Objective:

To demonstrate the effectiveness of Incobotulinumtoxin-A in patients with chronic migraine.

Background:

The global prevalence of migraine is 12% (1) and in Mexico, it is estimated to be 19%, with women being the most affected (2). Onabotulinumtoxin-A was approved by the FDA in 2010 and is the only type of botulinum toxin approved for migraine, with its efficacy demonstrated in multiple clinical trials, meta-analyses, and real-world studies (3). There is lack of evidence in the use of Incobotulinumtoxin-A for Chronic Migraine. 

Design/Methods:

A retrospective study was conducted at a tertiary care level between January and August 2024. 145 Units of Incobotulinumtoxin-A were applied at the 31 sites described in the PREEMPT Protocol (4). Descriptive and inferential statistics were used for data analysis.

Results:

38 patients with chronic migraine (30 women and 8 men) were recruited with a mean age of 47, and 44.3% of those patients had been suffering from migraine for more than 10 years. The average duration of the toxin effect was 2.81 months with an average onset of action at 15.43 days. Patients reported a decrease in intensity (9 VAS vs 5.6 VAS, p< 0.0001), duration (43.2hrs vs 11.7hrs, p< 0.0001), number of episodes (19 vs 4.6, p< 0.0001), and use of rescue medications per month (7.4 vs 3.8, p< 0.0001) after the application of Incobotulinumtoxin-A. A statistically significant association was also found between the duration of migraine and the number of applications with the effect of the duration (p< 0.0001), but no correlation was found.

Conclusions:

Incobotulinumtoxin-A proved to be effective, it has a lower price than other types of toxins and does not require a cold chain, making it a better candidate for centers that do not have the correct cold chain storage facilities.