Long-term treatment of chronic migraine with onabotulinumtoxinA: Efficacy, quality of life, and tolerability in a real-life setting

Kollewe, Katja; Escher, Claus; Wulff, Dirk U.; Fathi, Davood; Paracka, Lejla; Mohammadi, Bahram; Karst, Matthias; Dressler, Dirk

doi:10.1016/j.toxicon.2016.11.144

Cited by 12 publications

(16 citation statements)

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“…Onabotulinumtoxin A (BT-A) is a safe and effective preventive treatment for CM, as shown in the Phase 3 Research Evaluating Migraine Prophylaxis Therapy (PREEMPT) trials [8][9][10][11][12]. Several real-life studies confirmed its safety and efficacy in clinical practice [13][14][15][16][17][18][19][20][21][22] and showed that a shorter disease duration, some characteristics of headache (ocular, imploding), allodynia, and the absence of medication overuse and depressive symptoms are predictors of clinical response [23][24][25][26][27][28][29][30][31][32][33]. However, it is common experience to observe fluctuations in the clinical response to BT-A as to other preventive treatments.…”

Section: Introductionmentioning

confidence: 97%

Sustained response to onabotulinumtoxin A in patients with chronic migraine: real-life data

et al. 2020

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Background: Treatment with onabotulinumtoxin A (BT-A) is safe and effective for chronic migraine (CM). Several studies assessed possible predictors of response to treatment with BT-A, but there is little knowledge on the frequency and predictors of sustained response. The aim of this study was to evaluate sustained response to BT-A in patients with CM. Main body: In this prospective open-label study, 115 patients with CM and treated with BT-A were consecutively enrolled in two Italian headache centers and followed up for 15 months. Anytime responders were defined as those patients who achieved a ≥ 50% reduction in headache days during any three-month treatment cycle compared with the 3 months prior to initiation of BT-A treatment. Sustained responders were defined as those who achieved a ≥ 50% reduction in headache days within the third treatment cycle and maintained response until the end of follow-up. Non-responders were defined as those patients who never achieved a ≥ 50% reduction in headache days during the follow-up. Headache characteristics prior to BT-A treatment were assessed in order to evaluate their ability in predicting treatment response. The 115 enrolled patients (84.3% female; median age 50 years) had a median migraine duration of 30 years (interquartile range 22-38). At the end of follow-up, 66 patients (57.4%) were classified as anytime responders. Among the 51 patients who achieved a clinical response within the third month of treatment, 33 (64.7%) were sustained responders. Patients with sustained response had a lower CM duration (median 31 vs 65 months; P = 0.030) and a lower number of headache days (median 25 vs 30; P = 0.013) at baseline compared with nonresponders. Conclusions: About two thirds of patients who gain ≥50% response to BT-A within the third cycle of treatment maintain this positive response over time. More recent onset of CM and more headache-free days at baseline are associated with sustained response. We suggest not to delay preventive treatment of CM with BT-A, in order to increase the likelihood to achieve sustained clinical response.

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Section: Introductionmentioning

confidence: 97%

Sustained response to onabotulinumtoxin A in patients with chronic migraine: real-life data

et al. 2020

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“…It is the most widely used generic questionnaire to assess the QOL. It contains 36 questions in eight health related categories: Physical Functioning (3)(4)(5)(6)(7)(8)(9)(10)(11)(12), Role Limitations due to Physical Health (13-16), Role Limitation due to emotional problems (17)(18)(19), Energy/Fatigue (23, 27, 29, and 31), Emotional well-being (24, 25, 26, 28, and 30), Social Functioning (20,32), Pain (21,22) and General health (1,(33)(34)(35)(36). It also includes which is about health change (2) compared to a year ago.…”

Section: Health Related Quality Of Life In Migraine Patients Using Gementioning

confidence: 99%

“…General drugs used for preventive therapy are beta-blockers, tricyclic antidepressants, antiepileptic, antihistamines, barbiturates, botulinum toxins, and ergot derivatives. 19,21 The main goal of migraine therapy is evolved from reducing pain towards preventing migraine symptoms and disability as well as increased HRQOL and reduction in activity limitations. 14,15 Person living with migraine often refuse or avoid taking treatment because of low healthcare focus and belief that they are not suffering from migraine but a normal headache.…”

Section: Introductionmentioning

confidence: 99%

Educational Intervention With Medications Impact on Health-Related Quality of Life in Migraineurs

Kishore¹,

Pravallika²,

Sridhar³

et al. 2019

Int. Res. J. Pharm.

