PO-42 | OnaBotulinumtoxin-A in chronic migraine patients with short or long disease history and psychiatric comorbidities: preliminary data from an Italian multicentric study (the BACH Study)
Fabrizio Vernieri,1,2 Marilena Marcosano,2 Licia Grazzi,3 Danilo Antonio Montisano,3 Raffaele Ornello,4 Simona Sacco,4 Chiara Rosignoli,4 Alberto Doretti,5 Maria Albanese,6 Giovanna Viticchi,7 Nicoletta Brunelli, Luigi d’Onofrio,2 Luisa Fofi,1 Claudia Altamura,1,2 Patrizio Pasqualetti8 | 1Fondazione Policlinico Campus Bio-Medico, Roma, Italy; 2Università Campus Bio-Medico di Roma, Italy; 3Istituto Neurologico Besta, Milano, Italy; 4Università degli Studi l’Aquila, Italy; 5Istituto Auxologico, Milano, Italy; 6Policlinico Tor Vergata, Roma, Italy; 7Università Politecnica Marche, Italy; 8Sapienza Università di Roma, Italy
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Background: The aim of this ongoing observational prospective multicentric study is to investigate whether the duration of Chronic Migraine (CM) for over or less than 10 years can predict Onabotulinumtoxin-A (OBT-A) effectiveness. Since psychiatric symptoms impact migraine treatment effectiveness, we also aimed at evaluating if the psychopathological profile may influence the outcome of the enrolled patients.
Methods: Consecutive CM patients, undergoing OBT-A treatment in 6 Italian headache centers, have been enrolled since January 2024. Evaluation times were at baseline and after 3, 6, 9 and 12 months. We collected Monthly Headache Days (MHDs), number of Monthly Acute Medications (MAMs), HIT-6 and MIDAS scores for disability. Pain intensity was evaluated by NRS. The psychopathological profile was evaluated by means of BDI-II, BIS-11, STAI-Y, DERS, TAS-20 questionnaires.
Results: We have currently enrolled 185 patients (mean age 46.9 yrs, SD 15.7; 160 females, 85.5%), undergoing OBT-A for the first time; 115 patients (62.7%) had a CM history longer than 10 years. At latest data reconnaissance, 163 participants (88%) have been followed for ≥3 months, 140 (76%) for ≥6 months, 111 (60%) for ≥9 months, 83 (45%) for 12 months. To capitalize on all available follow-up measurements and taking into account drop-outs, a mixed-linear model was applied.
MHD, MAMs, MIDAS, HIT-6 and NRS showed a strongly significant decrease (p<.001) across the follow-up. In almost all cases, the trend was neither influenced by disease duration, psychiatric comorbidities, nor by their combination (p>0.05). Only for MIDAS a clear dependence on psychiatric symptoms was found (p=0.002). This interaction is due to the higher scores in the group with psychiatric comorbidities (PSY+) at baseline and at three months, while afterwards the two groups (PSY+ and PSY-) reached approximately the same levels of migraine-related disability. In addition, a slight significance (p=0.064) was found for the triple interaction duration x psychiatric comorbidities x time, mainly due to the high MIDAS score in the group with disease duration <10 years and psychiatric symptoms.
Conclusion: In this preliminary report OBT-A effectiveness was not affected by disease history or psychiatric comorbidities, except for the latter influencing MIDAS in the short term.
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