Real-World Use of CGRPs in Combination With OnabotulinumtoxinA: Andrew M. Blumenfeld, MD


The director of the Headache Center of Southern California discussed his research from AHS 2021 which evaluated safety and efficacy of combined treatment with CGRPs and onabotulimtoxinA.

"On average, what we saw happening across this year-long treatment is an additional 4-day reduction [in monthly headache days], from 12 to 8. That’s interesting that it didn’t go to zero. If it had gone to zero, you might have argued that the monoclonal antibody was the driving force that wiped out the headache and that you don’t need the Botox.”

Led by Andrew M. Blumenfeld, MD, a study presented at the 2021 American Headache Society 63rd Annual Scientific Meeting, June 3-6, evaluated the real-world safety and benefits of combination treatment with a calcitonin gene-related peptide (CGRP) monoclonal antibody (mAb) and onabotulinumtoxinA (Botox; Allergan/AbbVie) in a cohort of patients with chronic migraine. A total of 172 patients were treated with 2 or more consecutive cycles of onabotulinumtoxinA with at least 1 month of subsequent combination treatment with a CGRP mAb and onabotulinumtoxinA.

Results showed that the dual treatment was well tolerated, with no new safety signals identified. The combination was associated with additional clinically meaningful improvements in headache frequency and migraine-related disability compared with onabotulinumtoxinA alone.

Blumenfeld, director of the Headache Center of Southern California, sat down with NeurologyLive to discuss the study and the implications of the results for clinical practice.

For more coverage of AHS 2021, click here.

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