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Migraine has greater impact on person's quality of life and also contributes a financial burden on health care system. Assessing quality of life of the patient has become an important tool that helps in the management of migraine. Educational programs are used to provide information and teaching the skills that are difficult to understand by patients. Migraine education programs by the Clinical Pharmacist will have a positive impact on person living with migraine understanding of the disease that results in satisfaction of the patient and can also improve migraineur physician consultation rates and overall care. The study revealed that mostly prescribed monotherapy agent is NSAID and single pill combination therapy is Antiemetic and NSAID. Monotherapy is mostly preferred than combination therapy. There was a significant improvement in the Health-related Quality of Life in the both scales, MSQ and SF 36. The patient education along with appropriate treatment helped the Migraine patients in the improvement of their Health-related Quality of life and thus decreased the Migraine related burden on the individual.

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“…Onabotulinumtoxin A (BT-A) is a safe and effective preventive treatment for CM, as shown in the Phase 3 Research Evaluating Migraine Prophylaxis Therapy (PREEMPT) trials [7][8][9][10][11]. Several real-life studies confirmed its safety and efficacy in clinical practice [12][13][14][15][16][17][18][19][20][21] and showed that a shorter disease duration, some characteristics of headache (ocular, imploding), allodynia, and the absence of medication overuse and depressive symptoms are predictors of clinical response [22][23][24][25][26][27][28][29][30][31][32]. However, it is common experience to observe fluctuations in the clinical response to BT-A as to other preventive treatments.…”

Section: Introductionmentioning

confidence: 97%

Sustained Response To Onabotulinumtoxin A In Patients With Chronic Migraine: Real-Life Data

Ornello

Guerzoni

Baraldi

et al. 2020

Preprint

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Background Treatment with onabotulinumtoxin A (BT-A) is safe and effective for chronic migraine (CM). Several studies assessed possible predictors of response to treatment with BT-A, but there is little knowledge on the frequency and predictors of sustained response. The aim of this study was to evaluate sustained response to BT-A in patients with CM. Main body In this prospective open-label study, 115 patients with CM and treated with BT-A were consecutively enrolled in two Italian headache centers and followed up for 15 months. Anytime responders were defined as those patients who achieved a ≥50% reduction in headache days during any three-month treatment cycle compared with the three months prior to initiation of BT-A treatment. Sustained responders were defined as those who achieved a ≥50% reduction in headache days within the third treatment cycle and maintained response until the end of follow-up. Non-responders were defined as those patients who never achieved a ≥50% reduction in headache days during the follow-up. Headache characteristics prior to BT-A treatment were assessed in order to evaluate their ability in predicting treatment response. The 115 enrolled patients (84.3% female; median age 50 years) had a median migraine duration of 30 years (interquartile range 22-38). At the end of follow-up, 66 patients (57.4%) were classified as anytime responders. Among the 51 patients who achieved a clinical response within the third month of treatment, 33 (64.7%) were sustained responders. Patients with sustained response had a lower CM duration (median 31 vs 65 months; P=0.030) and a lower number of headache days (median 25 vs 30; P=0.013) at baseline compared with non-responders. Conclusions About two thirds of patients who gain ≥50% response to BT-A within the third cycle of treatment maintain this positive response over time. More recent onset of CM and more headache-free days at baseline are associated with sustained response. We suggest not to delay preventive treatment of CM with BT-A, in order to increase the likelihood to achieve sustained clinical response.

show abstract

Long-term treatment of chronic migraine with onabotulinumtoxinA: Efficacy, quality of life, and tolerability in a real-life setting

Cited by 12 publications

References 0 publications

Sustained response to onabotulinumtoxin A in patients with chronic migraine: real-life data

Sustained response to onabotulinumtoxin A in patients with chronic migraine: real-life data

Educational Intervention With Medications Impact on Health-Related Quality of Life in Migraineurs

Sustained Response To Onabotulinumtoxin A In Patients With Chronic Migraine: Real-Life Data

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