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Insights into the Functional Anatomy Behind the PREEMPT Injection Paradigm: Guidance on Achieving Optimal Outcomes

OBJECTIVE: To provide clinically relevant insights on the identification of the muscles and techniques involved in the safe and effective use of onabotulinumtoxinA for chronic migraine prophylaxis. BACKGROUND: Although guidance on the use of onabotulinumtoxinA for chronic migraine is available, base...

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Autores principales: Blumenfeld, Andrew M., Silberstein, Stephen D., Dodick, David W., Aurora, Sheena K., Brin, Mitchell F., Binder, William J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5434948/
https://www.ncbi.nlm.nih.gov/pubmed/28387038
http://dx.doi.org/10.1111/head.13074
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author Blumenfeld, Andrew M.
Silberstein, Stephen D.
Dodick, David W.
Aurora, Sheena K.
Brin, Mitchell F.
Binder, William J.
author_facet Blumenfeld, Andrew M.
Silberstein, Stephen D.
Dodick, David W.
Aurora, Sheena K.
Brin, Mitchell F.
Binder, William J.
author_sort Blumenfeld, Andrew M.
collection PubMed
description OBJECTIVE: To provide clinically relevant insights on the identification of the muscles and techniques involved in the safe and effective use of onabotulinumtoxinA for chronic migraine prophylaxis. BACKGROUND: Although guidance on the use of onabotulinumtoxinA for chronic migraine is available, based on the Phase III Research Evaluating Migraine Prophylaxis Therapy (PREEMPT) clinical program, clinical experience has shown that insufficient understanding of the anatomy and function of the head and neck muscles may lead to undesirable outcomes and suboptimal efficacy. DESIGN/METHODS: Each muscle involved in the standardized PREEMPT injection paradigm is reviewed with a thorough description of each muscle's anatomy (ie, muscle description and location, innervation, vascular supply) and function. Key insights based on clinical experience are also provided to help improve outcomes. RESULTS: The identification of the muscles in the PREEMPT injection paradigm should be based on each patient's unique anatomy and injections should be administered using the advised techniques. A thorough examination of the patient prior to treatment is also critical to determine if any preexisting conditions may increase the risk for unwanted outcomes and appropriate expectations should be communicated. CONCLUSIONS: Thorough knowledge of the functional anatomy of the muscles involved in the standardized PREEMPT injection paradigm is critical to achieve the efficacy and safety observed in clinical trials. In addition, it is important to assess a patient's baseline condition to anticipate the risk for unwanted outcomes that may result from treatment.
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spelling pubmed-54349482017-06-01 Insights into the Functional Anatomy Behind the PREEMPT Injection Paradigm: Guidance on Achieving Optimal Outcomes Blumenfeld, Andrew M. Silberstein, Stephen D. Dodick, David W. Aurora, Sheena K. Brin, Mitchell F. Binder, William J. Headache Views and Perspectives OBJECTIVE: To provide clinically relevant insights on the identification of the muscles and techniques involved in the safe and effective use of onabotulinumtoxinA for chronic migraine prophylaxis. BACKGROUND: Although guidance on the use of onabotulinumtoxinA for chronic migraine is available, based on the Phase III Research Evaluating Migraine Prophylaxis Therapy (PREEMPT) clinical program, clinical experience has shown that insufficient understanding of the anatomy and function of the head and neck muscles may lead to undesirable outcomes and suboptimal efficacy. DESIGN/METHODS: Each muscle involved in the standardized PREEMPT injection paradigm is reviewed with a thorough description of each muscle's anatomy (ie, muscle description and location, innervation, vascular supply) and function. Key insights based on clinical experience are also provided to help improve outcomes. RESULTS: The identification of the muscles in the PREEMPT injection paradigm should be based on each patient's unique anatomy and injections should be administered using the advised techniques. A thorough examination of the patient prior to treatment is also critical to determine if any preexisting conditions may increase the risk for unwanted outcomes and appropriate expectations should be communicated. CONCLUSIONS: Thorough knowledge of the functional anatomy of the muscles involved in the standardized PREEMPT injection paradigm is critical to achieve the efficacy and safety observed in clinical trials. In addition, it is important to assess a patient's baseline condition to anticipate the risk for unwanted outcomes that may result from treatment. John Wiley and Sons Inc. 2017-04-06 2017-05 /pmc/articles/PMC5434948/ /pubmed/28387038 http://dx.doi.org/10.1111/head.13074 Text en © 2017 Allergan plc. Headache published by Wiley Periodicals, Inc. on behalf of American Headache Society This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial (http://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Views and Perspectives
Blumenfeld, Andrew M.
Silberstein, Stephen D.
Dodick, David W.
Aurora, Sheena K.
Brin, Mitchell F.
Binder, William J.
Insights into the Functional Anatomy Behind the PREEMPT Injection Paradigm: Guidance on Achieving Optimal Outcomes
title Insights into the Functional Anatomy Behind the PREEMPT Injection Paradigm: Guidance on Achieving Optimal Outcomes
title_full Insights into the Functional Anatomy Behind the PREEMPT Injection Paradigm: Guidance on Achieving Optimal Outcomes
title_fullStr Insights into the Functional Anatomy Behind the PREEMPT Injection Paradigm: Guidance on Achieving Optimal Outcomes
title_full_unstemmed Insights into the Functional Anatomy Behind the PREEMPT Injection Paradigm: Guidance on Achieving Optimal Outcomes
title_short Insights into the Functional Anatomy Behind the PREEMPT Injection Paradigm: Guidance on Achieving Optimal Outcomes
title_sort insights into the functional anatomy behind the preempt injection paradigm: guidance on achieving optimal outcomes
topic Views and Perspectives
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5434948/
https://www.ncbi.nlm.nih.gov/pubmed/28387038
http://dx.doi.org/10.1111/head.13074
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