Headache prophylaxis with BoNTA: patient characteristics.
OBJECTIVE
To assess the characteristics of patients receiving botulinum toxin type A (BoNTA; BOTOX((R))) in the treatment of headache (HA) disorders.


METHODS
The following observational epidemiologic data and baseline patient characteristics were prospectively collected from eligible patients treated with BoNTA at 10 US HA specialty centers: demographics; HA diagnoses and characteristics (frequency, severity, and disability); prior and current HA treatments and response; clinical response to BoNTA; Migraine Disability Assessment (MIDAS) questionnaire; and adverse events. Patients maintained a daily HA diary and were evaluated at each follow-up visit.


RESULTS
Of 703 patients enrolled (mean age 43.1 years, 78.5% females, 95.4% white), nearly 66% had a diagnosis of chronic migraine (CM), with or without medication overuse. Approximately 75% had severe disability (MIDAS grade IV), and the mean pain rating was 6.5 (where 0 = no pain, 10 = pain as bad as it can be). More than 90% of patients had >or=1 prophylactic HA treatment failure; median number of failures was 4. Significant association was observed between HA frequency and MIDAS grade (P < .001). Approximately 80% of patients with CM had severe (grade IV) disability. The median number of monthly medication days was higher in the group with MIDAS grade IV (P < .001). HA frequency and severity, failed prophylactic therapies, and greater number of coexisting medical conditions were all negatively associated with measures of health-related quality of life.


CONCLUSIONS
Majority of patients treated with BoNTA in a specialty HA center presented with a CM diagnosis. HA disability was correlated with measures of frequency and treatment utilization.
Silberstein
Stephen D
SD
Jefferson Headache Center, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Marmura
Michael J
MJ
Shaw
James
J
Yu
Shengsheng
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D004185:Disability Evaluation; D004334:Drug Administration Schedule; D005260:Female; D020773:Headache Disorders / Q000188:drug therapy* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000188:drug therapy / Q000453:epidemiology; D009498:Neurotoxins / Q000627:therapeutic use*; D010147:Pain Measurement; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D017211:Treatment Failure; D055815:Young Adult
D009498:Neurotoxins; D019274:Botulinum Toxins, Type A