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Botox migraine

James E Frampton, Stephen Silberstein
An intramuscular formulation of onabotulinumtoxinA (onabotA; Botox® ) is currently the only therapy specifically approved for the prevention of headaches in adults with chronic migraine (CM) in the EU and North America. This article provides a narrative review of relevant data on the drug in this indication from an EU perspective. OnabotA was originally approved on the basis of pooled data from two phase III studies (PREEMPT 1 and 2). In these pivotal studies, injection of up to five cycles of onabotA (155-195 U/cycle) at 12-week intervals was generally well tolerated and effective in producing statistically significant and clinically meaningful improvements in headache symptoms, acute headache pain medication usage, headache impact and health-related quality of life in adults with CM, of whom approximately two-thirds were acute medication overusers and approximately one-third had failed to respond to ≥ 3 prior oral prophylactic therapies...
March 12, 2018: Drugs
Elina Zakin, David Simpson
Botulinum toxin (BoNT) is a neurotoxin produced by the bacteria Clostridium botulinum that has become widely used for various neurologic indications. The four toxin formulations currently available for use in the United States (approved by the Food and Drug Administration) are onabotulinumtoxinA (Botox® ), abobotulinumtoxinA (Dysport® ), incobotulinumtoxinA (Xeomin® ), and rimabotulinumtoxinB (Myobloc® ). While the FDA-approved labels indicate that potency conversions should not be done, literature supports relative dose equivalents of approximately 1:1:2-4:50-100, respectively...
February 3, 2018: Toxicon: Official Journal of the International Society on Toxinology
M V Naprienko, L V Smekalkina, E A Surnova
AIM: To compare the efficacy of botox used in doses of 155 U and 195 U for preventive treatment of chronic migraine (CM). MATERIAL AND METHODS: Thirty-nine women with CM were stratified into two groups according to the dose of botox. The duration of the study was 9 month, patient's state was assessed before treatment and after repeated injections (every 3 month). RESULTS AND CONCLUSION: With regard to the frequency of migraine attacks, the 1st and 2nd injections of botox were equally effective...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
(no author information available yet)
[This corrects the article DOI: 10.1097/GOX.0000000000001194.].
May 2017: Plastic and Reconstructive Surgery. Global Open
Jeffrey E Janis, Jenny C Barker, Marilly Palettas
BACKGROUND: Onabotulinumtoxin A (BOTOX) is an FDA-approved treatment for chronic migraine headaches (MHs) that involves on-label, high-dose administration across 31 anatomic sites. Anatomically specific peripheral nerve trigger sites have been identified that contribute to MH pathogenesis and are amenable to both BOTOX injection and surgical decompression. These sites do not always correlate with the on-label FDA-approved injection pattern, but represent a more targeted approach. The efficacy of peripheral nerve-directed BOTOX injection as an independent long-term therapeutic option has not been investigated...
March 2017: Plastic and Reconstructive Surgery. Global Open
Claus M Escher, Lejla Paracka, Dirk Dressler, Katja Kollewe
Chronic migraine (CM) is a severely disabling neurological condition characterized by episodes of pulsating unilateral or bilateral headache. The United States Food and Drug Administration (FDA) approved onabotulinumtoxinA (Botox® ) for the prophylactic treatment of CM in 2010. It has been shown that onabotulinumtoxinA is effective in the reduction of headache frequency and severity in patients with CM. Treatment is well tolerated by the patients. This review reports on the history of botulinum neurotoxin (BoNT) in CM and presents the current clinical evidence for the use of onabotulinumtoxinA in the treatment of CM...
February 2017: Therapeutic Advances in Neurological Disorders
Bardia Amirlak, Kyle Sanniec, Ronnie Pezeshk, Michael Chung
Migraine headaches are a debilitating disease that causes significant socioeconomic problems. One of the speculated etiologies of the generation of migraines is peripheral nerve irritation at different trigger points. The use of Onabotulinum toxin A (BOTOX), although initially a novel approach, has now been determined to be a valid treatment for chronic headaches and migraines as described in the Phase III Research Evaluating Migraine Prophylaxis Therapy trials that prompted the approval by the Food and Drug Administration for treatment of chronic migraines...
