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Botulinum Toxin Type A in the treatment of chronic migraine without medication overuse.
Headache. 2008 Feb; 48(2):201-9.H

Abstract

INTRODUCTION

Chronic migraine is a recent diagnostic term that has undergone evolution from its original description. Clinically it has been believed that medication overuse contributed to its development and would block attempts at prevention. Previous studies with Botulinum Toxin Type A have demonstrated that it is effective even in patients with medication overuse. This study undertakes to examine the effects of Botulinum Toxin Type A in the absence of medication overuse in patients with chronic migraine.

STUDY DESIGN

Double-blind placebo-controlled randomized trial of Botulinum Toxin Type A 100 units administered in a fixed dose and site paradigm.

PATIENTS

In total, 86 patients were enrolled. A total of 60 patients were randomized and 41 patients were treated with the study medication or placebo. Five patients failed to complete the study, which lasted 4 months after the study medication was injected.

RESULTS

Botulinum Toxin Type A was statistically superior to placebo for the primary endpoint of reduction in migraine headache episodes. Six patients on Botulinum Toxin Type A compared with 3 patients on Placebo had at least a 50% reduction in their migraine episodes. Active treatment was superior to placebo for the secondary endpoints of total headache days, headache index, and quality of life measures. It showed numerical superiority to placebo for acute medication use and Migraine Disability Assessment Scores. Adverse events were rare and similar in both treatment groups.

CONCLUSIONS

The use of Botulinum Toxin Type A may be an effective treatment for chronic migraine when the patient does not have concomitant medication overuse. It was well tolerated in this trial.

Authors+Show Affiliations

Diamond Headache Clinic, Chicago, IL 60614, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18042229

Citation

Freitag, Frederick G., et al. "Botulinum Toxin Type a in the Treatment of Chronic Migraine Without Medication Overuse." Headache, vol. 48, no. 2, 2008, pp. 201-9.
Freitag FG, Diamond S, Diamond M, et al. Botulinum Toxin Type A in the treatment of chronic migraine without medication overuse. Headache. 2008;48(2):201-9.
Freitag, F. G., Diamond, S., Diamond, M., & Urban, G. (2008). Botulinum Toxin Type A in the treatment of chronic migraine without medication overuse. Headache, 48(2), 201-9.
Freitag FG, et al. Botulinum Toxin Type a in the Treatment of Chronic Migraine Without Medication Overuse. Headache. 2008;48(2):201-9. PubMed PMID: 18042229.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Botulinum Toxin Type A in the treatment of chronic migraine without medication overuse. AU - Freitag,Frederick G, AU - Diamond,Seymour, AU - Diamond,Merle, AU - Urban,George, Y1 - 2007/11/28/ PY - 2007/11/29/pubmed PY - 2008/6/14/medline PY - 2007/11/29/entrez SP - 201 EP - 9 JF - Headache JO - Headache VL - 48 IS - 2 N2 - INTRODUCTION: Chronic migraine is a recent diagnostic term that has undergone evolution from its original description. Clinically it has been believed that medication overuse contributed to its development and would block attempts at prevention. Previous studies with Botulinum Toxin Type A have demonstrated that it is effective even in patients with medication overuse. This study undertakes to examine the effects of Botulinum Toxin Type A in the absence of medication overuse in patients with chronic migraine. STUDY DESIGN: Double-blind placebo-controlled randomized trial of Botulinum Toxin Type A 100 units administered in a fixed dose and site paradigm. PATIENTS: In total, 86 patients were enrolled. A total of 60 patients were randomized and 41 patients were treated with the study medication or placebo. Five patients failed to complete the study, which lasted 4 months after the study medication was injected. RESULTS: Botulinum Toxin Type A was statistically superior to placebo for the primary endpoint of reduction in migraine headache episodes. Six patients on Botulinum Toxin Type A compared with 3 patients on Placebo had at least a 50% reduction in their migraine episodes. Active treatment was superior to placebo for the secondary endpoints of total headache days, headache index, and quality of life measures. It showed numerical superiority to placebo for acute medication use and Migraine Disability Assessment Scores. Adverse events were rare and similar in both treatment groups. CONCLUSIONS: The use of Botulinum Toxin Type A may be an effective treatment for chronic migraine when the patient does not have concomitant medication overuse. It was well tolerated in this trial. SN - 0017-8748 UR - https://www.unboundmedicine.com/medline/citation/18042229/Botulinum_Toxin_Type_A_in_the_treatment_of_chronic_migraine_without_medication_overuse_ L2 - https://doi.org/10.1111/j.1526-4610.2007.00963.x DB - PRIME DP - Unbound Medicine ER -