Botulinum toxin type A for the prevention of headaches in adults with chronic migraine
This is an extract from the guidance. The complete guidance is available at guidance.nice.org.uk/ta260
1.1 Botulinum toxin type A is recommended as an option for the prophylaxis of headaches in adults with chronic migraine (defined as headaches on at least 15 days per month of which at least 8 days are with migraine):
that has not responded to at least three prior pharmacological prophylaxis therapies and
whose condition is appropriately managed for medication overuse.
1.2 Treatment with botulinum toxin type A that is recommended according to 1.1 should be stopped in people whose condition:
is not adequately responding to treatment (defined as less than a 30% reduction in headache days per month after two treatment cycles) or
has changed to episodic migraine (defined as fewer than 15 headache days per month) for three consecutive months.
1.3 People currently receiving botulinum toxin type A that is not recommended according to 1.1 and 1.2 should have the option to continue treatment until they and their clinician consider it appropriate to stop.