Botox reduces the impact of chronic migraine

This article summarizes data supporting the use of "botox" for migraine treatment. JR

Neurology. 2011 Sep 28. [Epub ahead of print]

OnabotulinumtoxinA improves quality of life and reduces impact of chronic migraine.

Lipton RB, Varon SF, Grosberg B, McAllister PJ, Freitag F, Aurora SK, Dodick DW, Silberstein SD, Diener HC, Degryse RE, Nolan ME, Turkel CC.

Source

From the Albert Einstein College of Medicine (R.B.L., B.G.), Bronx; Montefiore Headache Center (R.B.L., B.G.), Bronx, NY; Allergan, Inc. (S.F.V., R.E.D., C.C.T.), Irvine, CA; Associated Neurologists of Southern Connecticut (P.J.M.), Fairfield, CT; Baylor University Medical Center (F.F.), Dallas, TX; Swedish Neuroscience Institute (S.K.A.), Seattle, WA; Mayo Clinic Arizona (D.W.D.), Phoenix; Thomas Jefferson University (S.D.S.), Philadelphia, PA; University of Essen (H.C.D.), Essen, Germany; and Imprint Publication Science (M.E.N.), New York, NY.

Abstract

OBJECTIVE:

To assess the effects of treatment with onabotulinumtoxinA (Botox, Allergan, Inc., Irvine, CA) on health-related quality of life (HRQoL) and headache impact in adults with chronic migraine (CM).

METHODS:

The Phase III Research Evaluating Migraine Prophylaxis Therapy (PREEMPT) clinical program (PREEMPT 1 and 2) included a 24-week, double-blind phase (2 12-week cycles) followed by a 32-week, open-label phase (3 cycles). Thirty-one injections of 5U each (155 U of onabotulinumtoxinA or placebo) were administered to fixed sites. An additional 40 U could be administered "following the pain." Prespecified analysis of headache impact (Headache Impact Test [HIT]-6) and HRQoL (Migraine-Specific Quality of Life Questionnaire v2.1 [MSQ]) assessments were performed. Because the studies were similar in design and did not notably differ in outcome, pooled results are presented here.

RESULTS:

A total of 1,384 subjects were included in the pooled analyses (onabotulinumtoxinA, n = 688; placebo, n = 696). Baseline mean total HIT-6 and MSQ v2.1 scores were comparable between groups; 93.1% were severely impacted based on HIT-6 scores ≥60. At 24 weeks, in comparison with placebo, onabotulinumtoxinA treatment significantly reduced HIT-6 scores and the proportion of patients with HIT-6 scores in the severe range at all timepoints including week 24 (p < 0.001). OnabotulinumtoxinA treatment significantly improved all domains of the MSQ v2.1 at 24 weeks (p < 0.001).

CONCLUSIONS:

Treatment of CM with onabotulinumtoxinA is associated with significant and clinically meaningful reductions in headache impact and improvements in HRQoL.Classification of evidence:This study provides Class 1A evidence that onabotulinumtoxinA treatment reduces headache impact and improves HRQoL.

PMID:

 

21956721

 

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