Could Botox Reduce Chronic Migraine Frequency and Medication Overuse?

In a recent study, researchers found that Onabotulinumtoxin A (OncabotA, or "botox") reduced medication overuse and the number of headache days for patients with migraines after the first year of treatment.

Researchers collected data from 3 headache units of patients who completed at least 5 sessions of OnabotA therapy and a headache diary. The study included 115 participants, 98 females and 17 males, between 14-74 years old, and with a latency between chronic migraine diagnosis and OnabotA therapy between 6-166 months. Patients in the study had not responded to topiramate and at least one other preventative treatment. There were 107 participants receiving a concurrent oral preventive therapy at the start of OnabotA treatment, and 80% (92 patients) fulfilled criteria for medication overuse, including 40.8% (47 patients) overusing triptans.
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OnabotA therapy was continued in patients who saw at least a 30% reduction in headache days, and stopped if patients did not experience a reduction in headache days by at least 30%.

Their findings showed that 45.2% patients stopped taking oral drugs, 13.9% reduced their dose of oral drugs, and 68.7% saw a reduction in chronic migraine to episodic migraine. Medication overuse stopped in 61.9% of patients.

“One of our objectives during OnabotA treatment was to retire concurrent oral therapy and we began to decrease its use after third procedure. We were able (and this is again a point not previously considered in these kind of studies) to retire oral preventatives in almost half of our patients,” the researchers stated.

Overall, the results showed that OnabotA may have long-term benefits for patients with chronic migraine in reducing the number of headache days and reducing acute medication overuse.

—Melissa Weiss

Reference:

Aicua-Rapun E, Martínez-Velasco E, Rojo A, et al. Real-life data in 115 chronic migraine patients treated with Onabotulinumtoxin A during more than one year. [published online December 12, 2016]. Journal of Headache and Pain. Doi:10.1186/s10194-016-0702-1.