OnabotulinumtoxinA in elderly patients with chronic migraine: insights from a real-life European multicenter study

被引：9

作者：

Altamura, Claudia ^{[1
,2
]}

Ornello, R. ^{[3
]}

Ahmed, F. ^{[4
]}

Negro, A. ^{[5
]}

Miscio, A. M. ^{[6
]}

Santoro, A. ^{[6
]}

Alpuente, A. ^{[7
,8
]}

Russo, A. ^{[9
]}

Silvestro, M. ^{[9
]}

Cevoli, S. ^{[10
]}

Brunelli, N. ^{[1
,2
]}

Grazzi, L. ^{[11
]}

Baraldi, C. ^{[12
]}

Guerzoni, S. ^{[12
]}

Andreou, A. P. ^{[13
]}

Lambru, G. ^{[13
]}

Frattale, I ^{[3
]}

Kamm, K. ^{[14
]}

Ruscheweyh, R. ^{[14
,15
]}

Russo, M. ^{[16
]}

Torelli, P. ^{[17
]}

Filatova, E. ^{[18
]}

Latysheva, N. ^{[19
]}

Gryglas-Dworak, A. ^{[19
]}

Straburzynski, M. ^{[20
]}

Butera, C. ^{[21
]}

Colombo, B. ^{[22
]}

Filippi, M. ^{[21
,22
,23
]}

Pozo-Rosich, P. ^{[7
,8
]}

Martelletti, P. ^{[5
]}

Sacco, S. ^{[3
]}

Vernieri, F. ^{[1
,2
]}

机构：

[1] Univ Campus Biomed Roma, Dept Med & Surg, Unit Headache & Neurosonol, Via Alvaro Portillo 21, I-00128 Rome, Italy

[2] Fdn Policlin Univ Campus Biomed, Via Alvaro del Portil 200, I-00128 Rome, Italy

[3] Univ LAquila, Dept Appl Clin Sci & Biotechnol, Neurosci Sect, Via Vetoio 1 Coppito, I-67100 Laquila, Italy

[4] Hull Univ Teaching Hosp, Dept Neurosci, Kingston Upon Hull, N Humberside, England

[5] Sapienza Univ, St Andrea Hosp, Fac Med & Psychol, Dept Clin & Mol Med, I-00189 Rome, Italy

[6] Fdn IRCCS Casa Sollievo Sofferenza, Headache Ctr, Unit Neurol, San Giovanni Rotondo, FG, Italy

[7] Vall dHebron Univ, Dept Neurol, Headache Unit, Barcelona, Spain

[8] Univ Autonoma Barcelona, Vall dHebron Inst Res VHIR, Dept Med, Headache & Neurol Pain Res Grp, Barcelona, Spain

[9] Univ Campania Luigi Vanvitelli, Headache Ctr, Dept Med Surg Neurol Metab & Aging Sci, Naples, Italy

[10] IRCCS Ist Sci Neurol Bologna, Bologna, Italy

[11] IRCCS Fdn Carlo Besta Neurol Inst, Neurol Dept, Headache Ctr, Via Celoria 11, I-20133 Milan, Italy

[12] AOU Policlin Modena, Digital & Predict Med Pharmacol & Clin Metab Toxi, Lab Clin Pharmacol & Pharmacogen, Dept Specialist Med, Modena, Italy

[13] Guys & St Thomas NHS Fdn Trust, Headache Serv, London, England

[14] Ludwig Maximilians Univ Munchen, Dept Neurol, Munich, Germany

[15] Tech Univ Munich, Dept Psychosomat Med & Psychotherapy, Munich, Germany

[16] Azienda USL IRCCS Reggio Emilia, Neuromotor & Rehabil Dept, Neurol Unit, Headache Ctr, Reggio Emilia, Italy

[17] Univ Parma, Headache Ctr, Parma, Italy

[18] Sechenov First Moscow State Med Univ, Inst Postgrad Educ, Dept Neurol, Sechenov Univ, Moscow, Russia

[19] Headache Ctr Wroclaw, Wroclaw, Poland

[20] Terapia Neurologiczna Samodzielni, Headache Clin, Maurycego Mochnackiego 10, PL-02042 Warsaw, Poland

[21] IRCCS San Raffaele Sci Inst, Neurophysiol Serv, Milan, Italy

[22] IRCCS San Raffaele Sci Inst, Neurol Unit, Milan, Italy

[23] IRCCS San Raffaele Sci Inst, Neurorehabil Unit, Milan, Italy

来源：

JOURNAL OF NEUROLOGY | 2023年 / 270卷 / 02期

关键词：

OnabotulinumtoxinA; Chronic migraine; Prevention; Elderly; TOXIN TYPE-A; DOUBLE-BLIND;

D O I：

10.1007/s00415-022-11457-5

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Introduction Although migraine prevalence decreases with aging, some older patients still suffer from chronic migraine (CM). This study aimed to investigate the outcome of OnabotulinumtoxinA (OBT-A) as preventative therapy in elderly CM patients. Methods This is a post hoc analysis of real-life prospectively collected data at 16 European headache centers on CM patients treated with OBT-A over the first three treatment cycles (i.e., Cy1-3). We defined: OLD patients aged >= 65 years and nonOLD those < 65-year-old. The primary endpoint was the changes in monthly headache days (MHDs) from baseline to Cy 1-3 in OLD compared with nonOLD participants. The secondary endpoints were the responder rate (RR) >= 50%, conversion to episodic migraine (EM) and the changes in days with acute medication use (DAMs). Results In a cohort of 2831 CM patients, 235 were OLD (8.3%, 73.2% females, 69.6 years SD 4.7). MHDs decreased from baseline (24.8 SD 6.2) to Cy-1 (17.5 SD 9.1, p < 0.000001), from Cy-1 to Cy-2 (14.8 SD 9.2, p < 0.0001), and from Cy-2 to Cy-3 (11.9 SD 7.9, p = 0.001). DAMs progressively reduced from baseline (19.2 SD 9.8) to Cy-1 (11.9 SD 8.8, p < 0.00001), to Cy-2 (10.9 SD 8.6, p = 0.012), to Cy-3 (9.6 SD 7.4, p = 0.049). The 50%RR increased from 30.7% (Cy-1) to 34.5% (Cy-2), to 38.7% (Cy-3). The above outcome measures did not differ in OLD compared with nonOLD patients. Conclusion In a population of elderly CM patients with a long history of migraine OBT-A provided a significant benefit, over the first three treatment cycles, as good as in non-old patients.

引用

页码：986 / 994

页数：9

共 46 条

[21] Persistence and switching patterns of oral migraine prophylactic medications among patients with chronic migraine: A retrospective claims analysis [J].