Impact of long term treatment with OnabotulinumtoxinA in chronic migraine

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Impact of long term treatment with OnabotulinumtoxinA in chronic migraine

The effectiveness of the botulinum toxin in the treatment of migraine is already known, but the long term efficacy and tolerability has not been explored yet. A recent study was conducted to evaluate the efficacy, quality of life and tolerability of onabotulinumtoxinA in a real-life setting.

A total of 27 patients (age 45.6 ± 10.8 years, 25 females, 2 males) were given altogether 176 injection series (IS) with 189.7 ± 45.8MU onabotulinumtoxinA (Botox(®) according to the PREEMPT scheme. Each patient was given 6.5 ± 2.9 (min 4, max 13) IS throughout the study.

Significant improvement was seen in 96% patients. There was reduction in monthly headache days from 18.9 ± 3.9 to 8.7 ± 4.5 (p < 0.001, -53.7 %), migraine days from 16.8 ± 4.9 to 7.4 ± 4.6 (p < 0.001, -55.1 %), autonomic days from 8.6 ± 7.5 to 2.7 ± 4.2 (p < 0.001, -71.9 %) and medication days from 14.2 ± 4.6 to 8.3 ± 4.2 (p < 0.001, -71.1 %). There was improvement in health-related quality of life by 0.6-1.5 standard deviations (SD) (Short Form Health Survey), migraine-related quality of life by 1.4-2.0 SD (Migraine-Specific Quality of Life Questionnaire) and by 1.9 SD (Headache Impact Test), depression by 1.1 SD (Beck Depression Inventory). Subjective global clinical improvement was 2.6 ± 0.6 as measured on global clinical improvement scale.

All the improvements were stable during the study and few mild adverse effects were reported. This study provides a strong evidence about the efficacy and safety of botulinum toxin in the long term treatment of chronic migraine.

J Neural Transm (Vienna).

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