title: The use of onabotulinum toxin A (Botox(®)) in the treatment of chronic migraine at the Parma Headache Centre: a prospective observational study.
abstract: Chronic migraine is a debilitating headache, whose treatment is often complicated by the concomitant overuse of symptomatic medication and by the poor efficacy of standard prophylactic treatments. The PREEMPT studies have demonstrated the efficacy and tolerability of onabotulinum toxin A (Botox(®)) in the treatment of this headache type. Data about its use in clinical practice are still scarce. Our study evaluated all subjects with chronic migraine who were treated with onabotulinum toxin A between February 2014 and November 2015 at the Parma Headache Centre. Botox was injected according to the PREEMPT paradigm every 3 months. The data about variations in the number of headache days and in symptomatic medication intake before and after the Botox injections were collected from the patients' headache diaries. The study also evaluated tolerability to treatment, disability, and depressive symptoms. Of the 52 treated subjects, 14 received Botox treatment for at least 9 months and showed a significant decrease in the median number of headache days (from 19 to 14.5, p = 0.011) and in the median number of days of symptomatic medications intake and symptomatic drugs. Overall, the treatment was well tolerated. The average MIDAS and BDI-II scores after 9 months were reduced, though not significantly. The treatment with Botox proved effective and well tolerated in our clinical practice. Further studies on larger patient samples will help shed light on the persistence of the drug's effect at long term and identify the predictive factors of response to treatment.
authors.affiliation: Department of Clinical and Experimental Medicine, Parma Headache Centre, University of Parma, via Gramsci 14, 43100, Parma, Italy. marco.russo@studenti.unipr.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Russo
authors.affiliation: Department of Clinical and Experimental Medicine, Parma Headache Centre, University of Parma, via Gramsci 14, 43100, Parma, Italy.
authors.forename: Gian Camillo
authors.initials: GC
authors.lastname: Manzoni
authors.affiliation: Department of Clinical and Experimental Medicine, Parma Headache Centre, University of Parma, via Gramsci 14, 43100, Parma, Italy.
authors.forename: Arens
authors.initials: A
authors.lastname: Taga
authors.affiliation: Department of Clinical and Experimental Medicine, Parma Headache Centre, University of Parma, via Gramsci 14, 43100, Parma, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Genovese
authors.affiliation: Department of Hygiene and Public Health, University of Parma, Via Volturno 39, 43125, Parma, Italy.
authors.forename: Licia
authors.initials: L
authors.lastname: Veronesi
authors.affiliation: Department of Hygiene and Public Health, University of Parma, Via Volturno 39, 43125, Parma, Italy.
authors.forename: Cesira
authors.initials: C
authors.lastname: Pasquarella
authors.affiliation: Department of Hygiene and Public Health, University of Parma, Via Volturno 39, 43125, Parma, Italy.
authors.forename: Giuliano Ezio
authors.initials: GE
authors.lastname: Sansebastiano
authors.affiliation: Department of Clinical and Experimental Medicine, Parma Headache Centre, University of Parma, via Gramsci 14, 43100, Parma, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Torelli
mesh_terms: D065087:Acetylcholine Release Inhibitors / Q000627:therapeutic use*; D000328:Adult; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000188:drug therapy*; D010147:Pain Measurement; D011446:Prospective Studies; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D065087:Acetylcholine Release Inhibitors; D019274:Botulinum Toxins, Type A
keywords: Chronic migraine (CM); Clinical efficacy; Medication overuse headache (MOH); Onabotulinum toxin A (Botox)