OnabotulinumtoxinA for primary new daily persistent headache and comparison to chronic migraine.

IF 5 2区 医学 Q1 CLINICAL NEUROLOGY
Sanjay Cheema, Susie Lagrata, Khadija Rerhou Rantell, Maha Ahmed, Salwa Kamourieh, Manjit Singh Matharu
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Abstract

Background: New daily persistent headache (NDPH) is an often treatment-refractory primary headache disorder with a lack of evidence base for treatment.

Methods: We performed an observational study using prospectively collected data in consecutive patients with NDPH, chronic migraine with daily headache (daily-CM) and without daily headache (non-daily-CM). Patients were treated with two cycles of OnabotulinumtoxinA. Propensity score matching was used to control for imbalances between the groups. The primary outcome measure was the proportion who experienced a ≥ 30% improvement in monthly moderate-to-severe headache days at 24 weeks.

Results: We included 58 patients with NDPH, 148 with daily-CM, and 84 with non-daily-CM. In NDPH, 34.5% of patients experienced a ≥ 30% improvement in monthly moderate-to-severe headache days, compared to 43.2% in daily-CM and 51.2% in non-daily CM. In NDPH, 6.9% experienced an improvement in monthly headache days, 27.6% an improvement in headache severity, 25.9% a ≥ 6 point improvement in HIT-6 score, and 59% a patient reported improvement. There was no significant difference in response rates between the three groups. Adverse event rates were similar in all groups and there were no serious adverse events.

Conclusion: OnabotulinumtoxinA is effective in approximately 1/3 patients with NDPH and has a favourable safety profile.

背景:新发每日持续性头痛(NDPH)是一种常常难以治疗的原发性头痛疾病,其治疗缺乏证据基础:新的每日持续性头痛(NDPH)通常是一种难治性原发性头痛疾病,其治疗缺乏证据基础:方法:我们利用前瞻性收集的数据,对NDPH、慢性偏头痛伴每日头痛(daily-CM)和非每日头痛(non-daily-CM)的连续患者进行了观察性研究。患者接受了两个周期的奥那曲妥毒素治疗。采用倾向得分匹配法控制各组之间的不平衡。主要结果指标是24周时每月中度至重度头痛天数改善≥30%的患者比例:我们纳入了 58 名 NDPH 患者、148 名每日头痛患者和 84 名非每日头痛患者。在NDPH患者中,34.5%的患者每月中度至重度头痛天数改善≥30%,而在日间CM患者中,这一比例为43.2%,在非日间CM患者中,这一比例为51.2%。在 NDPH 中,6.9% 的患者每月头痛天数有所改善,27.6% 的患者头痛严重程度有所改善,25.9% 的患者 HIT-6 评分改善≥6 分,59% 的患者报告病情有所改善。三组患者的反应率无明显差异。各组的不良反应发生率相似,没有出现严重不良反应:结论:奥那布林妥昔单抗对大约 1/3 的 NDPH 患者有效,而且安全性良好。
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来源期刊
Cephalalgia
Cephalalgia 医学-临床神经学
CiteScore
10.10
自引率
6.10%
发文量
108
审稿时长
4-8 weeks
期刊介绍: Cephalalgia contains original peer reviewed papers on all aspects of headache. The journal provides an international forum for original research papers, review articles and short communications. Published monthly on behalf of the International Headache Society, Cephalalgia''s rapid review averages 5 ½ weeks from author submission to first decision.
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