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OnabotulinumtoxinA treatment was found to reduce the frequency of headache days in patients with chronic migraine with and without daily headaches, according to a study published in the Journal of Headache and Pain.
Patients with chronic migraine with and without daily headache (n=138 and n=503, respectively) received onabotulinumtoxinA 155 U with or without concomitant oral preventative treatment were stratified according to daily headache status based on daily diary reporting during a 28-day baseline period. The study’s primary outcome was reduction in headache-day frequency per 28-day period at 108 weeks (after 9 treatment cycles) compared with baseline. The number of moderate to severe headache days, migraine disability (evaluated with the Migraine Disability Assessment [MIDAS] questionnaire), and health-related quality of life (assessed with the Migraine-Specific Quality-of-Life Questionnaire v2 [MSQ]) were the study’s secondary outcomes.
Treatment with onabotulinumtoxinA was associated with a mean reduction in 28-day headache frequency at week 108 in participants with and without daily headache (−10.5 vs −12.2, respectively; P <.001 for both). There was no between-group difference (P =.132). At week 108, the mean reduction in moderate to severe headache days was significant in participants with and without daily headache (−11.5 and −9.9, respectively; P <.001 for both), with no between-group difference (P =.153).
From baseline to week 108, MIDAS scores were improved in participants with and without daily headache (−43.4 and −43.6, respectively; P <.001 for both), with no significant between-group difference (P =.962). Results were similar for MSQ subscale scores.
The results indicate that onabotulinumtoxinA was well tolerated in both participants with and without daily headache.
“Although patients with daily headache may need to continue treatment with onabotulinumtoxinA for up to 9 cycles to experience maximal benefit in headache-day reduction, clinically meaningful reductions in migraine-related disability and quality of life occur earlier,” the researchers wrote.
Reference
Young WB, Lopez JI, Rothrock JF, et al. Effects of onabotulinumtoxinA treatment in chronic migraine patients with and without daily headache at baseline: results from the COMPEL study [published online February 1, 2019]. J Headache Pain. doi:10.1186/s10194-018-0953-0
