The Effect of Onabotulinum Toxin-A on Frequency of Headache, Severity of Headache and Health Related Life-Quality at Patients With Resistant Chronic Migraine
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Tarih
2015
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş: Dirençli kronik migren(DKM), yaşam fonksiyonlarında kısıtlılığa neden olan bir hastalıktır. Baş ağrısı ataklarında hastaların acil servislere başvurması, sağlık kaynaklarının meşgul etmesi ve yine hastaların sağlığa bağlı yaşam kalitesi ve üretkenliklerinin kaybı gibi nedenlerle sosyoekonomik yük getirir. Bu çalışmada retrospektif olarak onabotulinum toksin A (OBoNT-A) tedavisinin DKM hastalarında etkinliği ve yaşam kalitesine olan etkisi değerlendirildi. Yöntem: Kliniğimizde 12 hafta arayla iki kez uygulanan 155 IU OBoNT-A tedavisi alan, modifiye DKM kriterlerini karşılayan, 15 hastanın retrospektif olarak 24 haftalık süreçte baş ağrısı sıklığı, şiddeti, yaşam kalitesi (fiziksel fonksiyon, fiziksel rol kısıtlanması, ağrı, genel sağlık algısı, enerji, sosyal fonksiyon, emosyonel durum ve mental sağlık) skorlarında değişimi incelendi. Tedavi yanıtı her 12 haftada bir baş ağrısı sıklığında ?%30 azalma olarak tanımlandı. Tedavi öncesi ve tedavi sonrası Kısa Form-36 ile yaşam kalitesinde değişim değerlendirildi. Bulgular: 15 hastanın tedavi öncesi baş ağrısı sıklığı 26,3 gün/aydı. Hastaların %93,3'ü 24 hafta sonunda tedaviye yanıtlıydı. OBoNT-A enjeksiyonu sonrası bazale göre baş ağrısı sıklığında ortalamada 12 haftada 16,6 gün/ay ve 24 haftada 17,8 gün/ay azalma izlenmiş oldu (p<0.001). Tedavi öncesi yaşam kalitesi skorları ortalamada %50'nin altındaydı, tedavi sonrası sosyal fonksiyon, fiziksel rol kısıtlanması ve enerji kategorilerinde başta olmak üzere tüm kategorilerde sağlık ilişkili yaşam kalitesi skorlarında iyileşme izlendi (p<0.001). Baş ağrısı şiddetinde 24 hafta sonunda anlamlı azalma saptandı (p<0.001). Sonuç: DKM hastalarında OBoNT-A etkin bir tedavidir. Maliyet-etkinlik araştırmaları yapılarak DKM hastalarında öncelikli tedavi olarak düşünülmelidir.
Introduction: Resistant chronic migraine (RCM) causes a considerable decline in the quality of life and work efficiency of the patients and ultimately might even decrease their socio- economic level because of severe and permanent headaches. In addition, migraine attacks force patients to rush to the emergency rooms, which leads to overcrowding and exhaustion of medical resources. In this study, the effect of onabotulinum toxin A (OBoNT-A) treatment was assessed in terms of efficiency and the quality of life retrospectively at patients with RCM. Method: 15 patients with RCM who were given 155 IU OBoNT-A treatment twice in 12 weeks have been studied retrospectively in terms of change of headache frequency, severity, and the health related quality of life scores (physical function, physical restriction, pain, general health, vitality, social function, emotion and mental health categories) for 24 weeks. Response to treatment is identified as &#8805;30% decrease in headache frequency while the change in the quality of life was determined with short form-36 before and after treatment. Findings: Average headache frequency was 26.3 day/month before treatment. After 24 weeks, 93% of the patients were responsive to the treatment. After OBoNT-A treatment average headache frequency decreased to 16,6 day/month in 12 weeks and to 17,8 day/month in 24 weeks (p<0.001). Average health related quality of life scores before treatment were under 50%, while all the health related quality of life scores improved after treatment(p<0.001). At the end of 24 weeks, headache severity significantly decreased (p<0.001). Conclusion: OBoNT-A is an effective treatment in patients with RCM and it must be considered a first line treatment for RCM patients considering the cost-effectiveness researches.
Introduction: Resistant chronic migraine (RCM) causes a considerable decline in the quality of life and work efficiency of the patients and ultimately might even decrease their socio- economic level because of severe and permanent headaches. In addition, migraine attacks force patients to rush to the emergency rooms, which leads to overcrowding and exhaustion of medical resources. In this study, the effect of onabotulinum toxin A (OBoNT-A) treatment was assessed in terms of efficiency and the quality of life retrospectively at patients with RCM. Method: 15 patients with RCM who were given 155 IU OBoNT-A treatment twice in 12 weeks have been studied retrospectively in terms of change of headache frequency, severity, and the health related quality of life scores (physical function, physical restriction, pain, general health, vitality, social function, emotion and mental health categories) for 24 weeks. Response to treatment is identified as &#8805;30% decrease in headache frequency while the change in the quality of life was determined with short form-36 before and after treatment. Findings: Average headache frequency was 26.3 day/month before treatment. After 24 weeks, 93% of the patients were responsive to the treatment. After OBoNT-A treatment average headache frequency decreased to 16,6 day/month in 12 weeks and to 17,8 day/month in 24 weeks (p<0.001). Average health related quality of life scores before treatment were under 50%, while all the health related quality of life scores improved after treatment(p<0.001). At the end of 24 weeks, headache severity significantly decreased (p<0.001). Conclusion: OBoNT-A is an effective treatment in patients with RCM and it must be considered a first line treatment for RCM patients considering the cost-effectiveness researches.
Açıklama
Anahtar Kelimeler
Nörolojik Bilimler
Kaynak
Journal of Neurological Sciences (Turkish)
WoS Q Değeri
Scopus Q Değeri
Cilt
32
Sayı
3
