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.
Highlights
Migraine is a highly disabling primary headache disorder that affects 6%–10% and 17%–25% of the adult population in men and women, respectively, with a male to female ratio of 1:3 [1,2,3].The disease is ranked among the top 10 causes of disability worldwide [2,4]
The importance of chronic migraine (CM) as a disease is reflected by the fact that the International Classification of Headache Disorders (ICHD) 3 beta has recently categorized it as an independent disease entity [5]
A literature search was conducted in the database of PubMed up to 25 May 2015 for articles related to pathomechanism of chronic migraine, the mode of action of OBOT-A and the efficacy, safety and tolerability of OBOT-A for preventive treatment of chronic migraine
Summary
Migraine is a highly disabling primary headache disorder that affects 6%–10% and 17%–25% of the adult population in men and women, respectively, with a male to female ratio of 1:3 [1,2,3].The disease is ranked among the top 10 causes of disability worldwide [2,4]. Migraine is a highly disabling primary headache disorder that affects 6%–10% and 17%–25% of the adult population in men and women, respectively, with a male to female ratio of 1:3 [1,2,3]. Chronic migraine is a common, highly disabling, underdiagnosed and undertreated entity of migraine. It affects 0.9%–2.2% of the general adult population. 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. 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
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