Efficacy of Botulinum Toxin-A Treatment in Chronic Migraine ? Kuwait Experience

Background: Botulinum toxin-A (BoNT-A) is approved for prophylactic treatment of chronic migraine (CM). We aimed to assess the efficacy and safety of BoNT-A in the treatment of CM. Methods: This open-label prospective study included 40 CM patients. Each patient received 100 units of BoNT-A following fixed site fixed dose protocol. Patient’s headache was assessed by their headache dairy and recording Headache Impact test (HIT-6) at baseline and 4th, 8th and 12th weeks following BoNT-A injection. Adverse events (AEs) were monitored to assess the safety of BoNT-A. For willing patients, BoNT-A injection was given and they were assessed at 3 months interval. Results: After BoNT-A treatment, there were reduction in all parameters (headache frequency and severity, analgesic consumption and HIT-6 score) by 40% at 4th week, 45% at 8th weeks and 42% at 12th week post treatment. At 4th week, 62.5% of patients achieved good response while, 37.5% indicated no alteration in their headache frequency and severity. At 8th week and 12th week post treatment 30%, 25% respectively were found to have no response to treatment. Five patients (12.5%) experienced mild and short lasting AEs. There was 70% improvement of variables after repeated injections at 3 months interval. Conclusions: BoNT-A is effective and well tolerated therapy in the prophylaxis of CM.