EHC 2022 | OnabotulinumtoxinA in elderly patients with chronic migraine: real-world evidence
Raffaele Ornello, MD, University of L’Aquila, Avezzano, Italy, describes insights from a real-life European multicenter study aimed at investigating the outcome of onabotulinumtoxinA as preventative therapy in elderly chronic migraine patients. This post-hoc analysis included data from 16 European headache centers on patients treated with onabotulinumtoxinA for chronic migraine over the first three treatment cycles. In a population of elderly patients, onabotulinumtoxinA provided a significant benefit, as good as in non-old patients. This interview took place at the 16th European Headache Congress (EHC) in Vienna, Austria.
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Transcript (edited for clarity)
This is a bright example of the added value of real-world studies over clinical trials because elderly patients were not included in the original OnabotulinumtoxinA studies on chronic migraine. So the use of botulinum toxin was not prohibited in elderly patients. So why not study the outcomes of that treatment in real life? We have patients that have been treated with that kind of treatment, so why not publish in our results?
So we generated data from a real-world cohort of almost 3,000 patients...
This is a bright example of the added value of real-world studies over clinical trials because elderly patients were not included in the original OnabotulinumtoxinA studies on chronic migraine. So the use of botulinum toxin was not prohibited in elderly patients. So why not study the outcomes of that treatment in real life? We have patients that have been treated with that kind of treatment, so why not publish in our results?
So we generated data from a real-world cohort of almost 3,000 patients. Among them, we extracted a subpopulation, a subgroup of patients, aged to 65 years or older, which are not many in our clinics because we all know that migraine is a disease of the young. Still, we found that in elderly patients who continue to have migraine and chronic migraine in particular, OnabotulinumtoxinA is feasible and effective without generating new adverse events of concern. We lacked evidence about it and maybe no clinical trials would ever focus on that population. So maybe we are generating new evidence that can be the base for new consensus statements.
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Disclosures
Dr Ornello’s conflicts of interest include personal fees from Teva, Novartis, and Eli Lilly; non-financial support from Novartis, Allergan/AbbVie, Teva, and Eli Lilly; participation in advisory boards for Eli Lilly; and participation to the Editorial Board of “The Journal of Headache and Pain” and “Frontiers in Neurology”
