M‐H, Fixed, 95% CI) 1.09 [0.97, 1.23]
5 Proportion of participants with adverse events ‐ doses subgroup analysis 2   Risk Ratio (M‐H, Random, 95% CI) Subtotals only
5.1 5000 U 1 72 Risk Ratio (M‐H, Random, 95% CI) 1.07 [0.89, 1.29]
5.2 10,000 U 2 150 Risk Ratio (M‐H, Random, 95% CI) 1.09 [0.89, 1.33]
6 Proportion of participants with adverse events ‐ BtA‐responsive vs BtA‐non‐responsive subgroup analysis 2   Risk Ratio (M‐H, Random, 95% CI) Subtotals only
6.1 BtA‐responsive 1 73 Risk Ratio (M‐H, Random, 95% CI) 0.97 [0.79, 1.20]
6.2 BtA‐non‐responsive 1 77 Risk Ratio (M‐H, Random, 95% CI) 1.19 [1.03, 1.37]
7 Subjective change as assessed by the participant at week 4 3 316 Std. Mean Difference (IV, Fixed, 95% CI) 0.86 [0.61, 1.10]
8 Subjective change as assessed by the clinician at week 4 3 316 Std. Mean Difference (IV, Fixed, 95% CI) 0.80 [0.55, 1.04]
9 Subjective change as assessed by the participant at week 4 ‐ doses subgroup analysis 3   Mean Difference (IV, Fixed, 95% CI) Subtotals only
9.1 2500 U 1 67 Mean Difference (IV, Fixed, 95% CI) 12.30 [4.21, 20.39]
9.2 5000 U 2 137 Mean Difference (IV, Fixed, 95% CI) 9.71 [4.05, 15.37]
9.3 10,000 U 3 214 Mean Difference (IV, Fixed, 95% CI) 15.12 [10.32, 19.91]
10 Subjective change as assessed by the clinician at week 4 ‐ doses subgroup analysis 3   Mean Difference (IV, Fixed, 95% CI) Subtotals only
10.1 2500 U 1 67 Mean Difference (IV, Fixed, 95% CI) 8.60 [1.46, 15.74]
10.2 5000 U 2 137 Mean Difference (IV, Fixed, 95% CI) 10.84 [5.65, 16.04]
10.3 10,000 U 3 214 Mean Difference (IV, Fixed, 95% CI) 13.22 [9.39, 17.05]
11 Subjective change as assessed by the participant at week 4 ‐ BtA‐responsive vs BtA‐non‐responsive subgroup analysis 2 186 Mean Difference (IV, Fixed, 95% CI) 19.83 [13.61, 26.05]
11.1 BtA‐responsive 1 109 Mean Difference (IV, Fixed, 95% CI) 19.03 [10.41, 27.65]
11.2 BtA‐non‐responsive 1 77 Mean Difference (IV, Fixed, 95% CI) 20.70 [11.73, 29.67]
12 Subjective change as assessed by the clinician at week 4 ‐ BtA‐non‐responsive vs ‐responsive subgroup analysis 2   Mean Difference (IV, Fixed, 95% CI) Subtotals only
12.1 BtA‐responsive 1 109 Mean Difference (IV, Fixed, 95% CI) 12.74 [5.83, 19.65]
12.2 BtA‐non‐responsive 1 77 Mean Difference (IV, Fixed, 95% CI) 12.70 [7.04, 18.36]
13 Cervical dystonia associated pain: change from baseline to week 4 as assessed with TWSTRS 2   Mean Difference (Fixed, 95% CI) 2.20 [1.25, 3.15]
14 Cervical dystonia associated pain: change from baseline to week 4 as assessed with TWSTRS ‐ doses subgroup analysis 3   Mean Difference (Fixed, 95% CI) Subtotals only
14.1 2500 units 2   Mean Difference (Fixed, 95% CI) 2.58 [1.33, 3.84]
14.2 5000 units 2   Mean Difference (Fixed, 95% CI) 2.05 [0.83, 3.27]
14.3 10,000 units 3   Mean Difference (Fixed, 95% CI) 3.07 [1.99, 4.14]
