Publicaciones científicas
Long-term safety of OnabotulinumtoxinA treatment in chronic migraine patients: a five-year retrospective study
María Pilar Navarro-Pérez 1 2 , Vicente González-Quintanilla 3 , Albert Muñoz-Vendrell 4 , Elisabet Madrigal 5 , Alicia Alpuente 6 7 , Germán Latorre 8 , Francis Molina 9 , María José Monzón 10 , Vicente Medrano 11 , David García-Azorín 12 , Carmen González-Oria 13 , Ana Gago-Veiga 14 , Fernando Velasco 15 , Isabel Beltrán 16 , Noemí Morollón 17 , Javier Viguera 18 , Javier Casas-Limón 19 , Jaime Rodríguez-Vico 20 , Elisa Cuadrado 21 , Pablo Irimia 22 , Fernando Iglesias 5 , Ángel Luis Guerrero-Peral 12 , Robert Belvís 17 , Patricia Pozo-Rosich 6 7 , Julio Pascual 3 , Sonia Santos-Lasaosa 1 2
Background: Real-world studies have shown the sustained therapeutic effect and favourable safety profile of OnabotulinumtoxinA (BoNTA) in the long term and up to 4 years of treatment in chronic migraine (CM). This study aims to assess the safety profile and efficacy of BoNTA in CM after 5 years of treatment in a real-life setting.
Methods: We performed a retrospective chart review of patients with CM in relation to BoNTA treatment for more than 5 years in 19 Spanish headache clinics. We excluded patients who discontinued treatment due to lack of efficacy or poor tolerability.
Results: 489 patients were included [mean age 49, 82.8% women]. The mean age of onset of migraine was 21.8 years; patients had CM with a mean of 6.4 years (20.8% fulfilled the aura criteria). At baseline, patients reported a mean of 24.7 monthly headache days (MHDs) and 15.7 monthly migraine days (MMDs). In relation to effectiveness, the responder rate was 59.1% and the mean reduction in MMDs was 9.4 days (15.7 to 6.3 days; p < 0.001). The MHDs were also reduced by 14.9 days (24.7 to 9.8 days; p < 0.001). Regarding the side effects, 17.5% experienced neck pain, 17.3% headache, 8.5% eyelid ptosis, 7.5% temporal muscle atrophy and 3.2% trapezius muscle atrophy. Furthermore, after longer-term exposure exceeding 5 years, there were no serious adverse events (AE) or treatment discontinuation because of safety or tolerability issues.
Conclusion: Treatment with BoNTA led to sustained reductions in migraine frequency, even after long-term exposure exceeding 5 years, with no evidence of new safety concerns.
CITA DEL ARTÍCULO Front Neurol. 2024 Jun 13:15:1417831. doi: 10.3389/fneur.2024.1417831
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