MEDİKAL TEDAVİYE DİRENÇLİ KRONİK MİGREN HASTALARINDA BOTULİNUM TOKSİN TİP A UYGULAMASINDAKİ DENEYİMLERİMİZ

Yıl 2022, Cilt: 24 Sayı: 3, 443 - 447, 31.12.2022

Oktay Faysal Tertemiz , Nermin Tepe

https://doi.org/10.24938/kutfd.1088537

Öz

Amaç: Botulinum toksini tip A, kronik migrenin önleyici tedavisi için iyi tolere edilen bir seçenek olarak kabul edilmiştir. Bu çalışmanın amacı, kronik migren tedavisinde botulinum toksin uygulamasının baş ağrısı atak sıklığını, atak şiddetini ve uygulama sayısı artıkça etkinliğinin nasıl olacağını değerlendirmektir.
Gereç ve Yöntemler: Medikal tedaviye dirençli kronik migren hastalarından üç ay arayla botulinum toksin A yapılmış hastalardan toplam 29 hastanın verisi toplandı. Demografik verileri, tedavi öncesi aylık atak sıklığı, atak şiddeti, ilacın etkinlik süresini karşılaştırıldı.
Bulgular: Botulinum toksini tip A uygulama öncesi ile üçüncü uygulama sonrası karşılaştırıldığında, migren ataklarının aylık sıklığında (21.7 'e karşı 11.4 gün) ve Nümerik derecelendirme skorunda (9.2 'e karşı 5.6) önemli ölçüde iyileşme bulundu (p<0.001). Botulinum toksin etkinliğinin süresi ilk uygulama sonrasında ortalama 3 ay 18 gün, ikinci uygulama sonrasında 3 ay 7 gün, üçüncü uygulama sonrasında 4 ay olarak bulundu.
Sonuç: Bu çalışma, Botulinum toksini tip A uygulanan kronik migrenli hastalarda baş ağrısı atak sıklığında ve şiddetinde azalma gösterdi. Uygulama sayısı artıkça hastaların ağrısız gecen sürelerinde de artış bulundu.

Anahtar Kelimeler

Botulinum nörotoksin A, Kronik migren, Numerik derecelendirme skoru

Destekleyen Kurum

Yok

Proje Numarası

yok

Teşekkür

yok

Our Experience in the Application of Botulinum Toxin Type A in Medically Resistant Chronic Migraine Patients

Öz

Objective: Botulinum toxin type-A has been recognized as a well-tolerated option for the preventive treatment of chronic migraine. The aim of this study is to evaluate the effect of botulinum toxin administration in frequency and severity of headache attacks , and also to show the changes in the effectiveness with repetative botulinum toxin applications in patients with chronic migraine.
Material and Methods: Data of 29 patients with migraine who were administered botulinum toxin-A at a three-month interval were collected. We evaluated demographic data, monthly attack frequency, and attack severity before treatment, and duration of drug effectiveness.
Results: A significant improvement was found in the monthly frequency of migraine attacks (21.7 vs. 11.4 days) and in the Numerical grading score (9.2 vs. 5.6) when compared pre- botulinum toxin type A application period with after the third application period (p < 0.001). The duration of botulinum toxin activity was found to be 3 months and 18 days after the first application, 3 months and 7 days after the second application, and 4 months after the third application.
Conclusion: This study showed a decrease in the frequency and severity of headache attacks in patients with chronic migraine who received Botulinum toxin type-A. As the number of applications increased, there was an increase in the pain-free time of the patients.

Anahtar Kelimeler

Botulinum neurotoxin A, Chronic migraine, Numeric rate scale

Proje Numarası

yok

Kaynakça

• GBD 2015 Disease and Injury Incidence and Prevalence Collaborators. Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries.1990-2015. A systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016; 388(10053):1545-602.
• Headache Classification Committee of the International Headache Society (IHS). The international classification of headache disorders (beta version). Cephalalgia. 2013;33(9):629–808.
• Natoli JL, Manack A, Dean B, Butler Q, Turkel CC, Stovner L et al. Global prevalence of chronic migraine: a systematic review. Cephalgia. 2010;30(5):599-609.
• Mathew NT.Pathophysiology of chronic migraine and mode of action of preventive medications. Headache. 2011;51(2):84-92.
• Blumenfeld A, Silberstein DS, Dodick DW, Aurora SK, Turkel CC, Binder WJ. Method of injection of onabotulinumtoxinA for chronic migraine: A safe, well-tolerated, and effective treatment paradigm based on the PREEMPT clinical program. Headache. 2010 ;50(9):1406-18.
• Tandon M, Singh A, Saluja V, Dhankhar D, Pandey C, Jain P. Validation of a new.objective score vs Numeric Rating Scale fob the evaluaiton of acute pain: A comparative study. Anesth Pain Med. 2016;6(1):e32101.
• Aurora SK, Dodick DW, Turkel CC, DeGryse RE, Silberstein SD, Lipton RB et.al. OnabotulinumtoxinA for treatment of chronic migraine: results from the double-blind, randomized, placebo-controlled phase of the PREEMPT 1 trial. Cephalalgia. 2010 ;30(7):793-803.
• Lv X, Wu Z, Li Y. Innervation of the cerebral dura mater. Neuroradiol J. 2014;27(3):293-8.
• Goldberg SW, Silberstein SD. Targeting CGRP: a new era for migraine treatment. CNS Drugs. 2015;29(6):443-52.
• Binder WJ, Brin MF, Blitzer A, Schoenrock LD, Pogoda JM. Botulinum toxin type A (BOTOX) for treatment of migraine headaches: an open-label study. Otolaryngol Head Neck Surg. 2000;123(6):669-76.
• Diener HC, Dodick DW, Aurora SK, Turkel CC, DeGryse RE, Lipton RB et.al. PREEMPT 2 Chronic Migraine Study Group. Onabotulinumtoxin A for treatment of chronic migraine: Results from the double-blind, randomized, placebo-controlled phase of the PREEMPT 2 trial. Cephalalgia. 2010;30(7):804-14.
• Aurora SK, Brin MF. Chronic migraine: an update on physiology, imaging, and the mechanism of action of two available pharmacologic therapies. Headache. 2017;57(1):109-25.
• Burstein R, Blumenfeld AM, Silberstein SD, Adams MA, Brin MF. Mechanism of Action of OnabotulinumtoxinA in Chronic Migraine: A Narrative Review. Headache. 2020; 60(7):1259-72.
• Bendtsen L, Sacco S, Ashina M, Mitsikostas D, Ahmed F, Pozo-Rosich P et al. Guideline on the use of onabotulinumtoxinA in chronic migraine: A consensus statement from the European Headache Federation. J. Headache Pain. 2018;19(1):91.
• Andrea N, Martina C, Luana L, Paolo M. A two years open-label prospective study of OnabotulinumtoxinA 195 U in medication overuse headache: a real-world experience. J Headache Pain. 2016;17:1.