December 2016: Plastic and Reconstructive Surgery. Global Open
Michail Vikelis, Andreas A Argyriou, Emmanouil V Dermitzakis, Konstantinos C Spingos, Dimos D Mitsikostas
BACKGROUND: Chronic migraine is a disabling condition, with limited treatment options. We conducted an open label, single arm, prospective clinical trial, to assess the efficacy and safety of onabotulinumtoxin-A in Greek patients with chronic migraine. Since recent evidence suggests that a meaningful clinical response may be delayed until after a third onabotulinumtoxin-A administration, we aimed at assessing outcomes at this time point. METHODS: A total of 119 patients with CM, scheduled to be treated with Onabotulinumtoxin-A (Botox ®) every 3 months, according to the approved indication and standard clinical practice, were prospectively enrolled...
December 2016: Journal of Headache and Pain
B Brüggenjürgen, T Baker, R Bhogal, F Ahmed
BACKGROUND: Chronic migraine (CM) is a neurological disorder associated with substantial disability. Botulinum toxin type A (Botox) is an approved and effective preventive treatment option for adult patients with CM. Transcranial magnetic stimulation (TMS) is an alternative treatment device delivering a brief pre-set magnetic pulse used for self-administration by the patient at home. Despite being available in a risk share scheme TMS is perceived to be more costly in the UK. The objective of this study was to analyse the incremental costs of TMS compared to Botox in refractory CM patients both for a UK individual funding request setting as well as for an average UK specialist center setting...
2016: SpringerPlus
Lorraine A Sanassi
Chronic migraines are a common condition among patients seen in primary care and management often is a challenge. Despite existing therapies to help manage this condition, many patients continue to experience undue stress and diminished quality of life secondary to pain. This article briefly reviews treatments for migraine and introduces the role of onabotulinumtoxin A (Botox A) in improving the management of chronic migraines.
June 2016: JAAPA: Official Journal of the American Academy of Physician Assistants
Francis X Conidi
Post-traumatic headache (migraine) is the most common symptom of concussion and traumatic brain injury. An expert opinion-based review along with a literature review (PubMed) was conducted looking at known interventional procedures for post-traumatic headache using the keywords post-traumatic headache, post-traumatic migraine headache, concussion, mild traumatic brain injury, and traumatic brain injury and the following categories: mechanism, pathophysiology, treatment, physical therapy, neurostimulation, Botox@/Onabotulinum toxin, and surgical intervention...
June 2016: Current Pain and Headache Reports
Marco Russo, Gian Camillo Manzoni, Arens Taga, Antonio Genovese, Licia Veronesi, Cesira Pasquarella, Giuliano Ezio Sansebastiano, Paola Torelli
Chronic migraine is a debilitating headache, whose treatment is often complicated by the concomitant overuse of symptomatic medication and by the poor efficacy of standard prophylactic treatments. The PREEMPT studies have demonstrated the efficacy and tolerability of onabotulinum toxin A (Botox(®)) in the treatment of this headache type. Data about its use in clinical practice are still scarce. Our study evaluated all subjects with chronic migraine who were treated with onabotulinum toxin A between February 2014 and November 2015 at the Parma Headache Centre...
July 2016: Neurological Sciences
Shlomi Laufer, Steve J Kempton, Kimberly Maciolek, Aliyya Terry, Rebeca D Ray, Carla M Pugh, Ahmed M Afifi
Insuring correct needle location is crucial in many medical procedures. This can be even more challenging for physicians injecting in a new location for the first time. Since they do not necessarily know how the tissue is supposed to feel, finding the correct location and correct depth can be difficult. In this study we designed a simulator for training needle injection. The simulator was fabricated to give a realistic feeling of injecting Botox® in the temporalis and the semispinalis muscles as part of migraine treatment...
2016: Studies in Health Technology and Informatics
Katja Kollewe, Claus M Escher, Dirk U Wulff, Davood Fathi, Lejla Paracka, Bahram Mohammadi, Matthias Karst, Dirk Dressler
Botulinum toxin was shown to be effective in treatment of chronic migraine. We wanted to explore its efficacy and tolerability in chronic application under real-life conditions. For this, 27 consecutive patients (age 45.6 ± 10.8 years, 25 females, 2 males) received altogether 176 injection series (IS) with 189.7 ± 45.8MU onabotulinumtoxinA (Botox(®)) according to the PREEMPT scheme. During the study period altogether 6.5 ± 2.9 (min 4, max 13) IS were applied per patient (total treatment time of 73...
