| Title |
Onabotulinum toxin A in the treatment of chronic migraine: patient selection and special considerations
|
|---|---|
| Published in |
Journal of Pain Research, September 2017
|
| DOI | 10.2147/jpr.s113614 |
| Pubmed ID | |
| Authors |
Piero Barbanti, Patrizia Ferroni |
| Abstract |
Discovered by serendipity, onabotulinum toxin A (BoNT-A) is the only US Food and Drug Administration-approved treatment for the prevention of chronic migraine (CM), one of the most disabling and burdensome human conditions. Its efficacy, safety and tolerability, proved by the largest and longest migraine therapeutic trial (the Phase III Research Evaluating Migraine Prophylaxis Therapy program [PREEMPT]), have been replicated by various real-life studies also in the presence of medication overuse. The benefit of BoNT-A prophylaxis is likely due to its ability to counteract peripheral and central nociceptive sensitization through reversible chemical denervation of pericranial sensitive afferents. Its efficacy increases considerably over time during long-term treatments, significantly varying among patients. The present review focuses on the state-of-the art of current knowledge on putative instrumental, biochemical and clinical predictors of BoNT-A responsiveness, outlining the need for a thorough characterization of the full phenotypic migraine picture when trying to predict good responders. Available evidence suggests that disentangling the BoNT-A responsiveness puzzle requires 1) a reappraisal of easy-obtainable clinical details (eg, site and quality of pain, presence of cranial autonomic symptoms), 2) a proper stratification of patients with CM according to their headache frequency, 3) the evaluation of potential synergistic effects of concomitant prophylaxis/treatment and 4) a detailed assessment of modifiable risk factors evolution during treatment. |
Mendeley readers
The data shown below were compiled from readership statistics for 65 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 65 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 15 | 23% |
| Student > Bachelor | 5 | 8% |
| Other | 5 | 8% |
| Student > Master | 5 | 8% |
| Student > Ph. D. Student | 4 | 6% |
| Other | 6 | 9% |
| Unknown | 25 | 38% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 22 | 34% |
| Pharmacology, Toxicology and Pharmaceutical Science | 4 | 6% |
| Neuroscience | 4 | 6% |
| Biochemistry, Genetics and Molecular Biology | 2 | 3% |
| Social Sciences | 1 | 2% |
| Other | 3 | 5% |
| Unknown | 29 | 45% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 04 October 2017.
All research outputs
#20,449,496
of 23,005,189 outputs
Outputs from Journal of Pain Research
#1,603
of 1,761 outputs
Outputs of similar age
#276,159
of 316,308 outputs
Outputs of similar age from Journal of Pain Research
#48
of 50 outputs
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