Onabotulinum toxin A for treatment of chronic migraine with medication overuse

Grazzi, Licia

doi:10.1007/s10072-013-1381-1

Cited by 8 publications

(7 citation statements)

References 10 publications

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“…A similar beneficial effect was observed in patients with coexistent MOH. As such, our results, overall, are in agreement with previously published studies applying similar study design in patients with or without MOH [ 13 – 17 , 23 – 26 ].…”

Section: Discussionsupporting

confidence: 93%

“…The main limitation of our study was the relatively high percentage of early drop-outs before T3 ( n = 38; 32 %) from the initial cohort of 119 patients enrolled. Even so, the sample size of our efficacy population ( n = 81) was larger compared to other studies with similar design [ 13 – 16 ]. Moreover, ITT analysis also favoured Onabotulinumtoxin-A treatment in the current setting.…”

Section: Discussionmentioning

confidence: 90%

“…Given that recent literature contains publications reporting the outcome after administering Onabotulinumtoxin-A against CM in other South-European populations [ 13 – 17 ], but to our knowledge no such report exists from Greece, the aim of the current study was to explore and share our clinical experience with Onabotulinumtoxin-A in the treatment of CM in a cohort of Greek patients.…”

Section: Introductionmentioning

confidence: 99%

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Onabotulinumtoxin-A treatment in Greek patients with chronic migraine

et al. 2016

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BackgroundChronic migraine is a disabling condition, with limited treatment options. We conducted an open label, single arm, prospective clinical trial, to assess the efficacy and safety of onabotulinumtoxin-A in Greek patients with chronic migraine. Since recent evidence suggests that a meaningful clinical response may be delayed until after a third onabotulinumtoxin-A administration, we aimed at assessing outcomes at this time point.MethodsA total of 119 patients with CM, scheduled to be treated with Onabotulinumtoxin-A (Botox ®) every 3 months, according to the approved indication and standard clinical practice, were prospectively enrolled. Data documenting changes from baseline (T0—trimester before Onabotulinumtoxin-A first administration) to the period after its third administration (T3) in (i) mean number of monthly headache days (ii) migraine severity as expressed by the mean number of days with peak headache intensity of >4/10 in a 0–10 numerical scale, and (iii) mean number of days with use of any acute headache medication, were collected from patients’ headache diaries at each visit.ResultsOf the 119 patients, a total of 81 received 3 courses of onabotulinumtoxin-A and were included in the efficacy population. In those 81 patients, there was a significant decrease in mean headache days/month between T0 and T3 (21.3 ± 5.4 vs 7.7 ± 4.8; P < 0.001); a significant decrease in days with peak headache intensity of >4/10 (11.9 ± 5.5 vs 3.7 ± 3.3; P < 0.001) and finally, the change in days using acute headache medications per month between was also significant (16.2 ± 7.8 vs 5.2 ± 4.3; P < 0.001). Adverse events were few and of non- serious nature.ConclusionOur results strongly support the use of onabotulinumtoxin-A for the prophylaxis of CM, as this intervention proved effective, safe and well tolerated in our cohort of Greek patients.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

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Onabotulinumtoxin-A treatment in Greek patients with chronic migraine

et al. 2016

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“…A study analyzing long-term experience with OBOT-A in CM demonstrated that after an average of two years treatment with OBOT-A in responder CM patients the need for acute pain medication was decreased by 53% and emergency visits were reduced by 61% [ 77 ]. In a recent clinical trial, CM patients with medication overuse were studied after a five-day-long withdrawal period with 150 U OBOT-A injection, which confirmed the efficacy of OBOT-A [ 78 ]. Results of another clinical study in which OBOT-A was used in the dose of 155 U, in accordance with the PREEMPT study protocol, showed that the number of headache days per month and the acute medication intakes decreased significantly in the treatment group [ 79 ].…”

Section: Resultsmentioning

confidence: 99%

Treatment of Chronic Migraine with OnabotulinumtoxinA: Mode of Action, Efficacy and Safety

Delia

Csáti

Vécsei

et al. 2015

Toxins

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Background: Chronic migraine is a common, highly disabling, underdiagnosed and undertreated entity of migraine. It affects 0.9%–2.2% of the general adult population. The present paper overviews the preclinical and clinical data regarding the therapeutic effect of onabotulinumtoxinA in chronic migraineurs. Methods: A literature search was conducted in the database of PubMed up to 20 May 2015 for articles related to the pathomechanism of chronic migraine, the mode of action, and the efficacy, safety and tolerability of onabotulinumtoxinA for the preventive treatment of chronic migraine. Results: The pathomechanism of chronic migraine has not been fully elucidated. The mode of action of onabotulinumtoxinA in the treatment of chronic migraine is suggested to be related to the inhibition of the release of calcitonin gene-related peptide and substance P in the trigeminovascular system. Randomized clinical trials demonstrated that long-term onabotulinumtoxinA fixed-site and fixed-dose (155–195 U) intramuscular injection therapy was effective and well tolerated for the prophylactic treatment of chronic migraine. Conclusions: Chronic migraine is a highly devastating entity of migraine. Its exact pathomechanism is unrevealed. Two-third of chronic migraineurs do not receive proper preventive medication. Recent clinical studies revealed that onabotulinumtoxinA was an efficacious and safe treatment for chronic migraine.

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“…For example, the nerve-block procedure and botulinum toxin type A (BTX-A) injection can be beneficial for treating primary headache disorder [ 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ]. BTX-A is routinely administered as a treatment for chronic migraine in the frontal region [ 9 , 13 , 15 ]. The trigger point is generally targeted as the injection site for the BTX-A treatment to relieve the associated pain [ 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

Topographic Relationship between the Supratrochlear Nerve and Corrugator Supercilii Muscle—Can This Anatomical Knowledge Improve the Response to Botulinum Toxin Injections in Chronic Migraine?

Lee

Choi

Won

et al. 2015

Toxins

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Chronic migraine has been related to the entrapment of the supratrochlear nerve within the corrugator supercilii muscle. Recently, research has shown that people who have undergone botulinum neurotoxin A injection in frontal regions reported disappearance or alleviation of their migraines. There have been numerous anatomical studies conducted on Caucasians revealing possible anatomical problems leading to migraine; on the other hand, relatively few anatomical studies have been conducted on Asians. Thus, the aim of the present study was to determine the topographic relationship between the supratrochlear nerve and corrugator supercilii muscle in the forehead that may be the cause of migraine. Fifty-eight hemifaces from Korean and Thai cadavers were used for this study. The supratrochlear nerve entered the corrugator supercilii muscle in every case. Type I, in which the supratrochlear nerve emerged separately from the supraorbital nerve at the medial one-third portion of the orbit, was observed in 69% (40/58) of cases. Type II, in which the supratrochlear nerve emerged from the orbit at the same location as the supraorbital nerve, was observed in 31% (18/58) of cases.

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Onabotulinum toxin A for treatment of chronic migraine with medication overuse

Cited by 8 publications

References 10 publications

Onabotulinumtoxin-A treatment in Greek patients with chronic migraine

Onabotulinumtoxin-A treatment in Greek patients with chronic migraine

Treatment of Chronic Migraine with OnabotulinumtoxinA: Mode of Action, Efficacy and Safety

Topographic Relationship between the Supratrochlear Nerve and Corrugator Supercilii Muscle—Can This Anatomical Knowledge Improve the Response to Botulinum Toxin Injections in Chronic Migraine?

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