MedPath

Abobotulinumtoxina Efficacy in Post-Traumatic Headache

Phase 4
Completed
Conditions
Post-Traumatic Headache
Interventions
Drug: Normal saline
Registration Number
NCT03928496
Lead Sponsor
VA Greater Los Angeles Healthcare System
Brief Summary

This study will evaluate the efficacy of abobotulinumtoxina on Veterans with post-traumatic headache

Detailed Description

A significant proportion of headaches occur following head trauma, and therefore are referred to as post-traumatic headaches (PTH). Traumatic brain injury (TBI) is highly prevalent in the Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) population and consequently there has been a rise in PTH in the clinical setting at VA hospitals. Botulinum toxin type A (BoNT-A) has been shown to be effective in treating chronic migraine and chronic daily headache. It is therefore reasonable to predict that BoNT-A may also be effective in treating PTH. This study proposes that PTH and its associated symptoms may respond positively to BoNT-A treatment due to its similar pathophysiology and clinical resemblance to other headache disorders including tension type headache, typical migraine with or without aura, and chronic daily headache.

Study Design: Veterans with mild, moderate or severe brain injury with a headache developing within 7 days after head trauma and persisting greater than 3 months were recruited from the Veterans Affairs Greater Los Angeles Healthcare System. The study is a prospective, double-blind, randomized, placebo-controlled, cross-over trial.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
40
Inclusion Criteria
  • male or female
  • age 18-65
  • meets International Classification Headache Disorders II (ICHD-II) criteria for post-traumatic headache
  • average pain score of greater than 4/10 in severity on the numerical rating system
  • Rancho Los Amigos cognitive scale score greater than seven.
Exclusion Criteria
  • Uncontrolled medical condition other than PTH
  • Severe additional chronic pain complaint which could not be distinguished from headache pain
  • pregnancy, breast feeding,
  • prior treatment with botulinum toxin within one year of enrollment
  • current substance abuse/dependence
  • medical condition that would increase risk of neuromuscular junction blockade with botulinum toxin (myasthenia gravis, Eaton Lambert, amyotrophic lateral sclerosis)
  • poorly controlled psychiatric
  • initiation of a new anti-depressant or anti-seizure medication within three months of enrolling in study
  • ongoing disability or litigation claim.

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
PlaceboNormal saline0.9% preservative free sterile saline. 0.1 ml were injected into 31 sites of the head and neck
AbobotulinumtoxinaAbobotulinumtoxinA300 units of abobotulinumtoxinA was reconstituted with 2.4 ml of 0.9% preservative free sterile saline so that each 0.1 ml contained 12.5 units of Abobotulinumtoxina 0.1 ml were injected into 31 sites of the head and neck
Primary Outcome Measures
NameTimeMethod
Incidence of headaches from baselineevaluation from time of injection until completion of 12 week follow-up

Evaluation in weekly incidence of headaches from baseline based on headache diary or weekly phone follow-up

Secondary Outcome Measures
NameTimeMethod
Intensity of headache painevaluation from time of injection until completion of 12 week follow-up

Evaluation of pain intensity using score of headache on Numerical Rating Scale (NRS) over time. The NRS is an 11-point scale for patient self-reporting of pain with 0 being no pain and 10 being the most severe pain.

Number of headache days per weekevaluation from time of injection until completion of 12 week follow-up

Evaluation of the number of days a headache was present over each week

Trial Locations

Locations (1)

VA Greater Los Angeles Healthcare System

🇺🇸

Los Angeles, California, United States

© Copyright 2025. All Rights Reserved by MedPath