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Treatment of Chronic Migraine with OnabotulinumtoxinA: Mode of Action, Efficacy and Safety

1
Department of Neurology, University of Szeged, Semmelweis str. 6, Szeged H-6725, Hungary
2
MTA—SZTE Neuroscience Research Group, Szeged H-6725, Hungary
*
Author to whom correspondence should be addressed.
Academic Editor: Bahman Jabbari
Toxins 2015, 7(7), 2659-2673; https://doi.org/10.3390/toxins7072659
Received: 28 May 2015 / Revised: 29 May 2015 / Accepted: 26 June 2015 / Published: 17 July 2015
(This article belongs to the Collection Botulinum Toxins on Human Pain)
Background: Chronic migraine is a common, highly disabling, underdiagnosed and undertreated entity of migraine. It affects 0.9%–2.2% of the general adult population. The present paper overviews the preclinical and clinical data regarding the therapeutic effect of onabotulinumtoxinA in chronic migraineurs. Methods: A literature search was conducted in the database of PubMed up to 20 May 2015 for articles related to the pathomechanism of chronic migraine, the mode of action, and the efficacy, safety and tolerability of onabotulinumtoxinA for the preventive treatment of chronic migraine. Results: The pathomechanism of chronic migraine has not been fully elucidated. The mode of action of onabotulinumtoxinA in the treatment of chronic migraine is suggested to be related to the inhibition of the release of calcitonin gene-related peptide and substance P in the trigeminovascular system. Randomized clinical trials demonstrated that long-term onabotulinumtoxinA fixed-site and fixed-dose (155–195 U) intramuscular injection therapy was effective and well tolerated for the prophylactic treatment of chronic migraine. Conclusions: Chronic migraine is a highly devastating entity of migraine. Its exact pathomechanism is unrevealed. Two-third of chronic migraineurs do not receive proper preventive medication. Recent clinical studies revealed that onabotulinumtoxinA was an efficacious and safe treatment for chronic migraine. View Full-Text
Keywords: chronic migraine; efficacy; mode of action; onabotulinumtoxinA; pathomechanism; safety; tolerability; treatment chronic migraine; efficacy; mode of action; onabotulinumtoxinA; pathomechanism; safety; tolerability; treatment
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Szok, D.; Csáti, A.; Vécsei, L.; Tajti, J. Treatment of Chronic Migraine with OnabotulinumtoxinA: Mode of Action, Efficacy and Safety. Toxins 2015, 7, 2659-2673.

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