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December 4, 2025Cephalalgia

Combination preventive therapy with onabotulinumtoxinA and atogepant for chronic migraine: A 24-week, prospective, real-world evaluation (SYNERGY study)

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Authors

LILuigi Francesco IannoneMRMarina RomozziARAntonio Russo

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Overview

Prospective evaluation shows a 45.1% response rate and reduced disability in chronic migraine patients, suggesting benefits of combined treatment.

Key Points

  • Mean monthly migraine days decreased by 6.5 days after treatment with onabotulinumtoxinA and atogepant, showing significant efficacy.
  • Among 101 patients, 45.1% experienced a ≥50% reduction in migraine frequency, indicating potential effectiveness of the combination therapy.
  • Multivariable analysis revealed baseline medication use as a predictor of treatment response in chronic migraine patients receiving co-treatment.
  • Additive therapy is well tolerated, with mild adverse events consistent with safety profiles of onabotulinumtoxinA and atogepant, requiring further validation.

Cite This Study

Iannone et al. (2025) studied this question.

synapsesocial.com/papers/6930e8dbea1aef094cca3e10https://doi.org/10.1177/03331024251398011
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Effectiveness and tolerability of atogepant as preventive treatment in resistant individuals with chronic migraine: Six-month real-world evidence2025
  2. 2Outcomes, unmet needs, and challenges in the management of patients who withdraw from anti-CGRP monoclonal antibodies: A prospective cohort study2024 · 11 citations
  3. 3Combined onabotulinumtoxinA/atogepant treatment blocks activation/sensitization of high-threshold and wide-dynamic range neurons2020 · 45 citations
  4. 4Real-World Evidence of the Safety and Effectiveness of Atogepant Added to OnabotulinumtoxinA for the Preventive Treatment of Chronic Migraine: A Retrospective Chart Review2024 · 3 citations
  5. 5Exploring the effects of extracranial injections of botulinum toxin type A on prolonged intracranial meningeal nociceptors responses to cortical spreading depression in female rats2019 · 44 citations