OnabotulinumtoxinA treatment was found to reduce the frequency and severity of monthly headache days and to improve quality of life and disability in patients with chronic migraine with or without allodynia, according to a study published in The Journal of Headache and Pain.
In this study, a total of 715 patients with chronic migraine with (n=289) and without allodynia (n=426) were enrolled and treated with 155 U onabotulinumtoxinA every 12 weeks for 9 treatment cycles. The Allodynia Symptom Checklist was used to identify participants with allodynia (score ≥3). The study’s primary outcome was reduction in monthly headache days from baseline to weeks 105 and 108 for patients with and without allodynia, respectively. Changes in the number of moderate to severe headache days, disability (assessed with the Migraine Disability Assessment questionnaire), and health-related quality of life (evaluated with the Migraine-Specific Quality-of-Life Questionnaire v2) were also examined.
OnabotulinumtoxinA was associated with a mean reduction in headache day frequency at week 108 compared with baseline in participants with and without allodynia (-10.8±7.1 and -12.5±7.4, respectively; P <.001 for both). The number of moderate to severe headache days were reduced significantly in participants with and without allodynia at week 108 compared with baseline (-9.6±6.9 and -10.5±7.2, respectively; P <.001 for both). Significant improvement in Migraine Disability Assessment scores (allodynia: -53.0±50.3; no allodynia: -37.7; P <.001 for both) and in Migraine-Specific Quality-of-Life Questionnaire Role Function Preventive scores (allodynia: 57.0±22.2; no allodynia: 62.4±22.3) were also observed at week 108 vs baseline.
“The effect of onabotulinumtoxinA on headache days at week 108 was significantly lower in patients with allodynia than in those without allodynia,” the researchers wrote. “However, the effect on other efficacy measures was similar or greater in those with allodynia vs those without allodynia, despite some reports that patients with allodynia are resistant to acute treatments.”
Young WB, Lopez JI, Rothrock JF, et al. Effects of onabotulinumtoxinA treatment in patients with and without allodynia: results of the COMPEL study. J Headache Pain. 2019;20:10.