Objective To determine if patients with chronic migraine continue onabotulinumtoxinA (onabotA) long-term Methods We performed a retrospective cohort analysis using aggregated, de-identified patient data from the Stanford Headache Center. We included patients in California who received at least one prescription for onabotA during the years of 2011–2021. The primary outcome was the number of onabotA treatments each patient received. Secondary outcomes included sex, age, race, ethnicity, body mass index (BMI), distance to the treatment facility, and zip code income quartile. Results A total of 1,551 patients received a mean of 7.60 ± 7.26 treatments and a median of 5 treatments, with 16.2% of patients receiving only one treatment and 10.6% receiving at least 19. Time-to-event survival analysis suggested 26.0% of patients would complete at least 29 treatments if able. Younger age and female sex were associated with statistically significant differences between quartile groups of number of onabotA treatments (p = 0.007, p = 0.015). BMI, distance to treatment facility, and zip code income quartile were not statistically significantly different between quartile groups (p > 0.500 for all). Prescriptions of both triptans and non-onabotA preventive medications showed a statistically significant increase with each higher quartile of number of onabotA treatments (p < 0.001; p < 0.001). Discussion We show long-term persistence to onabotA is high and that distance to treatment facility and income are not factors in continuation. Our work also demonstrates that as patients continue onabotA over time, there may be an increased need for adjunctive or alternative treatments.

中文翻译：

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长期坚持使用 OnabotulinumtoxinA 可预防慢性偏头痛：三级头痛中心 11 年患者数据的结果

目的 确定慢性偏头痛患者是否继续长期服用肉毒杆菌毒素 A (onabotA) 方法 我们使用斯坦福头痛中心汇总的、去识别化的患者数据进行了回顾性队列分析。我们纳入了在 2011 年至 2021 年期间至少接受过一张 onabotA 处方的加利福尼亚州患者。主要结果是每位患者接受的 onabotA 治疗次数。次要结果包括性别、年龄、种族、民族、体重指数 (BMI)、距治疗机构的距离和邮政编码收入四分位。结果 总共 1,551 名患者接受了平均 7.60 ± 7.26 次治疗，中位数为 5 次治疗，其中 16.2% 的患者仅接受 1 次治疗，10.6% 接受至少 19 次治疗。事件发生时间生存分析表明，26.0% 的患者接受治疗如果可以的话，将完成至少 29 次治疗。年龄较小和女性与 onabotA 治疗次数四分位组之间的统计学显着差异相关（p = 0.007，p = 0.015）。 BMI、距治疗机构的距离和邮政编码收入四分位数在四分位数组之间没有统计学上的显着差异（所有组的 p > 0.500）。曲坦类药物和非onabotA预防性药物的处方均显示出随着onabotA治疗次数每增加一个四分位数，统计学上显着增加（p < 0.001；p < 0.001）。讨论 我们表明对 onabotA 的长期坚持率很高，并且距治疗设施的距离和收入不是持续的因素。我们的工作还表明，随着患者继续服用 abotA，随着时间的推移，对辅助或替代治疗的需求可能会增加。