Excellent Response to OnabotulinumtoxinA: Different Definitions, Different Predictors

Raffaele Ornello, Carlo Baraldi (), Fayyaz Ahmed, Andrea Negro, Anna Maria Miscio, Antonio Santoro, Alicia Alpuente, Antonio Russo, Marcello Silvestro, Sabina Cevoli, Nicoletta Brunelli, Fabrizio Vernieri, Licia Grazzi, Luca Pani, Anna Andreou, Giorgio Lambru, Ilaria Frattale, Katharina Kamm, Ruth Ruscheweyh, Marco Russo, Paola Torelli, Elena Filatova, Nina Latysheva, Anna Gryglas-Dworak, Marcin Straburzyński, Calogera Butera, Bruno Colombo, Massimo Filippi, Patricia Pozo-Rosich, Paolo Martelletti, Simona Guerzoni and Simona Sacco
Additional contact information
Raffaele Ornello: Neuroscience Section, Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, Via Vetoio 1 Coppito, 67100 L’Aquila, Italy
Carlo Baraldi: Digital and Predictive Medicine, Pharmacology and Clinical Metabolic Toxicology-Headache Center and Drug Abuse-Laboratory of Clinical Pharmacology and Pharmacogenomics, Department of Specialist Medicines, AOU Policlinico di Modena, 41125 Modena, Italy
Fayyaz Ahmed: Department of Neurosciences, Hull University Teaching Hospitals, Hull HU3 2JZ, UK
Andrea Negro: Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sant’Andrea Hospital, Sapienza University, 00189 Rome, Italy
Anna Maria Miscio: Headache Center, Unit of Neurology, Fondazione IRCCS “Casa Sollievo Della Sofferenza”, 71013 San Giovanni Rotondo, Italy
Antonio Santoro: Headache Center, Unit of Neurology, Fondazione IRCCS “Casa Sollievo Della Sofferenza”, 71013 San Giovanni Rotondo, Italy
Alicia Alpuente: Headache Unit, Department of Neurology, Vall D’Hebron University, 08035 Barcelona, Spain
Antonio Russo: Headache Center, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania “Luigi Vanvitelli”, 81100 Naples, Italy
Marcello Silvestro: Headache Center, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania “Luigi Vanvitelli”, 81100 Naples, Italy
Sabina Cevoli: IRCCS Istituto delle Scienze Neurologiche di Bologna, 40139 Bologna, Italy
Nicoletta Brunelli: Headache and Neurosonology Unit, Campus Bio-Medico University Hospital, 00128 Rome, Italy
Fabrizio Vernieri: Headache and Neurosonology Unit, Campus Bio-Medico University Hospital, 00128 Rome, Italy
Licia Grazzi: Headache Center, Neuroalgology Department, IRCCS Foundation “Carlo Besta” Neurological Institute, Via Celoria, 11, 20133 Milan, Italy
Luca Pani: Digital and Predictive Medicine, Pharmacology and Clinical Metabolic Toxicology-Headache Center and Drug Abuse-Laboratory of Clinical Pharmacology and Pharmacogenomics, Department of Specialist Medicines, AOU Policlinico di Modena, 41125 Modena, Italy
Anna Andreou: Headache Service, Guy’s and St Thomas’ NHS Foundation Trust, London SE1 7EH, UK
Giorgio Lambru: Headache Service, Guy’s and St Thomas’ NHS Foundation Trust, London SE1 7EH, UK
Ilaria Frattale: Child Neurology and Psychiatry Unit, Systems Medicine Department, Tor Vergata University, 00133 Rome, Italy
Katharina Kamm: Department of Neurology, Ludwig Maximilians University München, 80539 Munich, Germany
Ruth Ruscheweyh: Department of Neurology, Ludwig Maximilians University München, 80539 Munich, Germany
Marco Russo: Headache Center, Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS Di Reggio Emilia, 42122 Reggio Emilia, Italy
Paola Torelli: Headache Center, University of Parma, 43121 Parma, Italy
Elena Filatova: Department of Neurology, Institute for Postgraduate Education, Sechenov First Moscow State Medical University (Sechenov University), 119435 Moscow, Russia
Nina Latysheva: Department of Neurology, Institute for Postgraduate Education, Sechenov First Moscow State Medical University (Sechenov University), 119435 Moscow, Russia
Anna Gryglas-Dworak: Headache Center Wroclaw, 50-307 Wrocław, Poland
Marcin Straburzyński: Department of Family Medicine and Infectious Diseases, University of Warmia and Mazury, 10-719 Olsztyn, Poland
Calogera Butera: Neurophysiology Service, IRCCS San Raffaele Scientific Institute, 71013 Milan, Italy
Bruno Colombo: Neurology Unit, IRCCS San Raffaele Scientific Institute, 71013 Milan, Italy
Massimo Filippi: Neurophysiology Service, IRCCS San Raffaele Scientific Institute, 71013 Milan, Italy
Patricia Pozo-Rosich: Headache Unit, Department of Neurology, Vall D’Hebron University, 08035 Barcelona, Spain
Paolo Martelletti: Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sant’Andrea Hospital, Sapienza University, 00189 Rome, Italy
Simona Guerzoni: Digital and Predictive Medicine, Pharmacology and Clinical Metabolic Toxicology-Headache Center and Drug Abuse-Laboratory of Clinical Pharmacology and Pharmacogenomics, Department of Specialist Medicines, AOU Policlinico di Modena, 41125 Modena, Italy
Simona Sacco: Neuroscience Section, Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, Via Vetoio 1 Coppito, 67100 L’Aquila, Italy

IJERPH, 2022, vol. 19, issue 17, 1-12

Abstract: The identification of patients who can benefit the most from the available preventive treatments is important in chronic migraine. We explored the rate of excellent responders to onabotulinumtoxinA in a multicenter European study and explored the predictors of such response, according to different definitions. A pooled analysis on chronic migraineurs treated with onabotulinumtoxinA and followed-up for, at least, 9 months was performed. Excellent responders were defined either as patients with a ≥75% decrease in monthly headache days (percent-based excellent responders) or as patients with <4 monthly headache days (frequency-based excellent responders). The characteristics of excellent responders at the baseline were compared with the ones of patients with a <30% decrease in monthly headache days. Percent-based excellent responders represented about 10% of the sample, whilst frequency-based excellent responders were about 5% of the sample. Compared with non-responders, percent-based excellent responders had a higher prevalence of medication overuse and a higher excellent response rate even after the 1st and the 2nd injection. Females were less like to be frequency-based excellent responders. Chronic migraine sufferers without medication overuse and of female sex may find fewer benefits with onabotulinumtoxinA. Additionally, the excellent response status is identifiable after the first cycle.

Keywords: chronic migraine; onabotulinumtoxinA; predictors of response; excellent responders (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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