{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T20:16:07Z","timestamp":1792440967096,"version":"4.5.0"},"reference-count":43,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T00:00:00Z","timestamp":1765756800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T00:00:00Z","timestamp":1765756800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100006483","name":"AbbVie","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006483","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["headachejournal.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Headache"],"published-print":{"date-parts":[[2026,5]]},"abstract":"Abstract<\/jats:title>\n \n Objective<\/jats:title>\n \n Examine treatment responses to and safety of\n onabotulinumtoxinA<\/jats:styled-content>\n for the preventive treatment of chronic migraine (\n CM<\/jats:styled-content>\n ) among diverse racial groups.\n <\/jats:p>\n <\/jats:sec>\n \n Background<\/jats:title>\n Evidence suggests there are differences in headache treatment patterns, symptom profiles, and burden based on race. However, limited data are available describing the response to preventive migraine treatments among these groups.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n The\n C<\/jats:styled-content>\n hronic Migraine\n \n O<\/jats:styled-content>\n nabotulinu\n M<\/jats:styled-content>\n toxinA\n <\/jats:styled-content>\n P<\/jats:styled-content>\n rolonged\n E<\/jats:styled-content>\n fficacy open\n L<\/jats:styled-content>\n abel (\n COMPEL<\/jats:styled-content>\n ) trial was a single\u2010arm, open\u2010label, multicenter, prospective study (January 23, 2012\u2013November 16, 2015) that enrolled adults of various races with\n CM<\/jats:styled-content>\n to receive\n onabotulinumtoxinA<\/jats:styled-content>\n 155 U every 12\u2009weeks over 108\u2009weeks. These analyses assessed White, Asian (primarily Republic of Korea residents), and Black\/African American subgroups based on self\u2010report. Pacific Islander\/American Indian\/Alaska Native and Hispanic\/Latinx subgroups were not analyzed separately because of the small sample sizes and potential overlap with predefined racial categories (e.g., Hispanic\/Latinx White) for the latter. Analyses of baseline demographics and clinical characteristics, including headache features, across the subgroups were performed. Change from baseline in the number of monthly headache days (\n MHDs<\/jats:styled-content>\n ), including proportions with \u226550% reduction in\n MHDs<\/jats:styled-content>\n , and change from baseline scores on the 6\u2010item Headache Impact Test (\n HIT<\/jats:styled-content>\n \u20106), Migraine Disability Assessment (\n MIDAS<\/jats:styled-content>\n ) absenteeism, presenteeism, and total scores, and Migraine\u2010Specific Quality of Life questionnaire version 2.1 (\n MSQ<\/jats:styled-content>\n v2.1) Role Function\u2013Restrictive (\n RFR<\/jats:styled-content>\n ), Emotional Function (\n EF<\/jats:styled-content>\n ), and Role Function\u2013Preventive (\n RFP<\/jats:styled-content>\n ) domains were evaluated for each subgroup.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 716 enrolled participants, 582 (81.3%) were White, 89 (12.4%) were Asian, 41 (5.7%) were Black\/African American, and 4 (0.6%) were Pacific Islander\/American Indian\/Alaska Native. Withdrawal from the study occurred for 50.5% of the White subgroup, 32.6% of the Asian subgroup, and 48.8% of the Black\/African American subgroup. The most common reasons for study discontinuation were participant withdrawal of granted consent (12.8%) and lost to follow\u2010up (11.5%). After treatment with\n onabotulinumtoxinA<\/jats:styled-content>\n 155 U every 12\u2009weeks, all subgroups demonstrated significant reductions from baseline in\n MHDs<\/jats:styled-content>\n at all time points to week 108 (all\n p<\/jats:italic>\n \u2009<\u20090.001) and 60.3%\u201373.3% experienced \u226550% reduction from baseline in\n MHDs<\/jats:styled-content>\n at week 108. Each analyzed subgroup demonstrated significant reductions from baseline to week 108 in\n HIT<\/jats:styled-content>\n \u20106 total (all\n p<\/jats:italic>\n \u2009<\u20090.001),\n MIDAS<\/jats:styled-content>\n total (White,\n p<\/jats:italic>\n \u2009<\u20090.001; Asian,\n p<\/jats:italic>\n \u2009<\u20090.001; Black\/African American,\n p<\/jats:italic>\n \u2009=\u20090.0062),\n MIDAS<\/jats:styled-content>\n absenteeism (White,\n p<\/jats:italic>\n \u2009<\u20090.001; Asian,\n p<\/jats:italic>\n \u2009<\u20090.001; Black\/African American,\n p<\/jats:italic>\n \u2009=\u20090.002),\n MIDAS<\/jats:styled-content>\n presenteeism (all\n p<\/jats:italic>\n \u2009<\u20090.001),\n MSQ<\/jats:styled-content>\n v2.1\n RFR<\/jats:styled-content>\n (all\n p<\/jats:italic>\n \u2009<\u20090.001),\n MSQ<\/jats:styled-content>\n v2.1\n EF<\/jats:styled-content>\n (White,\n p<\/jats:italic>\n \u2009<\u20090.001; Asian,\n p<\/jats:italic>\n \u2009<\u20090.001; Black\/African American,\n p<\/jats:italic>\n \u2009=\u20090.009), and\n MSQ<\/jats:styled-content>\n v2.1\n RFP<\/jats:styled-content>\n (all\n p<\/jats:italic>\n \u2009<\u20090.001) scores. Results in the total population were similar to those in the subgroups. Treatment\u2010related adverse events were consistent with the known safety profile of\n onabotulinumtoxinA<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n OnabotulinumtoxinA<\/jats:styled-content>\n safely reduced\n MHD<\/jats:styled-content>\n frequency and patient\u2010reported disability and improved quality of life as a preventive treatment of\n CM<\/jats:styled-content>\n among diverse subgroups, with results directionally consistent among groups.\n <\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n COMPEL,\n ClinicalTrials.gov<\/jats:ext-link>\n identifier: NCT01516892.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/head.70007","type":"journal-article","created":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T10:52:27Z","timestamp":1765795947000},"page":"1069-1080","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["OnabotulinumtoxinA<\/scp>\n treatment among diverse racial groups: Post hoc analysis of the phase 4 Chronic migraine\n OnabotulinuMtoxinA<\/scp>\n Prolonged Efficacy open\u2010Label (\n COMPEL<\/scp>\n ) trial"],"prefix":"10.1111","volume":"66","author":[{"given":"Andrew M.","family":"Blumenfeld","sequence":"first","affiliation":[{"name":"The Los Angeles Headache Center Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7708-5394","authenticated-orcid":false,"suffix":"IV","given":"Larry","family":"Charleston","sequence":"additional","affiliation":[{"name":"Department of Neurology and Ophthalmology Charleston Health Neurology & Head Pain Consultants Pinckney Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deena","family":"Kuruvilla","sequence":"additional","affiliation":[{"name":"Westport Headache Institute Westport Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Belinda","family":"Savage\u2010Edwards","sequence":"additional","affiliation":[{"name":"Rehabilitation & Neurological Services Huntsville Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard B.","family":"Lipton","sequence":"additional","affiliation":[{"name":"The Saul R. 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