Ruan Qing Zhao, Pak Daniel J, Gulati Amitabh, Dominguez Moises, Diwan Sudhir, Hasoon Jamal, Deer Timothy R, Yong R Jason, Albilali Abdulrazaq, Macone Amanda, Ashina Sait, Robinson Christopher L
Department of Anesthesiology, Weill Cornell Medicine, New York, NY, USA.
Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
J Pain Res. 2024 Dec 10;17:4163-4176. doi: 10.2147/JPR.S485548. eCollection 2024.
To systematically examine the literature on the clinical consequences of inadvertent delays in scheduled onabotulinumtoxin A (OTA) therapy for chronic migraine during the COVID-19 pandemic and assess recommendations when access to OTA is limited.
The coronavirus (COVID-19) pandemic was unprecedented in its impact on the global medical community. Most healthcare institutions in the United States (US) and the world had begun significantly limiting elective procedures, undermining management of many debilitating chronic conditions. OTA injections, were similarly involuntarily postponed, leading to significant setbacks in symptom control.
A comprehensive literature search was conducted on databases of Medline and Embase with search timeframe defined as the point of database inception to March 1st, 2024, and the search was performed on March 2nd, 2024. The search strategy was independently formulated by two authors (QR and CR) and was reviewed and approved by all authors of the article after appropriate amendments.
A total of nine articles met the defined inclusion criteria. They collectively demonstrated marked delays in OTA treatment with decline in migraine symptom control measured in the form of migraine intensity, frequency, as well as patient satisfaction in disease management. Quality of care in the form of follow-ups also appeared compromised. Alternative strategies of telemedicine and the administration of calcitonin gene-related peptide monoclonal antibodies (CGRP mAb) were adopted in place of conventional treatment.
The COVID-19 pandemic had caused marked clinical deterioration in the migraine patient populations across US, Europe, and the Middle East. Strategies employed to circumvent this limitation included the adoption of remote consultation via telemedicine as well as the use of pharmacological agents such as CGRP antagonists. In the event of a reoccurrence of a worldwide pandemic, strategies should be implemented to prevent the cessation of needed treatment for those suffering from chronic migraine.
系统审查关于在2019冠状病毒病（COVID-19）大流行期间，A型肉毒毒素（OTA）治疗慢性偏头痛的预定治疗意外延迟的临床后果的文献，并评估在OTA获取受限的情况下的建议。
冠状病毒（COVID-19）大流行对全球医学界的影响是前所未有的。美国和世界上大多数医疗机构已开始大幅限制择期手术，破坏了许多使人衰弱的慢性病的管理。OTA注射同样被非自愿推迟，导致症状控制出现重大挫折。
在Medline和Embase数据库上进行了全面的文献检索，检索时间范围定义为数据库创建之时至2024年3月1日，并于2024年3月2日进行检索。检索策略由两位作者（QR和CR）独立制定，并在适当修改后经文章所有作者审查和批准。
共有9篇文章符合定义的纳入标准。它们共同表明OTA治疗明显延迟，偏头痛症状控制下降，以偏头痛强度、频率以及患者对疾病管理的满意度来衡量。随访形式的护理质量也似乎受到了影响。采用了远程医疗和降钙素基因相关肽单克隆抗体（CGRP mAb）给药等替代策略来取代传统治疗。
COVID-19大流行已导致美国、欧洲和中东偏头痛患者群体的临床状况显著恶化。为规避这一限制而采用的策略包括通过远程医疗进行远程咨询以及使用CGRP拮抗剂等药物。如果再次发生全球大流行，应实施策略以防止慢性偏头痛患者所需治疗的中断。
