Evidence map›Paper›PMID 41591179›Full record

SynthesisToxins2026

Botulinum Toxin Type A for the Prevention of Migraines: An Umbrella Review of Systematic Reviews.

Goli Chamani, Hajer Jasim, Ava Minston, Marlon Ferreira Dias, Rodrigo Lorenzi Poluha, Daniela A Godoi Gonçalves, Maria Christidis, Essam Ahmed Al-Moraissi, Nikolaos Christidis, Giancarlo De la Torre Canales and 1 more

Abstract readSystematic ReviewReview
In one paragraph

Synthesis in Toxins, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Review
  4. Review
  5. Article
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Goli ChamaniDivision of Oral Rehabilitation, Department of Dental Medicine, Karolinska Institutet, SE-14104 Huddinge, Sweden.ORCID 0000-0002-5532-0541
Hajer JasimDivision of Oral Rehabilitation, Department of Dental Medicine, Karolinska Institutet, SE-14104 Huddinge, Sweden.ORCID 0000-0003-2352-8070
Ava MinstonDivision of Oral Rehabilitation, Department of Dental Medicine, Karolinska Institutet, SE-14104 Huddinge, Sweden.
Marlon Ferreira DiasDivision of Oral Rehabilitation, Department of Dental Medicine, Karolinska Institutet, SE-14104 Huddinge, Sweden.ORCID 0000-0001-7837-3024
Rodrigo Lorenzi PoluhaDepartment of Dentistry, State University of Maringa (UEM), Maringá 87083-170, PR, Brazil.ORCID 0000-0001-7180-6448
Daniela A Godoi GonçalvesDepartment of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University (UNESP), Araraquara 14801-903, Brazil.ORCID 0000-0002-1987-1207
Maria ChristidisDepartment of Nursing Science, Sophiahemmet University, SE-114 86 Stockholm, Sweden.ORCID 0000-0001-6804-6855
Essam Ahmed Al-MoraissiDepartment of Oral and Maxillofacial Surgery, Faculty of Dentistry, Thamar University, Thamar 009676, Yemen.ORCID 0000-0002-3649-9662
Nikolaos ChristidisDivision of Oral Rehabilitation, Department of Dental Medicine, Karolinska Institutet, SE-14104 Huddinge, Sweden.ORCID 0000-0002-8199-7863
Giancarlo De la Torre CanalesDivision of Oral Rehabilitation, Department of Dental Medicine, Karolinska Institutet, SE-14104 Huddinge, Sweden.ORCID 0000-0002-0921-342X
Malin ErnbergDivision of Oral Rehabilitation, Department of Dental Medicine, Karolinska Institutet, SE-14104 Huddinge, Sweden.ORCID 0000-0003-4152-5439

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Botulinum toxin type A (BoNT-A) is an established preventive therapy for chronic migraines; however, uncertainty remains regarding its comparative efficacy and safety. Thus, we aimed to summarize current evidence from high-quality systematic reviews of the therapeutic effects of BoNT-A in migraine management. An umbrella review was conducted following PRISMA guidelines and registered in PROSPERO. High-quality systematic reviews with meta-analysis evaluating BoNT-A efficacy were identified through five databases up to August 2024. Primary outcomes included monthly headache frequency and severity. Methodological quality and risk of bias were assessed using the umbrella review checklist. Fourteen articles were included. Overall, quantitative evidence indicated favorable effects of BoNT-A compared with placebo for chronic migraines, across headache frequency, headache severity, and acute medication use, but less efficacy than topiramate and the CGRP monoclonal antibodies (CGRPmAbs) galcanezumab and fremanezumab. Though the adverse events were frequent, BoNT-A was generally well-tolerated. Comparative data suggested superior tolerability versus topiramate and a safety profile like CGRPmAbs. Although botulinum toxin type A is widely used as a preventive treatment for chronic migraines, the available evidence supports its efficacy at a moderate level. Further head-to-head and long-term analyses are needed to clarify its comparative role alongside newer biologic treatments.

Indexed as

Botulinum Toxins, Type AMigraine DisordersHumansSystematic Reviews as TopicBotulinum Toxins, Type Abotulinum toxin type ACGRP monoclonal antibodieschronic migrainepreventive therapyquality of lifeumbrella review

Identifiers

PMID41591179
PMCPMC12846396

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.