Different Methods of Treatment With Onabotulinum Toxin a in Chronic Migraine and Different Types of Botulinum Toxin Used Publisher



Farham F ; Onan D ; Moghadas F ; Martelletti P
Source: SN Comprehensive Clinical Medicine Published:2026

Abstract

Botulinum toxin (BTX) is a neurotoxin protein produced by bacterium Clostridium botulinum. There are seven serotypes (A-G). Three formulations of serotype A (Onabotulinum, Abobotulinum, and Incobotulinum) and one formulation of serotype B (Rimabotulinum toxin) are approved by the Food and Drug Administration (FDA) for therapeutic use. In 2010, the FDA approved Onabotulinum toxin-A (ONA) as a treatment option for chronic migraine (CM) using the PREEMPT protocol, which significantly improved migraine symptoms. Due to its mechanism of action, various administration methods of ONA have been examined in several studies, showing positive effects. Additionally, differences in structure and sites of action of other formulations suggest they may also be valid options for CM treatment. This review provides an overview of the efficacy of ONA using methods other than PREEMPT, as well as the effectiveness of other BTX formulations in treating CM. © The Author(s), under exclusive licence to Springer Nature Switzerland AG 2026.