The use of onabotulinumtoxin A in migraine: mechanism of action, efficacy, safety and tolerability
Bibliographic record
Abstract
Migraine is a common, yet disabling, neurological disorder that is characterised by recurrent attacks of headache lasting 4–72 hours at a time. Headaches may also present with associated symptoms, such as nausea, vomiting, photophobia and/or phonophobia. There is a distinction between episodic migraine (EM) and chronic migraine (CM). Classed as a distinct clinical entity, patients with CM suffer from more headache days, increased headache disability, reduced health-related quality of life and greater co-morbidity than those with EM. CM is also considered a greater socioeconomic burden and associated with higher healthcare resource utilisation compared to EM. The main goal in CM treatment is to reduce the impact of migraine on the patient's life. Treatments combine lifestyle changes, trigger management and pharmacological management based on two aims: immediate treatment of acute migraine attacks and prophylactic treatment. Onabotulinumtoxin A is the only botulinum toxin licensed for the prevention of headaches in CM patients. The efficacy of injectable onabotulinumtoxin A for headache prevention in adults with CM was evaluated over 1 year in the phase 3 clinical trials of PREEMPT 1 and PREEMPT 2. A longer term study over a period of 2 years took place, and this phase 4 study was known as COMPEL. Good clinical evidence was found that treatment with onabotulinumtoxin A leads to a reduction of monthly headache days, as well as improvement in quality of life, and was both safe and well tolerated.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".