Is Less More? Pediatric Intractable Migraine and OnabotulinumtoxinA Treatment

2.50
Hdl Handle:
http://hdl.handle.net/10755/621464
Category:
Full-text
Format:
Text-based Document
Type:
Poster
Level of Evidence:
N/A
Research Approach:
N/A
Title:
Is Less More? Pediatric Intractable Migraine and OnabotulinumtoxinA Treatment
Author(s):
Pezzuto, Tara Ayn
Lead Author STTI Affiliation:
Non-member
Author Details:
Tara Ayn Pezzuto, APRN, RN, MSN, PCNS-BC, Professional Experience: Nemours is a primary pediatric referral center in Delaware, New Jersey, Pennsylvania and Maryland. A need to create a headache center was identified in 2009. As a clinically practicing advanced practice registered nurse (APRN) in the division of child neurology with an interest in pediatric headaches, I worked diligently with our administration to create this program for our pediatric headache patients. I am the Director of the program in a flourishing neurology division. We encourage standardize pediatric headache treatment in primary care . We are establishing a base of knowledge from research and publication. I was awarded the Innovation in Clinical Practice Award for 2015 by the Child Neurology Society and I am now the president elect of the Association of Child Neurology Nurses. I have spoken in several areas across the country and plan to continue speaking internationally on the topic of pediatric headache management Author Summary: As Director of a Headache Program in Pediatric Neurology I have spoke across the United States and internationally on the topic of pediatric headache. As the recipient of the Innovation in Clinical Practice Award for 2015 by the Child Neurology Society and a Jonas Scholar in Leadership for 2016, I look forward to my role as president elect of the Association of Child Neurology Nurses and answering the need of patients who need neurological care.
Abstract:

Objectives: The objective of this study was to analyze pediatric and adolescent chronic daily migraine response rates to modified doses of onabotulinumtoxinA.

 

Background: Chronic migraine occurs in about three percent of pediatric headaches. Some children and adolescents are intractable to two or more preventive medications. OnabotulinumtoxinA, 155-200 units every three months was approved by the US Food and Drug Administration for the use of chronic migraine in adults in 2010. Data on effectiveness and tolerability in the pediatric population is very limited. Standard dosing is not established for children.

 

Methods: A retrospective chart review of forty-four patients’ between 11 and 21 years of age who had 15 or more headache days a month and had been intractable to at least two different prevention medication treatments for chronic daily headache prior to receiving OnabotulinumtoxinA . There were 35 female patients and 9 male patients. Those who received onabotulinumtoxinA for treatment of chronic migraine in a pediatric headache center from February of 2014 to March of 2016 were analyzed. OnabotulinumtoxinA is offered to any pediatric or adolescent patient coming to the clinic for chronic migraine if they fail two or more preventive medications. Dosing was based on location of pain and tolerance of the procedure. Injection sites were outlined based on adult standard dosing suggestions. The review analyzed age, sex, diagnosis, location of pain reported, doses of onabotulinumtoxinA tried, quantity of injection sets, and response to treatment.

 

Results: Seventy percent of this population decreased their headache frequency and/or intensity by at least fifty percent. Forty-eight percent had less than two headaches a month. Ninety four percent of those that responded positively did so with less than one hundred and ten units of onabotulinumtoxinA.

 

Conclusions: This suggests that “less is more” in the pediatric and adolescent dosing of onabotulinumtoxinA for treatment of chronic daily migraine.

Keywords:
Chronic Daily Migraine; OnabotulinumtoxinA; Pediatric Migraine
Repository Posting Date:
8-Jun-2017
Date of Publication:
8-Jun-2017
Other Identifiers:
INRC17PST462
Conference Date:
2017
Conference Name:
28th International Nursing Research Congress
Conference Host:
Sigma Theta Tau International
Conference Location:
Dublin, Ireland
Description:
Event Theme: Influencing Global Health Through the Advancement of Nursing Scholarship

