An Exploratory Study of Salivary Calcitonin Gene‐Related Peptide Levels Relative to Acute Interventions and Preventative Treatment With Onabotulinumtoxin<scp>A</scp> in Chronic Migraine

Cady, Roger; Turner, Ira M.; Dexter, Kent; Beach, M.E.; Cady, Ryan J.; Durham, Paul L.

doi:10.1111/head.12250

Cited by 47 publications

(37 citation statements)

References 30 publications

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“…Different studies have tried to find predictors of response to treatment with OnabotA either through clinical characteristics, neuroimaging features, or molecular biomarkers . Interictal GCRP levels have recently been described as predictors of response to OnabotA in CM when measured in peripheral blood or saliva …”

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confidence: 99%

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CGRP and PTX3 as Predictors of Efficacy of Onabotulinumtoxin Type A in Chronic Migraine: An Observational Study

et al. 2017

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confidence: 99%

“…20,21 Interictal GCRP levels have recently been described as predictors of response to OnabotA in CM when measured in peripheral blood or saliva. 22,23 The aim of this study is to identify potential molecular markers in peripheral blood that can predict outcome after treatment with OnabotA in CM patients.…”

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confidence: 99%

CGRP and PTX3 as Predictors of Efficacy of Onabotulinumtoxin Type A in Chronic Migraine: An Observational Study

et al. 2017

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“…The effect of BoNTA in the nervous system is the specific cleavage of synaptosomal membrane-associated protein 25 kDa (SNAP-25) [78][79][80]. In clinical testing, it has been revealed that BoNTA diminished the interictal CGRP serum level in CM patients and was also able to reduce central sensitization [4,[81][82][83]. The non-toxic components of the two forms of BoNTA (onabotulinum toxin A and abobotulinumtoxin A) each include a hemagglutinin [80].…”

Section: Bonta-hemagglutinin Complex Injection Therapy In Migrainementioning

confidence: 99%

Therapeutic strategies that act on the peripheral nervous system in primary headache disorders

Tajti

Delia

Nyári

et al. 2019

Expert Review of Neurotherapeutics

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Introduction: Acute and preventive treatment of primary headache disorders is not completely resolved with regard to efficacy, safety, and tolerability. Hence, peripheral and central neuromodulation can provide therapeutic alternatives in drug-resistant cases. Peripheral targets of neuromodulation include invasive and non-invasive neurostimulation and electrical and chemical nerve and ganglion blockades. Areas covered: A PubMed search of papers published from January 2012 to October 2018 was conducted. The goal of this review was to analyze the efficacy and safety of invasive (implantable) peripheral neurostimulation methods (the occipital nerve, the cervical branch of vagal nerve, the sphenopalatine ganglion) and non-invasive (transcutaneous) peripheral neurostimulation methods (the occipital nerve, the supraorbital nerve, and the cervical and auricular branches of the vagal nerve), based on the results of published clinical trials and case series. Acting also on the peripheral nervous system, peripheral nerve (i.e. greater occipital nerve) and ganglion (i.e. sphenopalatine ganglion) blockades, botulinum neurotoxin type A-hemagglutinin complex therapies, and calcitonin generelated peptide-related monoclonal antibody treatments in this patient population are also discussed. Expert opinion: This review summarizes the latest results on the therapeutic strategies acting on the periphery in primary headache disorders. These therapeutic options are minimally invasive or noninvasive, efficacious, safe, and well tolerated. ARTICLE HISTORY

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“…Seeking clinical biomarkers that may contribute to predict how our patients will evolve is an important goal for physicians since it helps to manage both patient and physician’s expectations, better understand the mechanisms of CM, and optimize the therapeutic resources . So far, most predictors of response to OnabotulinumtoxinA are not only based on clinical features, but also in molecular biomarkers such as calcitonin gene‐related peptide (CGRP) . However, results are limited or controversial, and are based on the presence of a good response (>50%).…”

Section: Introductionmentioning

confidence: 99%

“…16 So far, most predictors of response to OnabotulinumtoxinA are not only based on clinical features, [17][18][19][20][21] but also in molecular biomarkers such as calcitonin gene-related peptide (CGRP). [22][23][24] However, results are limited or controversial, and are based on the presence of a good response (>50%).…”

Section: Introductionmentioning

confidence: 99%

Short and Mid‐Term Predictors of Response to OnabotulinumtoxinA: Real‐Life Experience Observational Study

et al. 2020

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Objective To identify clinical predictors of excellent response to OnabotulinumtoxinA in patients with chronic migraine (CM) at 6 and 12 months of follow‐up. Background Clinical predictors of response to OnabotulinumtoxinA are scarce and have not been clearly reproduced and analyzed in detail. So far, predictors of response to OnabotulinumtoxinA assess response in general or good response, but not an excellent response. Methods Cohort study of patients attended in a specialized Headache Clinic in treatment with OnabotulinumtoxinA were classified according to their improvement in frequency: no‐response (<25%) and excellent response (≥75%). A comparative analysis was carried out at 6 and 12 months identifying clinical predictors of excellent response to OnabotulinumtoxinA at each timepoint. Results Data were collected from 221 patients. After 6 and also 12 months, we observed a statistically significant mean reduction in frequency and analgesic intake. At month 6, independent variables associated with excellent response (OR[95%CI]) were daily headache frequency (0.32[0.14‐0.74]; P = .005), medication overuse (MO) (2.28[1.19‐4.37]; P = .013), and a higher ratio of migraine days/month (MDM) (1.20[1.10‐1.45]; P = .018) at baseline. At month 12, independent predictors of excellent response were patients with less than 30 years of migraine evolution (0.43[0.23‐0.82]; P = .011), presence of anxiety (0.44[0.23‐0.85]; P = .018), and aura (0.48[0.25‐0.92]; P = .037). Excellent responders showed a higher improvement rate in pain intensity at 6 and 12 months. Conclusions Patients with daily frequency and MO show a clinical improvement in short‐term. Patients with comorbidities who start treatment earlier in the course of the disease need a longer duration of treatment. The profile of response to treatment with OnabotulinumtoxinA determines its minimum treatment duration and the timepoint of a meaningful response.

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An Exploratory Study of Salivary Calcitonin Gene‐Related Peptide Levels Relative to Acute Interventions and Preventative Treatment With OnabotulinumtoxinA in Chronic Migraine

Abstract: While CGRP levels were not elevated during a migraine attack in chronic migraine subjects as has been reported in episodic migraine, there was an overall decrease in the baseline/interictal levels in response to onabotulinumtoxinA.

Cited by 47 publications

References 30 publications

CGRP and PTX3 as Predictors of Efficacy of Onabotulinumtoxin Type A in Chronic Migraine: An Observational Study

CGRP and PTX3 as Predictors of Efficacy of Onabotulinumtoxin Type A in Chronic Migraine: An Observational Study

Therapeutic strategies that act on the peripheral nervous system in primary headache disorders

Short and Mid‐Term Predictors of Response to OnabotulinumtoxinA: Real‐Life Experience Observational Study

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