Department of Neurology, Walter Reed National Military Medical Center, Bethesda, Maryland; Department of Neurology, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
Department of Neurology, Walter Reed National Military Medical Center, Bethesda, Maryland; Department of Neurology, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
Pediatr Neurol. 2023 Oct;147:68-71. doi: 10.1016/j.pediatrneurol.2023.07.005. Epub 2023 Jul 13.
Onabotulinum toxin A is effective in adult chronic migraine, but the efficacy is not well established in adolescent patients. The objective of this study is to describe the safety and efficacy of onabotulinum toxin A and incobotulinum toxin A for adolescent chronic migraine headache.
We performed a chart review of adolescents who received onabotulinum toxin A or incobotulinum toxin A for headache prevention. Demographic information and baseline headache characteristics were collected. The primary end point was a 50% reduction in headache frequency. Secondary outcome measures included reduction in headache frequency, repeat appointments for injections, reduction in other migraine medications, and adverse events.
We included 51 adolescents who received at least one injection of either incobotulinum toxin A or onabotulinum toxin A for chronic migraine. Mean age at first dose was 16.0 (1.1; 13 to 17), (S.D. and range). Patients averaged 24.0 headache days per month (7.6; 4 to 28), (S.D. and range) before injection. In addition, 36 of the 51 adolescents (71%) were experiencing continuous headaches. Thirty-five (69%) adolescents had experienced 50% reduction in headache days by the time of first follow-up, which occurred on average at 16.6 weeks from initial injection (11.5; 2 to 55.7) (S.D. and range). Adolescents reported an average decrease of 13.1 headaches days per month. Only two adolescents reported side effects (4%), which were neck soreness and headache following injection.
Botulinum toxin had better efficacy in our adolescent migraine population than has been demonstrated in other studies.
肉毒毒素 A 对成人慢性偏头痛有效，但在青少年患者中的疗效尚未得到充分证实。本研究旨在描述肉毒毒素 A 和丁胺卡那毒素 A 治疗青少年慢性偏头痛头痛的安全性和疗效。
我们对接受肉毒毒素 A 或丁胺卡那毒素 A 预防头痛的青少年进行了病历回顾。收集了人口统计学信息和基线头痛特征。主要终点是头痛频率降低 50%。次要结局指标包括头痛频率降低、注射次数增加、其他偏头痛药物减少和不良事件。
我们纳入了 51 名至少接受过一次丁胺卡那毒素 A 或肉毒毒素 A 注射治疗慢性偏头痛的青少年患者。首次剂量时的平均年龄为 16.0（1.1；13 至 17）岁（标准差和范围）。患者在注射前平均每月有 24.0 天（7.6；4 至 28）头痛（标准差和范围）。此外，51 名青少年中有 36 名（71%）经历持续头痛。35 名（69%）青少年在首次随访时头痛天数减少 50%，平均在初始注射后 16.6 周（11.5；2 至 55.7）（标准差和范围）。青少年报告平均每月头痛天数减少 13.1 天。只有两名青少年（4%）报告了副作用，分别是注射后颈部疼痛和头痛。
在我们的青少年偏头痛患者中，肉毒毒素的疗效优于其他研究。
