000077202 001__ 77202
000077202 005__ 20200117221626.0
000077202 0248_ $$2sideral$$a110477
000077202 037__ $$aART-2018-110477
000077202 041__ $$aeng
000077202 100__ $$aGarcia-Azorin, D.
000077202 245__ $$aReal-world preventative drug management of Chronic Migraine among Spanish Neurologists
000077202 260__ $$c2018
000077202 5060_ $$aAccess copy available to the general public$$fUnrestricted
000077202 5203_ $$aO42
Background:
In migraine, the therapeutic preventive drug arsenal is varied. Whenprescribing both Guidelines and patient characteristics are taken intoaccount. In Spain, the use of preventive therapies seems to beheterogeneous.The objective of this study was to evaluate real-life clinical prescribingpractice amongst neurologists in Spain
Methods:
Observational descriptive study done with a survey by Neurologistsof the Spanish Neurological Society (SEN). Neurologists who participatedwere divided into Headache Specialists or not. The followingdata was collected: socio-demographic data, ; preventive treatmentand choices different migraine sub-types, and their personal perceptionof efficacy and tolerability to different drugs.
Results:
We analyzed 152 surveys from neurologists around our country.From them: 43.4% were female, 53.3% <40 years, and 34.9% were interestedin headache .In regards to preventive treatment choice; in chronic migraine topiramate(57%) amytriptiline (17.9%) and beta-blockers (14.6%), whereasin episodic migraine the preferred drugs were beta-blockers (47.7%), topiramate (21.5%) and amytriptiline (13.4%).Regarding perceived efficacy, topiramate was considered the bestoption in chronic migraine (42.7%) followed by onabotulinumtoxinA(25.5%) and amitryptiline (22.4%). In episodic migraine, neurologistpreferred topiramate (43.7%) and beta-blockers (30.3%).Regarding the duration of preventive therapy when improvementwas achieved, when treating episodic migraine 43.5% of the surveyedneurologists recommended 3 months and 39.5% preferred 6months. When they treated chronic migraine, 20.4% of neurologistsrecommended 3 months, 42.1% 6 months, 12.5% 9 months and22.4% preferred to maintain treatment during 12 months.When considering onabotulinumtoxinA treatment, the number ofprior therapeutical failures was cero in 7.2% of surveyed, one in5.9%, two in 44.1%, three in 30.9%, and four or more in 11.9%. Theincrease of OnabotulinumtoxinA dose up to 195 UI was consideredby 51% of neurologists after a first ineffective procedure, by 42.2% after two injections, and by 83% after a third infiltration. Surveyedcolleagues admitted to take into account in their decisions mainlypatient comorbidities (70.2%) rather than guidelines (13.9%).
Conclusions:
Initial management of Migraine among Spanish Neurologists is madewith the preventative drugs which are considered as first choices inmost of the guidelines. Management of episodic migraine differedfrom chronic migraine, both in the order or drugs and the perceptionof the most effective therapy.
000077202 540__ $$9info:eu-repo/semantics/openAccess$$aby-nc-nd$$uhttp://creativecommons.org/licenses/by-nc-nd/3.0/es/
000077202 590__ $$a3.918$$b2018
000077202 591__ $$aCLINICAL NEUROLOGY$$b46 / 199 = 0.231$$c2018$$dQ1$$eT1
000077202 591__ $$aNEUROSCIENCES$$b79 / 266 = 0.297$$c2018$$dQ2$$eT1
000077202 592__ $$a1.106$$b2018
000077202 593__ $$aAnesthesiology and Pain Medicine$$c2018$$dQ1
000077202 593__ $$aNeurology (clinical)$$c2018$$dQ1
000077202 593__ $$aMedicine (miscellaneous)$$c2018$$dQ1
000077202 655_4 $$ainfo:eu-repo/semantics/conferenceObject$$vinfo:eu-repo/semantics/publishedVersion
000077202 700__ $$0(orcid)0000-0001-5139-6031$$aSantos Lasaosa, S.$$uUniversidad de Zaragoza
000077202 700__ $$aGago-Veiga, A.B.
000077202 700__ $$aViguera Romero, J.
000077202 700__ $$aGuerrero-Peral, A.L.
000077202 700__ $$aPozo-Rosich, P.
000077202 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000077202 773__ $$g19, Suppl. 1 (2018), O42 [1 pp]$$pJ. headache pain$$tThe Journal of headache and pain$$x1129-2369
000077202 85641 $$uhttps://thejournalofheadacheandpain.biomedcentral.com/track/pdf/10.1186/s10194-018-0900-0$$zTexto completo de la revista
000077202 8564_ $$s73806$$uhttps://zaguan.unizar.es/record/77202/files/texto_completo.pdf$$yVersión publicada
000077202 8564_ $$s120732$$uhttps://zaguan.unizar.es/record/77202/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000077202 909CO $$ooai:zaguan.unizar.es:77202$$particulos$$pdriver
000077202 951__ $$a2020-01-17-21:57:13
000077202 980__ $$aARTICLE