Treating chronic migraine with onabotulinumtoxinA (BotoxTM) may reduce the number of headache days when administered according to the National Institute for Health and Care Excellence guidelines, according to a prospective study published in the European Journal of Neurology.

The study included participants with chronic migraine with or without medication overuse headache who had received at least 2 treatments of onabotulinumtoxinA (n=200). Participants completed a headache diary and Headache Impact Test-6 score at baseline and throughout the treatment period.

After 2 treatments, 63.5% of participants (n=127) had at least a 30% reduction in headache days. Participants who continued the treatment up to 3 years reported a stable beneficial effect compared with baseline.

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Among participants who responded to treatment, 53.5% (n=68) were reclassified as having episodic migraines. In 83.8% (n=57) of these individuals, headaches converted to an episodic migraine pattern after 6 months of follow-up.

The researchers did not observe any significant differences in treatment efficacy among participants treated with 155 U compared with those treated with >155 U.

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Andreou AP, Trimboli M, Al-Kaisy A, et al. A prospective real-world analysis of OnabotulinumtoxinA in chronic migraine post-NICE U.K. technology appraisal. [published online April 4, 2018] Eur J Neurol. doi:10.1111/ene.13657.