Meta-Analysis: Botulinum A Tops Placebo for Chronic Migraine
Frequency of chronic migraines significantly reduced after three months; QoL improved
MONDAY, Jan. 7, 2019 (Pharmacist's Briefing) -- For chronic migraine, botulinum type A injections are superior to placebo after three months of therapy, according to a meta-analysis published in the January issue of Plastic and Reconstructive Surgery.
Eva Bruloy, M.D., from the University Hospital of Picardie in France, and colleagues conducted a systematic literature review and meta-analysis to compare patients receiving botulinum toxin to those receiving placebo injections in the head and neck muscles for the preventive treatment of migraine. Data were included from 17 studies involving 3,646 patients.
At three months, the researchers found a tendency in favor of botulinum toxin over placebo, with a mean difference in the change of migraine frequency of −0.23 (95 percent confidence interval, −0.47 to 0.02; P = 0.08). There was a significant reduction in the frequency of chronic migraines, with a mean differential change of −1.56 (95 percent confidence interval, −3.05 to −0.07; P = 0.04). After two months, the analysis of chronic migraine frequency was also significant. At three months, the botulinum group had significant improvement in patient quality of life (P < 0.00001). The investigators noted a statistically significant risk ratio of 1.32 for adverse events in the botulinum group (P = 0.002).
"Botulinum toxin type A is a safe and well-tolerated treatment that should be offered to patients with migraine," the authors write.