title: IncobotulinumtoxinA for Migraine: A Retrospective Case Series.
abstract: OBJECTIVE
  IncobotulinumtoxinA is used for treating certain movement disorders but lacks published clinical data on use in chronic migraine.
  
  
  METHODS
  This retrospective case series was performed by using electronic chart reviews on patients receiving incobotulinumtoxinA for migraine at the Veterans Affairs San Diego Healthcare System between September 2013 and March 2014. Patients were administered 150 units each, with similar methods used for onabotulinumtoxinA injections.
  
  
  RESULTS
  A total of 21 patients were included in the analysis. Patients were 40 years old on average, 67% white, and 52% female. Patients had trialed an average of 4.19 oral prophylactic agents for migraine with 43% having previous history of onabotulinumtoxinA use and 29% having a history of traumatic brain injury. Patients reported a decrease in headache days per month (19.1 vs 9.1; P < 0.001) and headache intensity (8.3 vs 4.1; P < 0.001) after incobotulinumtoxinA injections. Most patients experienced an improvement in headache frequency and/or intensity (81.8%). The duration of action for these patients averaged 81.9 days (median, 70 days).
  
  
  CONCLUSIONS
  Significant improvements in headache frequency and intensity were observed. Chronic migraine is not an indication approved by the US Food and Drug Administration for incobotulinumtoxinA; however, the drug's effectiveness was documented in this small patient population.
authors.affiliation: Veterans Affairs San Diego Healthcare System, San Diego, California; University of California San Diego, San Diego, CA. Electronic address: rashid.kazerooni@va.gov.
authors.forename: Rashid
authors.initials: R
authors.lastname: Kazerooni
authors.affiliation: Veterans Affairs San Diego Healthcare System, San Diego, California; University of California San Diego, San Diego, CA.
authors.forename: Jane
authors.initials: J
authors.lastname: Lim
authors.affiliation: Veterans Affairs San Diego Healthcare System, San Diego, California; University of California San Diego, San Diego, CA.
authors.forename: PharmD
authors.initials: P
authors.lastname: Ashley Blake
authors.affiliation: Veterans Affairs San Diego Healthcare System, San Diego, California; University of California San Diego, San Diego, CA.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Lessig
mesh_terms: D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000188:drug therapy*; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D056687:Off-Label Use; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000700:Analgesics; D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A; C545476:incobotulinumtoxinA
keywords: Xeomin; botulinum; headache; migraine; toxin