P070. A 2-year prospective evaluation study on onabotulinumtoxinA 155 U in chronic migraine

Negro, Andrea; D'Alonzo, Lidia; Lala, Noemi; Martelletti, Paolo

doi:10.1186/1129-2377-16-s1-a137

Cited by 5 publications

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“…Moreover, even if 195 U and the 155 U doses were both effective and safe in the treatment of CM with MOH [ 25 ], we found the higher dose being significantly more effective then the 155 U in terms of mean reduction of headache days, migraine days, pain medication intake days and HIT-6 score. Only the severe HIT-6 score proportion of patients did not significantly differ between OnabotulinumtoxinA 195 U and 155 U over the 24 months, with the exception of the second injection time (6 months) in which the 195 U proportion of HIT-6 severe patients resulted significantly lower.…”

Section: Discussionmentioning

confidence: 83%

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A two years open-label prospective study of OnabotulinumtoxinA 195 U in medication overuse headache: a real-world experience

et al. 2015

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BackgroundThe efficacy and safety of OnabotulinumtoxinA (BOTOX®) in adults with chronic migraine (CM) were demonstrated in the PREEMPT program. However, the dosage used in this study was flexible from 155 U to 195 U at the physician’s discretion. Therefore, the objective of this prospective study was to compare the efficacy and safety of OnabotulinumtoxinA 195 U vs. 155 U for the treatment of CM and medication overuse headache (MOH) during a 2-year period.MethodsWe prospectively evaluated the mean reduction in headache days, migraine days, acute pain medication intake days and Headache Impact Test (HIT)-6 score in 172 patients injected with OnabotulinumtoxinA 195 U. Successively, we compared the efficacy measures with data of 155 patients injected with OnabotulinumtoxinA 155 U and followed up for 2 years. All patients were affected by CM and MOH, and failed one or more previous detoxification and preventative therapies.ResultsBoth OnabotulinumtoxinA 195 U and 155 U reduced significantly the number of headache and migraine days, acute pain medication intake days and HIT-6 score, when compared with the baseline measures. Nevertheless, OnabotulinumtoxinA 195 U proved to be superior of 155 U in all efficacy measures since the first injection and for all the 2 years of treatment, with the exception of the reduction in pain medication intake days that resulted significantly larger with 195 U only after the 4th injection. The safety and tolerability of the two doses were similar and treatment related adverse events were transient and mild-moderate.ConclusionsThis study represents the largest and longest post-marketing studies of doses comparison with OnabotulinumtoxinA in a real-life clinical setting.Here, we demonstrate the superior efficacy of OnabotulinumtoxinA 195 U compared to 155 U in CM patients with MOH during a 2-year treatment period with similar safety and tolerability profile.Electronic supplementary materialThe online version of this article (doi:10.1186/s10194-016-0591-3) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 83%

“…To evaluate if the 195 U was associate with a different efficacy and tolerability than the 155 U, we compared our outcomes with those from a population of patients treated with OnabotulinumtoxinA 155 U and followed up for 2 years with the same injections and clinical evaluation schedule [ 25 ].…”

Section: Methodsmentioning

confidence: 99%

A two years open-label prospective study of OnabotulinumtoxinA 195 U in medication overuse headache: a real-world experience

et al. 2015

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“…Both patients with migraine and tension-type headache with > 4 attacks per month received oral prevention treatments according to international guidelines [21]. With regard to CM prevention, 24 (68.6%) of 35 patients with this diagnosis were prescribed quarterly injections of onabotuli-numtoxinA [22,23] and 26 (83.9%) of 31 patients with MOH started an in-patient withdrawal and rehabilitation protocol [24].…”

