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Evaluation of the concomitant use of oral preventive treatments and onabotulinumtoxinA in chronic migraine: The PREVENBOX study

European Journal of Neurology Jun 25, 2020

Alpuente A, Gallardo VJ, Torres‐Ferrús M, et al. - This retrospective, multicentric, cross‐sectional analysis was performed to quantify the shift in the use of oral prophylactics following management with onabotulinumtoxinA in patients suffering from chronic migraine (CM). This study involved 542 patients, 90.0% of whom were receiving oral preventive treatments. The withdrawal of at least one prophylactic and cessation of using oral prophylactics altogether was noted in 47.8% and in 41.6% of patients, respectively, during treatment with onabotulinumtoxinA. In addition, >50% betterment in frequency and intensity, remission to episodic migraine, use of topiramate as an initial treatment, increased number of infiltrations and shorter chronification period, all were identified as the factors related to a decrease or stop of oral prophylactics. Predictors of a decrease in oral prophylactics, in multivariate analysis, were: a chronification span < 20 months, more than five cycles of onabotulinumtoxinA, > 50% improvement in pain intensity and topiramate as an initial treatment. Overall, findings showed that onabotulinumtoxinA is efficacious as well as safe. A decrease in the use of oral prophylactics was brought about by this treatment. Experts also noted that withdrawal of oral prophylactics was most likely to happen following five cycles of treatment.

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