Mathew NT, Jaffri SFA. A double-blind comparison of onabotulinumtoxinA (BOTOX®) and topiramate (TOPAMAX®) for the prophylactic treatment of chronic migraine: a pilot study. Headache: The Journal of Head and Face Pain. 2009;49(10):1466-1478. doi:10.1111/j.1526-4610.2009.01566.x
The study was done primarily to determine if onabotulinumtoxinA is a viable alternative treatment option for the prophylaxis of chronic migraines. In particular, the researchers wanted to determine if onabotulinumtoxinA would cause less severe side effects, in comparison to medications often used for migraine prophylaxis. The study was a prospective, double-blind study conducted at a single site. The subjects had never been given onabotulinumtoxinA or topiramate …show more content…
Firstly, there was no placebo group in this study. In addition, the small sample size could be considered a significant limitation of the study as well. Most importantly, a large number of individuals dropped out of the study before its completion due to adverse effects. 15 individuals from the topiramate group and 12 individuals from the onabotulinumtoxinA group chose to discontinue the study. The researchers noted that of the 15 individuals that dropped out from the topiramate group, eight individuals noted that adverse effects were the main reason they discontinued the study. Of the 12 that dropped out of the onabotulinumtoxinA group, three noted that adverse effects caused them to discontinue the study. All other individuals were either lost to follow up. Despite these limitations, this study was important for clinical practice because it allows clinicians to better understand the tolerability and efficacy of onabotulinumtoxinA in comparison to topiramate. If a patient has difficulty tolerating the effects of topiramate, this study allows clinicians to better educate their patients on a potentially more tolerable and similarly efficacious alternative. This study is significant to clinical practice because it showed that topiramate and onabotulinumtoxinA are essentially equal in terms of chronic migraine prophylaxis. This is relevant because more individuals in the topiramate withdrew from the study citing adverse effects as the reason. As this study has shown that onabotulinumtoxinA and topiramate can be equally effective, practitioners may be able to consider recommending onabotulinumtoxinA to patients who are not able to tolerate
The study was done primarily to determine if onabotulinumtoxinA is a viable alternative treatment option for the prophylaxis of chronic migraines. In particular, the researchers wanted to determine if onabotulinumtoxinA would cause less severe side effects, in comparison to medications often used for migraine prophylaxis. The study was a prospective, double-blind study conducted at a single site. The subjects had never been given onabotulinumtoxinA or topiramate …show more content…
Firstly, there was no placebo group in this study. In addition, the small sample size could be considered a significant limitation of the study as well. Most importantly, a large number of individuals dropped out of the study before its completion due to adverse effects. 15 individuals from the topiramate group and 12 individuals from the onabotulinumtoxinA group chose to discontinue the study. The researchers noted that of the 15 individuals that dropped out from the topiramate group, eight individuals noted that adverse effects were the main reason they discontinued the study. Of the 12 that dropped out of the onabotulinumtoxinA group, three noted that adverse effects caused them to discontinue the study. All other individuals were either lost to follow up. Despite these limitations, this study was important for clinical practice because it allows clinicians to better understand the tolerability and efficacy of onabotulinumtoxinA in comparison to topiramate. If a patient has difficulty tolerating the effects of topiramate, this study allows clinicians to better educate their patients on a potentially more tolerable and similarly efficacious alternative. This study is significant to clinical practice because it showed that topiramate and onabotulinumtoxinA are essentially equal in terms of chronic migraine prophylaxis. This is relevant because more individuals in the topiramate withdrew from the study citing adverse effects as the reason. As this study has shown that onabotulinumtoxinA and topiramate can be equally effective, practitioners may be able to consider recommending onabotulinumtoxinA to patients who are not able to tolerate