Treatment of Chronic Migraine with OnabotulinumtoxinA: Mode of Action, Efficacy and Safety

Overview

Journal Toxins (Basel)

Publisher MDPI

Specialty Toxicology

Date 2015 Jul 21

PMID 26193319

Citations 10

Authors

Delia Szok

Anett Csati

Laszlo Vecsei

Janos Tajti

Affiliations

Soon will be listed here.

Abstract

Background: Chronic migraine is a common, highly disabling, underdiagnosed and undertreated entity of migraine. It affects 0.9%-2.2% of the general adult population. The present paper overviews the preclinical and clinical data regarding the therapeutic effect of onabotulinumtoxinA in chronic migraineurs.

Methods: A literature search was conducted in the database of PubMed up to 20 May 2015 for articles related to the pathomechanism of chronic migraine, the mode of action, and the efficacy, safety and tolerability of onabotulinumtoxinA for the preventive treatment of chronic migraine.

Results: The pathomechanism of chronic migraine has not been fully elucidated. The mode of action of onabotulinumtoxinA in the treatment of chronic migraine is suggested to be related to the inhibition of the release of calcitonin gene-related peptide and substance P in the trigeminovascular system. Randomized clinical trials demonstrated that long-term onabotulinumtoxinA fixed-site and fixed-dose (155-195 U) intramuscular injection therapy was effective and well tolerated for the prophylactic treatment of chronic migraine.

Conclusions: Chronic migraine is a highly devastating entity of migraine. Its exact pathomechanism is unrevealed. Two-third of chronic migraineurs do not receive proper preventive medication. Recent clinical studies revealed that onabotulinumtoxinA was an efficacious and safe treatment for chronic migraine.

Citing Articles

Chronic Migraine as a Primary Chronic Pain Syndrome and Recommended Prophylactic Therapeutic Options: A Literature Review.

Szok D, Csati A, Vecsei L, Tajti J Life (Basel). 2023; 13(3).

PMID: 36983822 PMC: 10056004. DOI: 10.3390/life13030665.

A Single-Group Study on the Effect of OnabotulinumtoxinA in Patients with Chronic Migraine Associated with Medication Overuse Headache: Pain Catastrophizing Plays a Role.

Grazzi L, Montisano D, Rizzoli P, Guastafierro E, Marcassoli A, Fornari A Toxins (Basel). 2023; 15(2).

PMID: 36828401 PMC: 9967692. DOI: 10.3390/toxins15020086.

Pharmacogenetics in Primary Headache Disorders.

Belyaeva I, Subbotina A, Eremenko I, Tarasov V, Chubarev V, Schioth H Front Pharmacol. 2022; 12:820214.

PMID: 35222013 PMC: 8866828. DOI: 10.3389/fphar.2021.820214.

Additive Interaction Between Onabotulinumtoxin-A and Erenumab in Patients With Refractory Migraine.

Silvestro M, Tessitore A, Scotto di Clemente F, Battista G, Tedeschi G, Russo A Front Neurol. 2021; 12:656294.

PMID: 33897608 PMC: 8060469. DOI: 10.3389/fneur.2021.656294.

Comparing the Efficacy, Safety, and Superiority of Calcitonin Gene-Related Peptide Monoclonal Antibodies and Botox in Preventing and Treating Migraines.

Siddiqui M, Shah P, Balani P, Lopez A, Nobleza C, Khan S Cureus. 2021; 13(1):e13002.

PMID: 33542885 PMC: 7847775. DOI: 10.7759/cureus.13002.

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