The director of the Headache Center of Southern California discussed the findings of the study, as well as what these data might suggest about how onabotulinumtoxinA fits into the shifting landscape of chronic migraine care.
“We don’t think of chronic migraine as a disease that disappears. We consider it like hypertension—if you control hypertension, you’re on a treatment, your blood pressure reading is normal. That’s how we looked at this group of patients. You had 15 days of headache or more, 22 days on average, and now you’re well-controlled and have less than 15 headache days per month.”
At the American Academy of Neurology (AAN) 2020 Annual Meeting, data were accepted from a number of analyses the COMPEL study, including an assessment which sought to ascertain the proportion of those with chronic migraine that achieved a reduction to <15 monthly headache days following onabotulinumtoxinA treatment in the study.
All told, an increasing proportion of treated individuals achieved that mark of <15 headache days over time: 56% (302 of 539 patients) did so at Week 24, 69% (292 of 423 patients) at Week 60, 70.2% (262 of 373 patients) at Week 84, and 74.3% (226 of 304 patients) at Week 108. Additionally, a large majority of those who hit that mark met the criteria for ≥50% responder rates. In total, 70.9% (214 of 302) did so at Week 24, 78.1% (228 of 292) at Week 60, 80.5% (211 of 262) at Week 84, and 83.2% (188 of 226) at Week 108. The mean change in moderate/severe MHDs was also statistically significant compared to baseline values for these patients at all time points (P <.001).
In an interview with NeurologyLive, study author Andrew Blumenfeld, MD, director, Headache Center of Southern California, spoke to the importance and impact of these results. Blumenfeld offered his perspective on the findings of the study, as well as what these data might suggest about how onabotulinumtoxinA fits into the shifting landscape of chronic migraine care with the introduction of the monoclonal antibodies against calcitonin gene-related peptide (CGRP).
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Blumenfeld AM, Luo L, Lipton R. Benefits of Long-Term OnabotulinumtoxinA Treatment in Chronic Migraine: Results from the COMPEL Study. Neurology. 2020;94(15 Suppl): 1694.