Comparative Long-Term Effectiveness Of OnabotulinumtoxinA (Botox) And Anti CGRP In Migraine Prevention: A Systematic Review
Abstract
Background Every year, 15% of the global population suffers from migraines, making it a substantial social burden with a significant negative impact on quality of life. This systematic review aims to evaluate the comparative efficacy, safety profiles, cost-effectiveness, and additional dimensions of two prominent chronic migraine (CM) prophylactics: OnabotulinumtoxinA (BoNT-A) and calcitonin gene-related peptide (CGRP) monoclonal antibodies (mAbs). Methods Using specific keywords related to onabotulinumtoxinA and anti-CGRP treatments for migraines, we conducted a comprehensive search of electronic databases, including PubMed and the Cochrane Library, spanning from 2015 to 2024. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results Our analysis included 13 publications that revealed notable decreases in migraine frequency and severity with both treatment modalities. While CGRP mAbs demonstrated significant reductions in migraine days with minimal adverse effects, BoNT-A emerged as a superior option due to its cost-efficiency and higher patient satisfaction. Both treatments exhibited mild short-term side effects; however, CGRP mAbs were occasionally associated with extended periods of constipation. The simplicity of adherence, with either monthly self-administered injections of CGRP mAbs or quarterly physician-administered BoNT-A injections, further distinguished these treatments. BoNT-A, in particular, was…
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