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Published on: June 2, 2014
IncobotulinumtoxinA for Migraine: A Retrospective Case Series
Rashid Kazerooni1, Jane Lim1, PharmD Ashley Blake1
1Veterans Affairs San Diego Healthcare System, San Diego, California; University of California San Diego, San Diego, CA.
Purpose:
IncobotulinumtoxinA is used for treating certain movement disorders but lacks published clinical data on use in chronic migraine.
Methods:
This retrospective case series was performed by using electronic chart reviews on patients receiving incobotulinumtoxinA for migraine at the Veterans Affairs San Diego Healthcare System between September 2013 and March 2014. Patients were administered 150 units each, with similar methods used for onabotulinumtoxinA injections.
Findings:
A total of 21 patients were included in the analysis. Patients were 40 years old on average, 67% white, and 52% female. Patients had trialed an average of 4.19 oral prophylactic agents for migraine with 43% having previous history of onabotulinumtoxinA use and 29% having a history of traumatic brain injury. Patients reported a decrease in headache days per month (19.1 vs 9.1; P < 0.001) and headache intensity (8.3 vs 4.1; P < 0.001) after incobotulinumtoxinA injections. Most patients experienced an improvement in headache frequency and/or intensity (81.8%). The duration of action for these patients averaged 81.9 days (median, 70 days).
Implications:
Significant improvements in headache frequency and intensity were observed. Chronic migraine is not an indication approved by the US Food and Drug Administration for incobotulinumtoxinA; however, the drug's effectiveness was documented in this small patient population.
Insights
IncobotulinumtoxinA injections significantly reduced headache days and intensity in chronic migraine patients. This study documents the drug
Area of Science:
- Neurology
- Pharmacology
Background:
- IncobotulinumtoxinA is approved for movement disorders.
- Clinical data for chronic migraine treatment is limited.
Purpose of the Study:
- Evaluate incobotulinumtoxinA effectiveness for chronic migraine.
- Assess changes in headache frequency and intensity.
Main Methods:
- Retrospective case series of 21 patients.
- Electronic chart review from Sept 2013 to March 2014.
- 150 units of incobotulinumtoxinA administered per patient.
Main Results:
- Significant reduction in headache days (19.1 to 9.1) and intensity (8.3 to 4.1).
- 81.8% of patients showed improvement in headache frequency/intensity.
- Average duration of action was 81.9 days.
Conclusions:
- IncobotulinumtoxinA demonstrated effectiveness in chronic migraine patients.
- This finding supports its use despite lack of FDA approval for this indication.
- Further research is warranted for this patient population.
