Botox Modestly Improves Chronic Headaches, Migraines

But is not associated with reduction in frequency of episodic migraine or tension-type headaches

WEDNESDAY, April 25 (HealthDay News) -- Botulinum toxin A provides a modest benefit for patients with chronic migraine headaches and chronic daily headaches, compared with placebo, according to a meta-analysis published in the April 25 issue of the Journal of the American Medical Association.

Jeffrey L. Jackson, M.D., M.P.H., of the Medical College of Wisconsin in Milwaukee, and colleagues conducted a meta-analysis of published randomized controlled trials comparing botulinum toxin A with placebo or other interventions for headaches among adults. Migraines and daily or tension headaches were classified as either episodic (<15 headaches per month) or chronic (≥15 headaches per month).

In pooled analyses, the researchers found that botulinum toxin A was associated with a reduction in headaches per month for those with chronic daily headaches (1,115 patients from three studies; −2.06 headaches per month) and among patients with chronic migraines (1,508 patients from five studies; −2.30 headaches per month). No significant correlation was seen between botulinum toxin A and reduction in the number of episodic migraine headaches per month (1,838 patients from nine studies) or chronic tension-type headaches (675 patients from seven studies). Botulinum toxin A was associated with a greater frequency of adverse effects, including blepharoptosis, skin tightness, paresthesias, neck stiffness, muscle weakness, and neck pain, compared to placebo.

"Botulinum toxin A compared with placebo was associated with a small-to-modest benefit for chronic daily headaches and chronic migraines but was not associated with fewer episodic migraine or chronic tension-type headaches per month," the authors write.

One author disclosed financial ties to the pharmaceutical industry.

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