Early Management of OnabotulinumtoxinA Treatment in Chronic Migraine : Insights from a Real-Life European Multicenter Study
Ornello, Raffaele (University of L'Aquila. Neuroscience Section, Department of Applied Clinical Sciences and Biotechnology)
Ahmed, Fayyaz (Hull University Teaching Hospitals)
Negro, Andrea (Sapienza University)
Miscio, Anna Maria (Fondazione IRCCS "Casa Sollievo Della Sofferenza")
Santoro, Antonio (Fondazione IRCCS "Casa Sollievo Della Sofferenza")
Alpuente, Alicia (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Russo, Antonio (University of Campania "Luigi Vanvitelli")
Silvestro, Marcello (University of Campania "Luigi Vanvitelli".)
Cevoli, Sabina (IRCCS Istituto Delle Scienze Neurologiche Di Bologna)
Brunelli, Nicoletta (Campus Bio-Medico University Hospital)
Vernieri, Fabrizio (Campus Bio-Medico University Hospital)
Grazzi, Licia (IRCCS Foundation "Carlo Besta" Neurological Institute)
Baraldi, Carlo (University of Modena and Reggio Emilia)
Guerzoni, Simona (University of Modena and Reggio Emilia)
Andreou, Anna P. (Guy's and St Thomas' NHS Foundation Trust)
Lambru, Giorgio (Guy's and St Thomas' NHS Foundation Trust)
Frattale, Ilaria (Tor Vergata University)
Kamm, Katharina (Ludwig Maximilians University München)
Ruscheweyh, Ruth (Ludwig Maximilians University München)
Russo, Marco (Azienda USL-IRCCS Di Reggio Emilia)
Torelli, Paola (University of Parma)
Filatova, Elena (Sechenov First Moscow State Medical University)
Latysheva, Nina (Sechenov First Moscow State Medical University)
Gryglas-Dworak, Anna (Headache Center Wroclaw)
Straburzynski, Marcin (Terapia Neurologiczna Samodzielni)
Butera, Calogera (IRCCS San Raffaele Scientific Institute (Milà, Itàlia))
Colombo, Bruno (IRCCS San Raffaele Scientific Institute (Milà, Itàlia))
Filippi, Massimo (IRCCS San Raffaele Scientific Institute (Milà, Itàlia))
Pozo-Rosich, Patricia (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Martelletti, Paolo (Sapienza University'Andrea)
Sacco, Simona (University of L'Aquila)
Universitat Autònoma de Barcelona

Data:	2021
Resum:	OnabotulinumtoxinA (BT-A) quarterly was the first treatment approved specifically for chronic migraine (CM). It is unclear whether three cycles are better than two to assess early BT-A response. We performed a retrospective analysis on real-life prospectively collected data in 16 European headache centers. All the centers provided data on patients treated with BT-A for CM over the first three cycles of treatment. For each treatment cycle we defined patients as "good responders" if reporting a ≥ 50% reduction in monthly headache days compared with the three months before starting BT-A, "partial responders" if reporting a 30-49% reduction in monthly headache days, and "non-responders" if reporting a < 30% reduction in monthly headache days or stopping the treatment before the third cycle. We included 2879 patients. Seven hundred and eighty-four (64. 6%) of the 1213 patients reporting a good response during the first and/or the second cycle had a good response during the third cycle; 309 (49. 3%) of the 627 patients reporting a partial response (but no good response) during the first and/or the second cycle had a good response during the third cycle; only 65 (6. 3%) of the 1039 patients who did not respond during both the first two cycles achieved a good response during the third cycle. Multivariate analyses showed that partial or good response during the first or the second cycle were independently associated with good response during the third cycle. Our data suggest that patients with CM responding to BT-A during the first two cycles will likely benefit from the third cycle of treatment, while the probability that non-responders to the first two cycles start responding during the third cycle is low. These results can help guide the individual decision to stop or continue treatment after the second cycle in patients who have not responded to the first two cycles. The online version contains supplementary material available at 10. 1007/s40122-021-00253-0.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Chronic migraine ; Multicenter study ; OnabotulinumtoxinA ; Real-life evidence
Publicat a:	Pain and Therapy, Vol. 10 (march 2021) , p. 637-650, ISSN 2193-651X

DOI: 10.1007/s40122-021-00253-0
PMID: 33778933

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