Abstract Details

Title Comparison of different treatment strategies for medication overuse headache: a systematic review and meta-analysis

Topic Headache

Presentation(s) P6 - Poster Session 6 (11:45 AM-12:45 PM)

Poster/Presentation
Number 12-001

Objective

We sought to evaluate the efficacy and safety of different monoclonal antibodies targeting the CGRP and botulinum toxin A for treating medication-overuse headache (MOH) and migraine.

Background

There are many treatment options for medication overuse headaches, including botulinum toxin A and monoclonal antibodies, both acting through the calcitonin gene-related peptide (CGRP) pathway. However, there is inconclusive data regarding their efficacy.

Design/Methods

We searched “Medline”, “Cochrane”, and “Scopus” for randomized controlled trials. Continuous outcomes were assessed through mean difference (MD) with 95% confidence intervals. Statistical significance was set as p-values < 0.05. Heterogeneity was examined using the I2 statistics. For those outcomes, the Mantel-Haenszel random-effects model was applied. We used R software version 4.3.2 and the extension package “meta” for all statistical analyses.

Results A total of 10 randomized controlled trials and 3925 patients were included, of whom 2786 (70,98%) received monoclonal antibodies and 562 (14,3%) received botulinum toxin A, including erenumab, fremanezumab, and eptinezumab for both MOH and migraine treatments. During the follow-up period, patients treated with botulinum toxin experienced a decrease in headache compared to placebo (MD -1.90; 95% CI -2.68 to -1.12; P= 0.000002; I² = 0%). Furthermore, the use of monoclonal antibodies also presented significantly better results compared to placebo for both monthly migraine days (MD -2.65; 95% CI -3.19 to -2.12; P < 0.000001; I² = 77%) and monthly headache days (MD -2.33; 95% CI -2.85 to -1.81; P < 0.000001; I² = 95%).

Conclusions

In this meta-analysis, we concluded that both monoclonal antibodies and botulinum toxin A injections effectively achieved monthly headache and monthly migraine reductions.

Authors/Disclosures
Fernanda M. Tamashiro PRESENTER	Miss Tamashiro has nothing to disclose.
Beatriz Guerreiro Otoboni, MS	Miss Guerreiro Otoboni has nothing to disclose.
Cacilda L. Altoé, MS	Ms. Altoé has nothing to disclose.
Maria Carolina Sawadi Guizilini (University of Maringa, UniCesumar)	No disclosure on file
Khauana Carvalho de Lima, MS	Miss Carvalho de Lima has nothing to disclose.
Jeane C. De Melo	Mrs. De Melo has nothing to disclose.
Catarina Nobile Portezan (University of Maringa Unicesumar)	No disclosure on file
Vitor K. Sano, MS	Mr. Sano has nothing to disclose.
Artur Menegaz de Almeida, MS	Mr. Menegaz de Almeida has nothing to disclose.

��ɫ��

��ɫ��