Section: Follow-up In the Headache Centrementioning

confidence: 99%

Rapid referral for headache management from emergency department to headache centre: four years data

et al. 2020

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Background Headache is one of the most common reason for medical consultation to emergency department (ED). The inappropriate use of ED for non-emergency conditions is a problem in terms of overcrowding of emergency facilities, unnecessary testing and treatment, increased medical costs, burden on medical service providers and weaker relationships between patient and primary care provider. The aim of this study was to analyze the different stages of ED management of headache to identify those deficiencies that can be overcome by a fast referral to a headache clinic. Methods The study is a retrospective analysis of the electronic medical records of patients discharged from an academic ED between January 1, 2015 and December 31, 2018 and referred to the tertiary level headache centre of the same hospital. We analyzed all aspects related to the permanence in ED and also assessed whether there was a match between the diagnosis made in ED and ours. Results Among our sample of 244 patients, 76.2% were admitted as “green tag”, 75% underwent a head computed tomography, 19.3% received a neurological consultation, 43% did not receive any pharmacological treatment and 62.7% still had headache at discharge. The length of stay in ED was associated with reporting the first aura ever (p = 0.014) and whether patients received consultations (p < 0.001). The concordance analysis shown a significant moderate agreement only for the diagnosis of migraine and only between triage and headache centre. Conclusions Most patients who went to ED complaining of headache received the same treatment regardless of their diagnosis and in many cases the headache had not yet resolved at the time of discharge. Given the many shortcomings in headache management in ED, rapid referral to the headache centre is of paramount importance to help the patient achieve a definiteve diagnosis and appropriate treatment.

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“…Both patients with migraine and tension-type headache with > 4 attacks per month received oral prevention treatments according to international guidelines [21]. With regard to CM prevention, 24 (68.6%) of 35 patients with this diagnosis were prescribed quarterly injections of onabotulinumtoxinA [22,23] and 26 (83.9%) of 31 patients with MOH started an in-patient withdrawal and rehabilitation protocol [24].…”

Section: Follow-up In the Headache Centrementioning

confidence: 99%

Rapid referral for headache management from Emergency Department to Headache Centre: four years data

Negro

Spuntarelli

Sciattella

et al. 2020

Preprint

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Background Headache is one of the most common reason for medical consultation to emergency department (ED). The inappropriate use of ED for non-emergency conditions is a problem in terms of overcrowding of emergency facilities, unnecessary testing and treatment, increased medical costs, burden on medical service providers and weaker relationships between patient and primary care provider. The aim of this study was to analyze the different stages of ED management of headache to identify those deficiencies that can be overcome by a fast referral to a headache clinic. Methods The study is a retrospective analysis of the electronic medical records of patients discharged from an academic ED between January 1, 2015 and December 31, 2018 and referred to the tertiary level headache centre of the same hospital. We analyzed all aspects related to the permanence in ED and also assessed whether there was a match between the diagnosis made in ED and ours. Results Among our sample of 244 patients, 76.2% were admitted as “green tag”, 75% underwent a head computed tomography, 19.3% received a neurological consultation, 43% did not receive any pharmacological treatment and 62.7% still had headache at discharge. The length of stay in ED was associated with reportin the first aura ever (p = 0.014) and whether patients received consultations (p < 0.001). The concordance analysis shown a significant moderate agreement only for the diagnosis of migraine and only between triage and headache centre. Conclusions Most patients who went to ED complaining of headache received the same treatment regardless of their diagnosis and in many cases the headache had not yet resolved at the time of discharge. Given the many shortcomings in headache management in ED, rapid referral to the headache centre is of paramount importance to help the patient achieve a definiteve diagnosis and appropriate treatment.

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P070. A 2-year prospective evaluation study on onabotulinumtoxinA 155 U in chronic migraine

Cited by 5 publications

References 1 publication

A two years open-label prospective study of OnabotulinumtoxinA 195 U in medication overuse headache: a real-world experience

A two years open-label prospective study of OnabotulinumtoxinA 195 U in medication overuse headache: a real-world experience

Rapid referral for headache management from emergency department to headache centre: four years data

Rapid referral for headache management from Emergency Department to Headache Centre: four years data

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