Monocentric Prospective Study into the Sustained Effect of Incobotulinumtoxin A (XEOMIN®) Botulinum Toxin in Chronic Refractory Migraine

Ion, Ioana; Renard, Dimitri; Floch, Anne Le; Verdal, Marie De; Bouly, S.; Wacongne, Anne; Lozza, Alessandro; Castelnovo, Giovanni

doi:10.3390/toxins10060221

Cited by 13 publications

(8 citation statements)

References 18 publications

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“…The reduction of headache days and pain intensity was 48.5% and 20.5%, respectively, both statistically significant (p <0.006). Ion et al, (2018) intervened 61 patients -mean age 50 years old, 87% women, mean infiltration of 3.5. 73% showed a reduction greater than 50% for the frequency of migraine episodes, 48% for headache days and 48% for drug use.…”

Section: Neurological Manifestations Associated With Sars-cov-2 Infection: a Narrative Reviewmentioning

confidence: 99%

São Paulo Medical Journal

2021

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Section: Neurological Manifestations Associated With Sars-cov-2 Infection: a Narrative Reviewmentioning

confidence: 99%

São Paulo Medical Journal

2021

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“…When responsiveness was quantified as a decrease in migraine attacks of at least 50%, there was a 73% response rate. Measured as a decrease of >50% in abortive medication use, the response rate was 46% [ 24 ].…”

Section: Introductionmentioning

confidence: 99%

A Retrospective Comparison of Onabotulinum Toxin A and Incobotulinum Toxin A in Terms of Efficacy, Tolerability, Duration of Effect, and Pain on Injection Administration Site for the Treatment of Chronic Migraine

Lucchese,

Daripa,

Pulimamidi

2024

Cureus

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Background Onabotulinum toxin A (OnA) is a well-tolerated and effective treatment for chronic migraine (CM). However, based on research indications that incobotulinum toxin A (InA) would be equally effective, a Veterans Health Administration medical center mandated a two-year trial of InA as a more cost-effective alternative to OnA. Although InA is used for many similar indications as OnA, it is not Food and Drug Administration-approved for treating CM, and complications occurred in several patients with CM following this treatment change. We conducted this retrospective analysis to evaluate differences in the efficacy of OnA and InA and identify the reasons for the adverse effects of InA in some of these patients. Methods We performed a retrospective review of 42 patients who had been effectively treated with OnA and were then switched to InA. The differences between treatment responses to OnA and InA were assessed through the evaluation of pain on injection, number of headache days, and duration of action. Patients received injections at 10- to 13-week intervals. Those who reported severe pain on injection of InA were switched back to OnA. Results Severe burning pain on InA injection was reported by 38% of patients (nine males and seven females, i.e., a total of 16 patients out of 42 patients). One male patient reported the same degree of pain from both InA and OnA injections. A total of 66.7% of women with obesity and 83.3% of men with obesity or diabetes experienced severe pain on injection. Neither migraine suppression nor the duration of effect was significantly different between OnA and InA. Conclusions OnA is better tolerated than InA in the treatment of CM. InA appears to effectively suppress migraines, but some patients complain of a severe localized burning sensation during the injections. Some of these patients, all of whom were previously treated with OnA, requested to switch back to OnA. This suggested that InA is not equivalent to OnA in terms of tolerability and effectiveness. The present study found 2.38% of patients experienced an insufficient duration of effect with InA, and none with OnA. However, these lower rates may, in part, be due to variability in injection intervals in this sample, which could be because of scheduling considerations at the Harry S. Truman Veterans Health Administration Medical Center. In cases where OnA fails because of the development of antibodies, it might be reasonable to switch to InA treatment. Reformulation of InA with a pH-buffered solution may eliminate the difference in pain on injection. InA would then be a good alternative to OnA for treating CM.

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“…When responsiveness was quanti ed as a decrease in migraine attacks of at least 50%, there was a 73% response rate. Measured as a decrease of >50% in abortive medication use, the response rate was 46% [24].…”

Section: Introductionmentioning

confidence: 99%

Onabotulinum toxin A vs. incobotulinum toxin A for the treatment of chronic migraine: a retrospective review

Lucchese

Daripa

Pulimamidi

2023

Preprint

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Background: Onabotulinum toxin A (OnA) is a well-tolerated and effective treatment for chronic migraine (CM). However, based on research indications that incobotulinum toxin A (InA) would be equally effective, a Veterans’ Health Administration Medical Center mandated a 2-year trial of InA as more cost-effective alternative to OnA. Although InA is used for many similar indications as OnA, it is not Food and Drug Administration approved for treating CM, and complications occurred in several patients with CM following this treatment change. We conducted this retrospective analysis to evaluate differences in the efficacy of OnA and InA and identify the reasons for the adverse effects of InA in some of these patients. Methods: We performed a retrospective review of 42 patients who had been effectively treated with OnA and were then switched to InA. The differences between treatment responses to OnA and InA were assessed through the evaluation of pain on injection, number of headache days, and duration of action. Patients received injections at 10- to 13-week intervals. Those who reported excessive pain on injection of InA were switched back to OnA. Findings: Severe burning pain on injection was reported by 16 (38%) patients for InA only and by 1 (2%) patient for both InA and OnA. Neither migraine suppression nor the duration of effect was significantly different between OnA and InA. Conclusions: Reformulation of InA with a pH-buffered solution may eliminate the difference in pain on injection. InA would then be a good alternative to OnA for treating CM.

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Monocentric Prospective Study into the Sustained Effect of Incobotulinumtoxin A (XEOMIN®) Botulinum Toxin in Chronic Refractory Migraine

Cited by 13 publications

References 18 publications

São Paulo Medical Journal

São Paulo Medical Journal

A Retrospective Comparison of Onabotulinum Toxin A and Incobotulinum Toxin A in Terms of Efficacy, Tolerability, Duration of Effect, and Pain on Injection Administration Site for the Treatment of Chronic Migraine

Onabotulinum toxin A vs. incobotulinum toxin A for the treatment of chronic migraine: a retrospective review

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