Long-term use of onabotulinumtoxinA for chronic migraine prophylaxis was associated with reduced headache day frequency and improved quality of life, according to a study published in the Journal of Headache and Pain.
For this open-label multicenter prospective study, a total of 633 patients with chronic migraine (average age at baseline, 45.4 years) received onabotulinumtoxinA approximately every 3 months for a duration of 24 months (mean dose, 155.1 U; mean injection sites, 31.4). Participants were assessed for injection practices, headache frequency, quality-of-life measures, health state, and adverse reactions at baseline and at each administration visit.
Patients were treated at least once, and 58.6% had ≥5 treatment sessions (number of sessions: total, 3499; mean, 5.5; maximum, 13). A total of 22.7% of participants discontinued treatment for reasons that included lack of efficacy, inconvenience, and adverse effects. Most of these patients discontinued before the fourth visit.
At baseline, participants reported an average of 20.6 headache days per month. This was reduced to an average of 7.4 days at the eighth visit (P <.001). At each administration visit, patients indicated improvements in all domains of the Migraine-Specific Quality-of-Life Questionnaire and in health state scores and total scores on the Euro Quality-of-Life 5-Dimension Questionnaire (P <.001 for all).
A total of 18.3% of participants reported an adverse drug reaction, most of which were mild to moderate, and 1.3% of which were considered serious. The remaining adverse drug reaction included eyelid ptosis, neck pain, and musculoskeletal stiffness.
Study limitations include its observational design.
“[L]ong-term…routine clinical use of onabotulinumtoxinA as a preventive medication for [chronic migraine] is efficacious and safe…. Moreover, and with the exception of dose interval, onabotulinumtoxinA was utilised in routine clinical practice as recommended in the [summary of product characteristics],” noted the study authors.
Ahmed F, Gaul C, et al. An open-label prospective study of the real-life use of onabotulinumtoxinA for the treatment of chronic migraine: The REPOSE study [published online March 7, 2019]. J Headache Pain. doi:10.1186/s10194-019-0976-1