The use of onabotulinum toxin type A and other neurotoxins for the treatment of chronic migraine: An American Headache Society survey study

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Neurology and Neurosurgery Pub Date : 2025-05-08 DOI:10.1016/j.clineuro.2025.108960

Utkarsh Agarwal , Kendra Hamilton , Ashhar Ali , Paul G. Mathew

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引用次数: 0

Abstract

Purpose

OnabotA is the only US Food and Drug Administration-approved neurotoxin for chronic migraine prevention; however, non-onabotA toxins may be equally effective. Few studies have explored clinician practices and patient outcomes with non-onabotA neurotoxins. Our study aimed to generate a statistical snapshot of clinician perspectives and treatment practices regarding onabotulinum toxin A (onabotA) and other neurotoxins for chronic migraine and comorbid conditions.

Methods

A 15-question survey was distributed online to clinician members of the American Headache Society (AHS) assessing clinical practices using onabotA and non-onabotA toxins for chronic migraine and comorbid conditions, and descriptive analysis was performed.

Results

168 respondents (162 from the United States and 6 from Canada) completed the survey (response rate 10.1 % [168/1665]). Of 48 respondents (28 % of total) using non-onabotA toxins for chronic migraine, 27 (16 %) used incobotulinum toxin A; 23 (14 %) used abobotulinum toxin A; and 12 (7 %) used rimabotulinum toxin B. Non-onabotA toxins were predominantly used due to administration/payor imposed issues (19/48; 40 %) and cost (18/48 [38 %]). Most clinicians using non-onabotA toxins reported similar efficacy to onabotA (32/48; 67 %), while fewer reported better efficacy (9/48 [19 %]) or worse efficacy (7/48 [15 %]) than onabotA. Many respondents (114/168 [68 %]) had used neurotoxins for chronic migraine in addition to other comorbid conditions, including temporomandibular joint disorders (95/114 [83 %]) and cervical dystonia (64/114 [56 %]).

Conclusion

While non-onabotA toxins are used less frequently for chronic migraine, they may have similar efficacy as onabotA and are used off-label in clinical practice due to administrative/payor issues or cost.

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使用A型肉毒杆菌毒素和其他神经毒素治疗慢性偏头痛：一项美国头痛学会调查研究

onabota是美国食品和药物管理局唯一批准用于慢性偏头痛预防的神经毒素；然而，非onabota毒素可能同样有效。很少有研究探讨临床医生的做法和非奥那伯塔神经毒素的患者结果。我们的研究旨在生成临床医生的观点和治疗实践的统计快照，关于肉毒杆菌毒素a （onabotA）和其他神经毒素治疗慢性偏头痛和合并症。方法在线向美国头痛学会（American Headache Society， AHS）的临床医生成员发放一份15个问题的调查问卷，评估使用onabotA和非onabotA毒素治疗慢性偏头痛及合并症的临床实践，并进行描述性分析。结果168名受访者（美国162名，加拿大6名）完成调查，回复率为10.1 %[168/1665]。48名受访者（占总数的28% %）使用非onabota毒素治疗慢性偏头痛，27名（16% %）使用肉毒杆菌毒素A；23例（14 %）使用肉毒毒素A；12例（7 %）使用利玛肉毒杆菌毒素b。非奥那伯塔毒素主要是由于给药/付款人施加的问题而使用的(19/48；40 %)和成本（18/48[38 %]）。大多数使用非onabotA毒素的临床医生报告的疗效与onabotA相似(32/48；67 %)，而较少报告疗效优于onabotA（9/48[19 %]）或较差（7/48[15 %]）。许多受访者（114/168[68 %]）曾使用神经毒素治疗慢性偏头痛，此外还有其他合并症，包括颞下颌关节疾病（95/114[83 %]）和颈肌张力障碍（64/114[56 %]）。结论：非onabotA毒素治疗慢性偏头痛的频率较低，但其疗效可能与onabotA相似，但由于管理/付款问题或成本问题，在临床实践中被超说明书使用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Neurology and Neurosurgery 医学-临床神经学

CiteScore

3.70

自引率

5.30%

发文量

358

审稿时长

46 days

期刊介绍： Clinical Neurology and Neurosurgery is devoted to publishing papers and reports on the clinical aspects of neurology and neurosurgery. It is an international forum for papers of high scientific standard that are of interest to Neurologists and Neurosurgeons world-wide.