{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T21:50:03Z","timestamp":1774993803695,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,8,14]],"date-time":"2020-08-14T00:00:00Z","timestamp":1597363200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["headachejournal.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Headache"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To quantify wear\u2010off of the response to OnabotulinumtoxinA (OnabotA) treatment over the treatment cycle in chronic migraine at group and individual level.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>OnabotA administered quarterly is an effective treatment for chronic migraine. However, some patients report that headache recurs before the scheduled follow\u2010up injection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective chart review performed in 6 university outpatient centers or private practices specialized in headache treatment, 112 patients with a \u226530% response to OnabotA who completed headache diaries over 13\u00a0weeks after OnabotA treatment were included (age [mean\u00a0\u00b1\u00a0SD] 45\u00a0\u00b1\u00a012\u00a0years, 82% female, headache days\/month at baseline 24\u00a0\u00b1\u00a06).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared to weeks 5 to 8 after injection, headache days\/week increased significantly in weeks 12 (+0.52\u00a0\u00b1\u00a01.96, 95% CI [0.15, 0.88],\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a0.009) and 13 (+1.15\u00a0\u00b1\u00a01.95, CI[0.79, 1.52],\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a0.001), demonstrating significant wear\u2010off of the OnabotA effect. Similarly, acute medication days\/week significantly increased in weeks 12 (0.38\u00b11.67, CI [0.06, 0.69],\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0\u2264\u00a0.027) and 13 (+0.83\u00a0\u00b1\u00a01.76, CI [0.49, 1.16],\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a0.001). At an individual level, 57 patients (51%) showed \u226530% wear\u2010off by weeks 12 and 13, and 28 patients (25%) showed \u226530% wear\u2010off already by weeks 10 and 11. Age, gender, OnabotA dose or cycle number, or headache center did not predict individual wear\u2010off.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These data show that in clinical practice, on average the response of chronic migraine patients to OnabotA injection shows a clinically significant wear\u2010off from week 12 after treatment. About 25% of the patients experience wear\u2010off even by weeks 10 and 11. It must be noted that wear\u2010off detected in a real\u2010world study on OnabotA responders can be due to wear\u2010off of a pharmacological OnabotA effect or a placebo effect, or to regression to the mean effects. This wear\u2010off phenomenon may negatively affect quality of life of chronic migraine patients under OnabotA treatment. The best way to counteract wear\u2010off remains to be determined.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/head.13925","type":"journal-article","created":{"date-parts":[[2020,8,15]],"date-time":"2020-08-15T02:10:00Z","timestamp":1597457400000},"page":"1673-1682","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Wear\u2010Off of OnabotulinumtoxinA Effect Over the Treatment Interval in Chronic Migraine: A Retrospective Chart Review With Analysis of Headache Diaries"],"prefix":"10.1111","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9510-7158","authenticated-orcid":false,"given":"Ruth","family":"Ruscheweyh","sequence":"first","affiliation":[{"name":"Department of Neurology Ludwig Maximilians University Munich M\u00fcnchen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bal","family":"Athwal","sequence":"additional","affiliation":[{"name":"Department of Neurology Royal Free Hospital London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Gryglas\u2010Dworak","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Rare Diseases, Headache Center Wroclaw Wroclaw Medical University Wroclaw Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilaria","family":"Frattale","sequence":"additional","affiliation":[{"name":"Department of Applied Clinical Sciences and Biotechnology University of L\u2019Aquila L\u2019Aquila Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nina","family":"Latysheva","sequence":"additional","affiliation":[{"name":"Department of Neurology, Institute for Postgraduate Education First Moscow State Medical University (Sechenov University) Moscow 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