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Chronic migraine is one of the most common diseases in the world and it is often associated with medication overuse that can worsen the headache itself.
Medication
overuse headache (MOH) is the main and frequent evolution of chronic migraine
(CM) patients. This study puts light on that the chronic migraine and MOH are
susceptible to the use of OnabotA with an early discontinuation of medication
overused.
Chronic migraine
is one of the most common diseases in the world and it is often associated with
medication overuse that can worsen the headache itself. Thus, it is important
to adopt effective therapies to relieve pain and improve patients’ quality of
life. The PREEMT studies have already demonstrated the effectiveness of
OnabotulinumtoxinA in the treatment of chronic migraine. With this in mind, the
aim of this real life observation has been to assess the clinical improvements
as well as the impact on the quality of life of patients being regularly (every
three months) administered this therapy.
Data from 66
chronic-migraineurs treated with OnabotulinumtoxinA after failing previous
therapies were collected. Only 57 of them were analysed since 9 discontinued
the therapy due to administrative reasons. For every patient enrolled, headache
frequency, analgesic consumption, pain severity, headache-related disability,
health-related quality of life as well as anxiety and depression symptoms were
collected through the Headache Index (HI), analgesic consumption rate in one
day (AC), VAS score, Headache Impact Test (HIT-6) and the Short Form (36)
Health Survey Questionnaire Version 2 (SF-36®), Zung Self-Rating Anxiety Scale
(ZUNG-A) and Zung Self-Rating Depression Scale (ZUNG-D), respectively. All the
changes vs baseline (Tx vs T0) were expressed as mean ± SD and analysed with a
one-way ANOVA plus non-parametric Wilcoxon test, that was used for paired data
for each subject.
As the number of
injection increased, those patients injected regularly observed a statistically
significant reduction in the headache frequency, pain intensity, headache
disability score and an overall marked improvement in patients’ quality of
life. There was also a significant reduction in anxiety and depressive symptoms
as for the ZUNG-A and ZUNG-D scales scores. At any time point, those patients
who stopped the therapy worsened their overall conditions as confirmed by
quality of life parameters.
This study
outpoints that OnabotulinumtoxinA treatment is an effective treatment to reduce
the headache-related disability and improve patients’ quality of life when
patients are treated regularly every three months and consistently overtime.
Therapy discontinuation leads to a general worsening of health-related quality
of life. Long term treatment over one year confirms a consistently positive and
sustained trend of improvement with a high safety profile.
J Headache Pain 2015 Dec;17(1):48
Increased efficacy of regularly repeated cycles with OnabotulinumtoxinA in MOH patients beyond the first year of treatment
Simona Guerzoni et al.
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