Clinical Effectiveness of OnabotulinumtoxinA in Chronic Migraine: A Real-World Evaluation of Pain Severity, Attack Frequency and Duration

Volume 16 , Issue 1 , July 2026

Authors

Faiq Bramok Basa 1 ; Suha Saeed Azeez Shangula 2 ; Qoyama Noel Baito 2

1 Hawler Medical University, College of Medicine

2 College of Pharmacy, Hawler Medical University

DOI logo 10.17656/jsmc.10519

Keywords

Abstract

Background: Chronic migraine is a highly disabling neurological disorder, and many patients experience limited benefit or poor tolerability with conventional preventive medications. OnabotulinumtoxinA is an established treatment for chronic migraine, yet real-world data remain essential to understanding its effectiveness across diverse clinical settings. This study evaluates the therapeutic impact of onabotulinumtoxinA on pain severity, monthly attack frequency and attack duration in a real-world cohort. Methods: A cross-sectional observational study was conducted in a private neurology clinic between November 2023 and February 2025. Adults with chronic migraine who received onabotulinumtoxinA as part of routine care were included. Pre-treatment and post-treatment data were collected using a structured questionnaire covering migraine characteristics, symptom burden and medication use. Primary outcomes were changes in pain severity, monthly attack frequency and attack duration. Paired comparisons were performed using the Wilcoxon signed-rank test. Results: Fifty patients were included, with a mean age of 41.6 years and a female predominance of 82 percent. Significant improvement was observed across all primary outcomes. Mean pain severity decreased from 2.92 to 1.58, and median severity decreased from 3.0 to 1.0 (p < 0.001). Monthly attack frequency declined from a mean of 7.15 to 3.12 attacks (median 4.0 to 1.25, p < 0.001). Attack duration showed the most marked reduction, with mean duration decreasing from 61.92 hours to 26.33 hours and median duration from 72 hours to 3.75 hours (p < 0.001). Tolerability was favorable, and no meaningful adverse effects were reported. Conclusion: OnabotulinumtoxinA produced significant reductions in pain severity, attack frequency

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  • First online2 July 2026
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