■这项现实世界的研究旨在研究甲abotulinumtoxinA如何影响偏头痛的结果,伴随着焦虑,抑郁症,一组慢性偏头痛(CM)患者中的磨牙症和磨牙症,并确定了良好反应的预测因素。
■被诊断为CM的患者接受了乙酰磺胺醇毒素A,真实世界的回顾性队列研究。每月头痛天数(MHD),每月偏头痛日(MMD),在基线和治疗后12周评估头痛强度(数字评定量表-NRS)和头痛特征.患者报告的结局指标(PROM)包括偏头痛残疾评估量表(MIDAS),头痛影响测试-6(HIT-6)得分,12项异常性疼痛症状清单(ASC-12),贝克焦虑量表(BAI)和贝克抑郁量表(BDI)。还评估了对onabotulinumtoxinA的反应(MHD的减少百分比)和治疗相关的不良事件(TRAEs)。抱怨磨牙症的患者将OnabotulinumA应用于咬肌。
■共72例(平均±SD年龄:36.3±8.5岁;91.7%为女性)被诊断为CM。OnabotulinumtoxinA显示中位数(IQR)MHD显着降低[从基线时的20(15-25)到6(4-10),p<0.001],MMD[从9(6-12)到3(1-6),p<0.001和NRS[从9(8-10)到7(6-8),p<0.001],和MIDAS[从54(30-81)到16(7-24),p<0.001],HIT-6[从67(65-69)到58(54-64),p<0.001],ASC-12[从6(1.5-9)到2(0-9),p=0.002],BAI[从12(6.5-19)到9(3-17),在治疗后12周,p<0.001和BDI[从11(6.5-17)到3(2-7)p<0.001]评分。抱怨磨牙症的患者在最初的n=27(37.5%)和12中接受了乙酰磺胺醇毒素A注射。治疗后一周n=19(70.4%)期。总的来说,70.8%的患者有反应(MHD降低≥50%),而29.2%没有(<50%减少)。两组在人口统计学上表现出相似的特征,偏头痛史,PROM基线分数,合并症,和先前的治疗。
■OnabotulinumtoxinA是一种有效的治疗选择,可以迅速改善偏头痛的结局,残疾,和影响,同时也减轻共病抑郁和/或焦虑。这项研究的值得注意的发现是,在大多数的CM患者是有效的,不管他们以前的治疗史,偏头痛的特点,或并发合并症。此外,我们没有发现对单纯碱毒素A有良好反应的特异性预测因子。将onabotulinumtoxinA应用于咬肌可以缓解并发磨牙症的不适;然而,它不影响偏头痛结局.
UNASSIGNED: This real-world study aimed to investigate how onabotulinumtoxinA affects the outcome of migraine, along with accompanying anxiety, depression, and bruxism among a group of patients with chronic migraine (CM) and define predictors of good response.
UNASSIGNED: Patients diagnosed with CM who received onabotulinumtoxinA were included in this single-center, real-world retrospective cohort study. Monthly headache days (MHDs), monthly migraine days (MMDs), headache intensity (numeric rating scale-NRS) and headache characteristics were evaluated at baseline and 12 weeks post-treatment. Patient-reported outcome measures (PROMs) included Migraine Disability Assessment Scale (MIDAS), Headache Impact Test-6 (HIT-6) scores, 12-item Allodynia Symptom Checklist (ASC-12), Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI). Response to onabotulinumtoxinA (% reduction in MHDs) and treatment-related adverse events (TRAEs) were also evaluated. OnabotulinumA was applied to the masseter muscles in patients complaining of bruxism.
UNASSIGNED: A total of 72 patients (mean ± SD age: 36.3 ± 8.5 years; 91.7% were female) diagnosed with CM were included. OnabotulinumtoxinA revealed significant decrease in median (IQR) MHDs [from 20(15-25) at baseline to 6(4-10), p < 0.001], MMDs [from 9(6-12) to 3(1-6), p < 0.001] and NRS [from 9(8-10) to 7(6-8), p < 0.001], and the MIDAS [from 54(30-81) to 16(7-24), p < 0.001], HIT-6 [from 67(65-69) to 58(54-64), p < 0.001], ASC-12 [from 6(1.5-9) to 2(0-9), p = 0.002], BAI [from 12(6.5-19) to 9(3-17), p < 0.001] and BDI [from 11(6.5-17) to 3(2-7) p < 0.001] scores at 12 weeks post-treatment. Patients complaining of bruxism received onabotulinumtoxinA injections in the first n = 27 (37.5%) and 12. week post-treatment n = 19 (70.4%) periods. Overall, 70.8% of patients responded (≥50% reduction in MHDs), while 29.2% did not (<50% reduction). Both groups showed similar characteristics in demographics, migraine history, baseline PROMs scores, comorbidities, and prior treatments.
UNASSIGNED: OnabotulinumtoxinA is an effective treatment option that rapidly improves migraine outcomes, disability, and impact while also alleviating comorbid depression and/or anxiety. This study\'s noteworthy finding is that onabotulinumtoxinA is effective in a majority of CM patients, irrespective of their prior treatment history, migraine characteristics, or concurrent comorbidities. Furthermore, we identified no specific predictors for a favorable response to onabotulinumtoxinA. Applying onabotulinumtoxinA to the masseter muscles can relieve discomfort associated with concurrent bruxism; however, it does not impact migraine outcomes.