Botulinum toxin as preventive treatment for migraine: a randomized double-blind study

Eur Neurol. 2009;62(4):204-11. doi: 10.1159/000228987. Epub 2009 Jul 20.

Abstract

Aim: To determine if botulinum toxin type A (BoNT-A) injections can reduce the frequency and severity of migraines.

Methods: Patients (n = 127) were randomized to receive placebo or two doses of BoNT-A (Dysport). The primary endpoint was reduction in number of migraine attacks up to week 8 and between weeks 8 and 12 after injection. Patient diaries were used to record secondary endpoints, including frequency, severity and duration of migraine attacks.

Results: There was a mean reduction of 0.54 and 0.94 attacks/month with placebo and BoNT-A, respectively, and absolute attack count was less in the verum group (3.6 vs. 4.2 attacks/month), but this was not statistically significant. The patients' global assessment of efficacy was significantly better than placebo in the high-dose group (p = 0.02) but no effects were seen for the other secondary efficacy parameters.

Conclusion: Our study showed a trend towards a reduced attack rate with verum but did not show any statistically significant efficacy of BoNT-A in the prophylactic treatment of migraine.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Age of Onset
  • Aged
  • Botulinum Toxins, Type A / therapeutic use*
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Female
  • Humans
  • Injections, Intramuscular
  • Male
  • Middle Aged
  • Migraine Disorders / prevention & control*
  • Patient Selection
  • Statistics, Nonparametric
  • Treatment Outcome

Substances

  • Botulinum Toxins, Type A