Full metadata record

DC FieldValue Language
dc.language.isoen_USen
dc.type.categoryFull-texten
dc.formatText-based Documenten
dc.typePosteren
dc.evidence.levelN/Aen
dc.research.approachN/Aen
dc.titleIs Less More? Pediatric Intractable Migraine and OnabotulinumtoxinA Treatmenten_US
dc.contributor.authorPezzuto, Tara Aynen
dc.contributor.departmentNon-memberen
dc.author.detailsTara Ayn Pezzuto, APRN, RN, MSN, PCNS-BC, Professional Experience: Nemours is a primary pediatric referral center in Delaware, New Jersey, Pennsylvania and Maryland. A need to create a headache center was identified in 2009. As a clinically practicing advanced practice registered nurse (APRN) in the division of child neurology with an interest in pediatric headaches, I worked diligently with our administration to create this program for our pediatric headache patients. I am the Director of the program in a flourishing neurology division. We encourage standardize pediatric headache treatment in primary care . We are establishing a base of knowledge from research and publication. I was awarded the Innovation in Clinical Practice Award for 2015 by the Child Neurology Society and I am now the president elect of the Association of Child Neurology Nurses. I have spoken in several areas across the country and plan to continue speaking internationally on the topic of pediatric headache management Author Summary: As Director of a Headache Program in Pediatric Neurology I have spoke across the United States and internationally on the topic of pediatric headache. As the recipient of the Innovation in Clinical Practice Award for 2015 by the Child Neurology Society and a Jonas Scholar in Leadership for 2016, I look forward to my role as president elect of the Association of Child Neurology Nurses and answering the need of patients who need neurological care.en
dc.identifier.urihttp://hdl.handle.net/10755/621464-
dc.description.abstract<p><em>Objectives:</em> The objective of this study was to analyze pediatric and adolescent chronic daily migraine response rates to modified doses of onabotulinumtoxinA.</p> <p> </p> <p><em>Background:</em> Chronic migraine occurs in about three percent of pediatric headaches. Some children and adolescents are intractable to two or more preventive medications. OnabotulinumtoxinA, 155-200 units every three months was approved by the US Food and Drug Administration for the use of chronic migraine in adults in 2010. Data on effectiveness and tolerability in the pediatric population is very limited. Standard dosing is not established for children.</p> <p> </p> <p><em>Methods:</em> A retrospective chart review of forty-four patients’ between 11 and 21 years of age who had 15 or more headache days a month and had been intractable to at least two different prevention medication treatments for chronic daily headache prior to receiving OnabotulinumtoxinA . There were 35 female patients and 9 male patients. Those who received onabotulinumtoxinA for treatment of chronic migraine in a pediatric headache center from February of 2014 to March of 2016 were analyzed. OnabotulinumtoxinA is offered to any pediatric or adolescent patient coming to the clinic for chronic migraine if they fail two or more preventive medications. Dosing was based on location of pain and tolerance of the procedure. Injection sites were outlined based on adult standard dosing suggestions. The review analyzed age, sex, diagnosis, location of pain reported, doses of onabotulinumtoxinA tried, quantity of injection sets, and response to treatment.</p> <p> </p> <p><em>Results:</em> Seventy percent of this population decreased their headache frequency and/or intensity by at least fifty percent. Forty-eight percent had less than two headaches a month. Ninety four percent of those that responded positively did so with less than one hundred and ten units of onabotulinumtoxinA.</p> <p> </p> <p><em>Conclusions:</em> This suggests that “less is more” in the pediatric and adolescent dosing of onabotulinumtoxinA for treatment of chronic daily migraine.</p>en
dc.subjectChronic Daily Migraineen
dc.subjectOnabotulinumtoxinAen
dc.subjectPediatric Migraineen
dc.date.available2017-06-08T13:47:07Z-
dc.date.issued2017-06-08-
dc.date.accessioned2017-06-08T13:47:07Z-
dc.conference.date2017en
dc.conference.name28th International Nursing Research Congressen
dc.conference.hostSigma Theta Tau Internationalen
dc.conference.locationDublin, Irelanden
dc.descriptionEvent Theme: Influencing Global Health Through the Advancement of Nursing Scholarshipen
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