Pregnancy Outcomes in Patients Exposed to OnabotulinumtoxinA Treatment

Brin, Mitchell F.; Kirby, Russell S.; Slavotinek, Anne; Adams, Aubrey Manack; Parker, Lori; Ukah, Ahunna; Radulian, Lavinia; Elmore, Monica R. P.; Yedigarova, Larisa; Yushmanova, Irina

doi:10.1212/wnl.0000000000207375

Cited by 16 publications

(2 citation statements)

References 41 publications

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“…Spontaneous abortion and fetal defects have been reported with onabotulinumtoxinA treatment. 30 , 31 A recent 29-year retrospective study of the Allergan safety database reviewed the pregnancy outcomes of 397 mothers worldwide, a majority of whom ( n = 202 of the 242 pregnancies where dosage was reported) were exposed to <200 U of onabotulinumtoxinA during or within 3 months prior to pregnancy. 31 Of the 195 pregnancies that were recorded prospectively, 77.2% resulted in live births.…”

Section: Discussionmentioning

confidence: 99%

Safety and tolerability of onabotulinumtoxinA in the treatment of upper facial lines from global registration studies in 5298 participants: A meta-analysis

Brin,

De Boulle,

Liew

et al. 2024

JAAD International

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Section: Discussionmentioning

confidence: 99%

Safety and tolerability of onabotulinumtoxinA in the treatment of upper facial lines from global registration studies in 5298 participants: A meta-analysis

Brin,

De Boulle,

Liew

et al. 2024

JAAD International

Self Cite

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“…During lactation, they are considered a safe option, but it is recommended to monitor for anticholinergic symptoms like dry mouth or constipation [ 74 , 84 ]. Lastly, onabotulinumtoxinA is not expected to enter the systemic circulation or to transfer to breast milk due to its high molecular weight, and retrospective studies have not observed an effect on pregnancy outcomes, but further studies are warranted to assess its safety [ 85 , 86 ].…”

Section: Introductionmentioning

confidence: 99%

Health equity, care access and quality in headache – part 2

Raffaelli,

Rubio-Beltrán,

Cho

et al. 2023

J Headache Pain

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Background Headache disorders are a global public health concern affecting diverse populations. This review examines headache service organizations in low-, middle-, and high-income countries. It addresses global challenges in pharmacological headache treatment, with a focus on safety, tolerability, reproductive and child health, and outlines disparities in accessing innovative treatments worldwide. Main body Organized headache services are essential due to the wide prevalence and varying severity of headache disorders. The tiered headache service model is globally recognized, although its implementation varies based on financial and workforce considerations. Headache burden affects well-being, causing disability, economic challenges, and work limitations, irrespective of location or income. All nations still require improved diagnosis and treatment, and the majority of countries face obstacles including limited access, awareness, economic barriers, and inadequate health policies. Provided adequate internet availability, telemedicine could help improve health equity by expanding access to headache care, since it can offer patients access to services without lengthy waiting times or extensive travel and can provide healthcare unavailable in underserved areas due to staff shortages. Numerous health disparities restrict global access to many headache medications, especially impacting individuals historically excluded from randomized controlled trials, such as those with cardiovascular and cerebrovascular conditions, as well as pregnant women. Furthermore, despite advancements in researching migraine treatments for young patients, the options for treatment remain limited. Access to headache treatment relies on factors like medication availability, approval, financial coverage, and healthcare provider expertise. Inadequate public awareness leads to neglect by policymakers and undertreatment by patients and healthcare providers. Global access discrepancies are exacerbated by the introduction of novel disease-specific medications, particularly impacting Asian, African, and Latin American nations excluded from clinical trials. While North America and Europe experience broad availability of migraine treatments, the majority of countries worldwide lack access to these therapies. Conclusions Healthcare disparities, treatment access, and medication availability are concerning issues in headache medicine. Variations in national healthcare systems impact headache management, and costly innovative drugs are widening these gaps. Healthcare practitioners and experts should acknowledge these challenges and work towards minimizing access barriers for equitable global headache care in the future.

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Is Botulinum Toxin Treatment Safe?

Jabbari

2024

Botulinum Toxin Treatment

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Pregnancy Outcomes in Patients Exposed to OnabotulinumtoxinA Treatment

Cited by 16 publications

References 41 publications

Safety and tolerability of onabotulinumtoxinA in the treatment of upper facial lines from global registration studies in 5298 participants: A meta-analysis

Safety and tolerability of onabotulinumtoxinA in the treatment of upper facial lines from global registration studies in 5298 participants: A meta-analysis

Health equity, care access and quality in headache – part 2

Is Botulinum Toxin Treatment Safe?

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