Chronic migraine treatment: from OnabotulinumtoxinA onwards.
WHO ranks migraine as the 6th highest cause of disability worldwide when considered alone, and the 3rd highest when medication overuse headache (MOH) is included. Migraine is an episodic disorder but in its natural course, its frequency could progressively increase and evolve to a chronic form. More than 50% of chronic migraine patients show acute pain medications overuse which is linked to the development of MOH.



Our goal is to review the existing data on OnabotulinoumtoxinA and CGRP-targeting drugs such as anti-CGRP monoclonal antibodies, one of the most promising migraine drugs under development. The research of bibliographic databases has included only published peer-reviewed articles from indexed journals. Expert commentary: To date, real-life studies are supporting OnabotulinumtoxinA in the treatment of chronic migraine. Additionally, anti-CGRP mAbs showed good efficacy and safety in recent RCTs and may soon contribute to improve the quality of life of patients suffering with migraine.
a Department of Clinical and Molecular Medicine , Sapienza University , Rome , Italy.|b Regional Referral Headache Centre , Sant'Andrea Hospital , Rome , Italy.
Andrea
A
Negro
a Department of Clinical and Molecular Medicine , Sapienza University , Rome , Italy.|b Regional Referral Headache Centre , Sant'Andrea Hospital , Rome , Italy.|c Department of Psychiatry , Harvard Medical School , Boston , MA , USA.|d Bipolar & Psychotic Disorders Program , McLean Hospital , Belmont , Massachusetts , USA.
Martina
M
Curto
e Advanced Molecular Diagnostics , IDI-IRCCS , Rome , Italy.
Luana
L
Lionetto
f Headache Center and Geriatrics Clinic, Department of Medicine and Science of Aging , Gabriele D'Annunzio University , Chieti , Italy.
Maria Adele
MA
Giamberardino
a Department of Clinical and Molecular Medicine , Sapienza University , Rome , Italy.|b Regional Referral Headache Centre , Sant'Andrea Hospital , Rome , Italy.
Paolo
P
Martelletti
D065087:Acetylcholine Release Inhibitors / Q000627:therapeutic use*; D019274:Botulinum Toxins, Type A / Q000502:physiology / Q000627:therapeutic use*; D002908:Chronic Disease; D006801:Humans; D008881:Migraine Disorders / Q000188:drug therapy*; D011788:Quality of Life
D065087:Acetylcholine Release Inhibitors; D019274:Botulinum Toxins, Type A
CGRP; OnabotulinumtoxinA; migraine; migraine prophylaxis; monoclonal antibodies