May 2016: Journal of Neural Transmission
Shilpadevi Patil, Olga Willett, Terin Thompkins, Robert Hermann, Sathish Ramanathan, Elyse M Cornett, Charles J Fox, Alan David Kaye
Botulinum toxin, also known as Botox, is produced by Clostridium botulinum, a gram-positive anaerobic bacterium, and botulinum toxin injections are among the most commonly practiced cosmetic procedures in the USA. Although botulinum toxin is typically associated with cosmetic procedures, it can be used to treat a variety of other conditions, including pain. Botulinum toxin blocks the release of acetylcholine from nerve endings to paralyze muscles and to decrease the pain response. Botulinum toxin has a long duration of action, lasting up to 5 months after initial treatment which makes it an excellent treatment for chronic pain patients...
March 2016: Current Pain and Headache Reports
Andrea Negro, Martina Curto, Luana Lionetto, Paolo Martelletti
BACKGROUND: The efficacy and safety of OnabotulinumtoxinA (BOTOX®) in adults with chronic migraine (CM) were demonstrated in the PREEMPT program. However, the dosage used in this study was flexible from 155 U to 195 U at the physician's discretion. Therefore, the objective of this prospective study was to compare the efficacy and safety of OnabotulinumtoxinA 195 U vs. 155 U for the treatment of CM and medication overuse headache (MOH) during a 2-year period. METHODS: We prospectively evaluated the mean reduction in headache days, migraine days, acute pain medication intake days and Headache Impact Test (HIT)-6 score in 172 patients injected with OnabotulinumtoxinA 195 U...
2015: Journal of Headache and Pain
Sachin Narain, Lama Al-Khoury, Eric Chang
BACKGROUND: Migraine headaches are a common and functionally debilitating disorder affecting approximately 17% of women and 5.6% of men. Compared to episodic migraine patients, chronic migraineurs are more likely to be occupationally disabled, miss family activities, have comorbid anxiety and/or chronic pain disorders, and utilize significantly more health care dollars. Ziconotide is a calcium channel blocker used for the treatment of chronic severe pain without issues of tolerance or dependency found with opioid therapy...
2015: Journal of Pain Research
L Grazzi, S Usai
Chronic migraine is a common and debilitating headache syndrome. Botulinum neurotoxin, a potent toxin produced by the anaerobic bacterium clostridium botulinum, used largely for treatment of disorders associated with increased muscle tone and hyperhidrosis, is used for patients suffering from chronic migraine. In this study, a group of patients suffering from chronic migraine with medication overuse was treated with onabotulinum toxin A (Botox) to verify its efficacy for chronic migraine. The results confirmed the efficacy of onabotulinum toxin A (Botox) when used at the dosage of 155 UI according to the PREEMPT protocol...
May 2015: Neurological Sciences
P Barbanti, G Egeo, L Fofi, C Aurilia, S Piroso
Chronic migraine is a severely disabling headache evolving from episodic migraine as a result of different transforming factors and characterized by atypical pain modulation and peripheral and central sensitization. Discovered by serendipity, onabotulinum toxin A (BoNT-A) represents the only drug specifically approved for CM prophylaxis. According to the dominant opinion, BoNT-A acts peripherally, impairing the exocytosis of neuropeptide and neurotransmitter and the delivery of receptors and ion channels on the cell surface of peripheral trigeminal endings, thereby indirectly reducing central sensitization...
May 2015: Neurological Sciences
Guy P Boudreau, Brian M Grosberg, Peter J McAllister, Richard B Lipton, Dawn C Buse
BACKGROUND: Chronic migraine is associated with significant headache-related disability and psychiatric comorbidity. OnabotulinumtoxinA (BOTOX(®)) is effective and well tolerated in the prophylactic treatment of chronic migraine. This study aimed to provide preliminary data on the efficacy and safety of prophylactic onabotulinumtoxinA in patients with chronic migraine and comorbid depressive symptoms. METHODS: This was a prospective, open-label, multicenter pilot study...
2015: International Journal of General Medicine
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