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OnabotulinumtoxinA for chronic migraine: a critical appraisal

Authors Gooriah R, Ahmed F

Received 17 April 2015

Accepted for publication 10 June 2015

Published 29 June 2015 Volume 2015:11 Pages 1003—1013


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 5

Editor who approved publication: Professor Garry Walsh

Rubesh Gooriah, Fayyaz Ahmed

Department of Neurology, Hull Royal Infirmary, Kingston Upon Hull, UK

Abstract: Chronic migraine (CM) is a severe disabling condition with a few available evidence-based management options. OnabotulinumtoxinA (onaBoNTA) is approved for use in a number of disorders. Its benefits and potential use in migraine were observed incidentally while treating patients cosmetically for wrinkles. The mechanism of action of onaBoNTA in CM is not fully understood, but there is evidence that this involves axonal transport via sensory fibers. The Phase III REsearch Evaluating Migraine Prophylaxis Therapy trials have established the efficacy as well as the long-term safety and tolerability of onaBoNTA in CM. This review will discuss the evidence behind its use in this setting.

Keywords: migraine pathophysiology, botulinum toxin, botox, migraine prophylaxis, chronic daily headache

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