ArticleFrontiers in neurology2017
Stopping Onabotulinum Treatment after the First Two Cycles Might Not Be Justified: Results of a Real-life Monocentric Prospective Study in Chronic Migraine.
Article in Frontiers in neurology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Effectiveness of onabotulinumtoxinA (BOTOX®) for the preventive treatment of chronic migraine: A meta-analysis on 10 years of real-world data.Cephalalgia : an international journal of headache · 2022Pooled it
- Reversion from chronic migraine to episodic migraine following treatment with erenumab: Results of aCephalalgia : an international journal of headache · 2021Trial
- Comparing Phase III Research Evaluating Migraine Prophylaxis Therapy (PREEMPT) and Targeted Approaches for OnabotulinumtoxinA in Chronic Migraine Treatment.Plastic and reconstructive surgery. Global open · 2026Article
- Searching for the Predictors of Response to BoNT-A in Migraine Using Machine Learning Approaches.Toxins · 2023Article
- Article
- Algometer Assessment of Pressure Pain Threshold After Onabotulinumtoxin-A and Physical Therapy Treatments in Patients With Chronic Migraine: An Observational Study.Frontiers in pain research (Lausanne, Switzerland) · 2022Article
- OnabotulinumtoxinA in Migraine: A Review of the Literature and Factors Associated with Efficacy.Journal of clinical medicine · 2021Review
- Early Management of OnabotulinumtoxinA Treatment in Chronic Migraine: Insights from a Real-Life European Multicenter Study.Pain and therapy · 2021Article
- Mapping Assessments Instruments for Headache Disorders against the ICF Biopsychosocial Model of Health and Disability.International journal of environmental research and public health · 2020Review
- Real world preventative drug management of migraine among Spanish neurologists.The journal of headache and pain · 2019Observational
- Guideline on the use of onabotulinumtoxinA in chronic migraine: a consensus statement from the European Headache Federation.The journal of headache and pain · 2018Article
- Review
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionOnabotulinum toxin A (OnabotA) cyclic treatment is approved for the prophylactic treatment of chronic migraine (CM), a highly disabling disorder. Although treatment response varies among patients, current guidelines suggest to stop treatment after cycle 2 if no response is achieved. This prospective study aimed to define, in real-life setting, the evolution of the response to OnabotA over five cycles of treatment among patients non-responding to cycle 1. The results of this study might help in decision-making, in particular whether prosecuting OnabotA further or not, when facing a patient not responding to cycle 1.
methodsPatients failing to respond at cycle 1 were recruited to complete five cycles. Key outcomes were: (i) a ≥50% reduction in headache days, (ii) a ≥50% reduction in total cumulative hours of headache on headache days and (iii) a ≥5-point improvement in Headache Impact Test-6 (HIT-6) scores.
resultsOverall, 56 patients were included. Mean age was 45.7 years (female 83.9%). Severe (≥60) HIT-6 score was reported at baseline by 95.8% of patients. Responders (headache days reduction of more than 50%) progressively increased cycle after cycle, doubling from cycle 2 to cycle 5 (from 27 to 48%). In addition, patients regressed from CM to episodic migraine moving on with each cycle, with 78% of them reaching less than nine migraine days/month after cycle 5. The headache days per month decreased significantly from cycle 1 to cycle 5 (overall from 23.3 ± 5.7 to 9.2 ± 3.6;
conclusionThe positive effect of OnabotA treatment spreads over the course of the treatment and might also manifest late in treatment course among patients with no benefit after the first two cycles. Thus, the results of this real-life study suggest to extend OnabotA treatment further, beyond cycle 2, to avoid premature withdrawal in patients who would have become responders at cycle 3, 4, or 5.
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