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Eur J Neurol. 2018 Feb;25(2):411-416. doi: 10.1111/ene.13523. Epub 2017 Dec 18.

OnabotulinumtoxinA in chronic migraine: predictors of response. A prospective multicentre descriptive study.

Author information

1
Service of Neurology, Headache Unit, Hospital Clínico Universitario, University of Santiago de Compostela, Santiago de Compostela.
2
Hospital Universitario Vall d'Hebron, Headache Research Group, Vall d'Hebron Institute of Research (VHIR), Universitat Autonoma de Barcelona, Barcelona, Spain.
3
Neuroclinica and Promedan, Medellin, Colombia.
4
Hospital Universitario Reina Sofía, Córdoba.
5
Hospital Universitario Virgen del Rocío, Sevilla.
6
Hospital Clínico Universitario Lozano Blesa, Zaragoza.
7
Hospital Royo Vilanova, Zaragoza.
8
Hospital Universitario de Fuenlabrada, Madrid.
9
Hospital Universitario Basurto, Bilbao.
10
Hospital Universitario La Princesa, Madrid.
11
Hospital General Universitario de Elda, Alicante.
12
Hospital Viladecans, Barcelona.
13
Hospital Universitario de Bellvitge, Barcelona.
14
Hospital Universitario Dexeus, Barcelona.
15
OMEQUI Research Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.

Abstract

BACKGROUND AND PURPOSE:

OnabotulinumtoxinA is a treatment specifically approved for the prophylaxis of chronic migraine in adults. The aim of this study was to assess the effectiveness of OnabotulinumtoxinA in chronic migraine after 1 year of treatment in a real-life setting and to identify clinical predictors of outcome.

METHODS:

We designed a prospective multicentre study performed in 13 hospitals in Spain. Patients underwent a complete medical history and examination. They were treated with OnabotulinumtoxinA every 12 weeks for 1 year. Data about outcome, adverse events, abortive medication use, emergency room use and disability were collected at 3 and 12 months.

RESULTS:

A total of 725 subjects completed the study. At 12 months, 79.3% showed >50% reduction in number of headaches per month and 94.9% reported no adverse events. Unilaterality of pain, fewer days of disability per month and milder headache at baseline were correlated with good outcome. Duration of disease <12 months increased the chances of response to treatment with OnabotulinumtoxinA (odds ratio, 1.470; 95% confidence interval, 1.123-2.174; P = 0.045).

CONCLUSIONS:

This study confirmed the effectiveness of treatment with OnabotulinumtoxinA after 1 year of treatment. The chances of a good outcome may be increased by starting treatment in the first 12 months after chronic migraine diagnosis.

KEYWORDS:

OnabotulinumtoxinA; chronic migraine; early treatment; effectiveness; predictors

PMID:
29171146
DOI:
10.1111/ene.13523

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