15 Cervical dystonia associated pain: change from baseline to week 4 as assessed with validated scales ‐ BtA‐responsive vs BtA‐non‐responsive subgroup analysis 2   Std. Mean Difference (Fixed, 95% CI) 0.96 [0.65, 1.27]
15.1 BtA‐responsive 1   Std. Mean Difference (Fixed, 95% CI) 0.92 [0.50, 1.34]
15.2 BtA‐non‐responsive 1   Std. Mean Difference (Fixed, 95% CI) 1.01 [0.53, 1.48]
16 Cervical dystonia severity: change from baseline to week 4 as assessed with TWSTRS 2   Mean Difference (Fixed, 95% CI) 2.43 [1.24, 3.63]
17 Cervical dystonia severity: change from baseline to week 4 as assessed with TWSTRS ‐ doses subgroup analysis 3   Mean Difference (Fixed, 95% CI) Subtotals only
17.1 2500 units 2   Mean Difference (Fixed, 95% CI) 1.9 [0.55, 3.25]
17.2 5000 units 2   Mean Difference (Fixed, 95% CI) 2.51 [1.25, 3.77]
17.3 10,000 units 3   Mean Difference (Fixed, 95% CI) 2.96 [1.87, 4.05]
18 Cervical dystonia associated disability: change from baseline to week 4 as assessed with TWSTRS 2   Mean Difference (Fixed, 95% CI) 2.29 [1.04, 3.54]
19 Cervical dystonia associated disability: change from baseline to week 4 as assessed with TWSTRS ‐ doses subgroup analysis 3   Mean Difference (Fixed, 95% CI) Subtotals only
19.1 2500 units 2   Mean Difference (Fixed, 95% CI) 2.32 [0.86, 3.78]
19.2 5000 units 2   Mean Difference (Fixed, 95% CI) 2.06 [0.55, 3.57]
19.3 10,000 units 3   Mean Difference (Fixed, 95% CI) 3.22 [2.09, 4.35]
20 Proportion of withdrawals due to adverse events 4 440 Risk Ratio (M‐H, Fixed, 95% CI) 0.88 [0.19, 4.06]
21 Adverse events: dry mouth 4 438 Risk Ratio (M‐H, Fixed, 95% CI) 7.65 [2.75, 21.32]
22 Adverse events: dysphagia 4 438 Risk Ratio (M‐H, Fixed, 95% CI) 6.78 [2.42, 19.05]
23 Adverse events: dry mouth ‐ doses subgroup analysis 4   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
23.1 2500 U 2 128 Risk Ratio (M‐H, Fixed, 95% CI) 0.97 [0.06, 14.78]
23.2 5000 U 3 198 Risk Ratio (M‐H, Fixed, 95% CI) 3.94 [0.87, 17.86]
23.3 10,000 U 4 274 Risk Ratio (M‐H, Fixed, 95% CI) 11.47 [3.95, 33.30]
24 Adverse events: dysphagia ‐ doses subgroup analysis 4   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
24.1 2500 U 2 128 Risk Ratio (M‐H, Fixed, 95% CI) 6.79 [0.86, 53.63]
24.2 5000 U 3 198 Risk Ratio (M‐H, Fixed, 95% CI) 5.50 [1.25, 24.17]
24.3 10,000 U 4 274 Risk Ratio (M‐H, Fixed, 95% CI) 9.19 [3.38, 25.01]
25 Adverse events: infection 3 308 Risk Ratio (M‐H, Random, 95% CI) 1.14 [0.38, 3.38]
26 Adverse events: neck pain secondary to CD 3 308 Risk Ratio (M‐H, Fixed, 95% CI) 1.08 [0.67, 1.73]
27 Adverse events: injection site pain 4 438 Risk Ratio (M‐H, Fixed, 95% CI) 1.39 [0.73, 2.66]
28 Adverse events: nausea 2 199 Risk Ratio (M‐H, Fixed, 95% CI) 2.06 [0.68, 6.28]
29 Adverse events: headache 3 361 Risk Ratio (M‐H, Fixed, 95% CI) 1.90 [0.82, 4.41]
30 Adverse events: flu syndrome 3 361 Risk Ratio (M‐H, Random, 95% CI) 1.44 [0.23, 8.92]
31 Adverse events: pain 2 231 Risk Ratio (M‐H, Fixed, 95% CI) 1.15 [0.51, 2.62]