OnabotulinumtoxinA Therapy May Reduce Frequency, Severity of New Daily Persistent Headache – Clinical Pain Advisor

By | January 15, 2019

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OnabotulinumtoxinA injections were typically administered at the clinic every 3 months.
OnabotulinumtoxinA injections were typically administered at the clinic every 3 months.

OnabotulinumtoxinA therapy may effectively reduce the frequency and severity of new daily persistent headache at 12 months, according to a small study published in Clinical Neuropharmacology.

The investigators of this single-center, retrospective study sought to examine the effectiveness of onabotulinumtoxinA therapy to treat participants with new daily persistent headache.

The investigators performed a chart review of consecutive patients at the Cleveland Clinic Headache Center who were diagnosed with new daily persistent headache and received onabotulinumtoxinA therapy between January 2013 and June 2015. 

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OnabotulinumtoxinA injections were typically administered at the clinic every 3 months, and participants reported primary outcomes of frequency and severity of headache for the previous 3 months. Individuals with baseline data and follow-up data for all study time points were included in the analyses, including 19 participants in frequency analysis and 14 in severity analysis.

Eight of 16 (50%) and 7 of 11 (63.6%) participants reported a decrease in headache frequency at 6 and 12 months, respectively. Five of 10 (50%) and 7 of 9 (77.8%) participants reported an improvement in headache severity at 6 and 12 months, respectively.

Study limitations include a small sample size, its retrospective nature, lack of quantitative data, and the possibility that individuals who perceived improvement continued with treatment while those that did not dropped out.

“[O]nabotulinumtoxinA, as well as other type A toxins, may be a reasonable choice for the treatment of [new daily persistent headache],” concluded the study authors. “[C]onsideration should be given for earlier initiation of onabotulinumtoxinA therapy in lieu of traditional therapies, which have been so disappointing in [new daily persistent headache].”

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Reference                    

Ali A, Kriegler J, Tepper S, Vij B. New daily persistent headache and onabotulinumtoxinA therapy [published online November 28, 2018]. Clin Neuropharmacol. doi: 10.1097/WNF.0000000000000313

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