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Ornello, Raffaele; Baraldi, Carlo; Ahmed, Fayyaz; Negro, Andrea; Miscio, Anna Maria; Santoro, Antonio; Alpuente, Alicia; Russo, Antonio; Silvestro, Marcello; Cevoli, Sabina; Brunelli, Nicoletta; Vernieri, Fabrizio; Grazzi, Licia; Pani, Luca; Andreou, Anna; Lambru, Giorgio; Frattale, Ilaria; Kamm, Katharina; Ruscheweyh, Ruth; Russo, Marco; Torelli, Paola; Filatova, Elena; Latysheva, Nina; Gryglas-Dworak, Anna; Straburzynski, Marcin; Butera, Calogera; Colombo, Bruno; Filippi, Massimo; Pozo-Rosich, Patricia; Martelletti, Paolo; Guerzoni, Simona and Sacco, Simona (2022): Excellent Response to OnabotulinumtoxinA: Different Definitions, Different Predictors. In: International Journal of Environmental Research and Public Health, Vol. 19, No. 17, 10975

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The identification of patients who can benefit the most from the available preventive treatments is important in chronic migraine. We explored the rate of excellent responders to onabotulinumtoxinA in a multicenter European study and explored the predictors of such response, according to different definitions. A pooled analysis on chronic migraineurs treated with onabotulinumtoxinA and followed-up for, at least, 9 months was performed. Excellent responders were defined either as patients with a >= 75% decrease in monthly headache days (percent-based excellent responders) or as patients with <4 monthly headache days (frequency-based excellent responders). The characteristics of excellent responders at the baseline were compared with the ones of patients with a <30% decrease in monthly headache days. Percent-based excellent responders represented about 10% of the sample, whilst frequency-based excellent responders were about 5% of the sample. Compared with non-responders, percent-based excellent responders had a higher prevalence of medication overuse and a higher excellent response rate even after the 1st and the 2nd injection. Females were less like to be frequency-based excellent responders. Chronic migraine sufferers without medication overuse and of female sex may find fewer benefits with onabotulinumtoxinA. Additionally, the excellent response status is identifiable after the first cycle.

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