Does starting migraine treatment earlier make it work better?

This trial is testing whether OnabotulinumtoxinA (a medication approved to prevent chronic migraine) works better when people start using it early in their migraine journey versus later. The study will compare how well this treatment reduces headache days, the need for pain relief medication, and how much migraine interferes with daily life in two groups of patients: those who have had chronic migraine for fewer than 10 years and those who have had it for 10 or more years.

While this medication is approved and known to help many chronic migraine patients, doctors want to understand which patients benefit most and whether starting treatment earlier in the disease makes a bigger difference. This study also looks at whether a patient's emotional or mental health can affect how well the treatment works.