Rials Unit, University of Birmingham, Birmingham, UK; 5Department of Neurology, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK The Journal of Headache and Pain 2017, 18(Suppl 1):P11 Objectives To assess the effects of botulinum toxins versus placebo, active treatment or distinctive dose for prevention of episodic or chronic migraine in adults. Background A lot of migraine individuals suffer prolonged and frequent migraine attacks regardless of optimised acute and prophylactic treatment options. Botulinum toxin form A has been licensed for use in chronic migraine in some nations, primarily based largely on two commercially sponsored trials. Procedures Relevant trials were identified via electronic searches of Cochrane Central Register of Controlled Trials, Medline, Embase, andFig. 1 (abstract P9). FORWARD Study methodologyThe Journal of Headache and CDPPB GPCR/G Protein Discomfort 2017, 18(Suppl 1):Web page 27 oftrials registries, handsearching reference lists and citation searches on key publications, and correspondence with makers. We included randomised, double-blind, controlled trials. Twelve week time-point information following final round of treatment was analysed. Final results Twenty-eight trials (N=4192) were eligible for inclusion. No trial carried out long-term stick to up. All bigger trials (N100) have been at higher risk industrial sponsorship bias, otherwise trial high-quality was mixed. Botulinum toxin was compared with placebo in 23 trials. Four trials (N=1497) of botulinum toxin in chronic migraineurs showed a reduced frequency of -3.1 migraine daysmonth (95 confidence interval (CI) -4.73 to -1.41) compared with placebo. Addition of a single trial (418 participants) in episodic migraine lowered this pooled estimate of impact to -2.39 daysmonth (95 CI -4.02 to -0.76), still in favour of botulinum toxin. Secondary efficacy measures were inconsistent. Data for Iron saccharate web variety of migraine attacks from six trials which includes chronic and episodic migraineurs showed no significant between group distinction (P=0.30), but severity of migraine (ten cm visual analogue scale), was improved by -3.30 points (95 CI -4.16 to -2.45) a lot more with active treatment. Worldwide assessment and excellent of life measures have been poorly reported. Botulinum toxin had a relative threat of remedy associated adverse events of twice that observed for placebo (two.18, 95 CI 1.73 to 2.75). Insufficient information was offered to establish any dose-response connection for any outcome measure. 3 trials of comparisons with oral prophylactic agents independently reported no important amongst group differences for any variety of diary data outcomes but meta-analysis was not probable. Compared with oral treatment options, botulinum toxin showed a reduced relative threat of treatment-related adverse events of 0.76 (95 CI 0.59 to 0.98). Conclusions In chronic migraine, botulinum toxin variety A reduces frequency of migraine by 3 daysmonth, reduces migraine severity by 30 and has a favourable security profile compared with other preventative drugs. Proof to assistance or refute the efficacy of botulinum toxin in episodic migraine was not identified.P13 Sphenopalatine ganglion block employing Tx360 device. First results in refractory chronic cluster headache in Spain Jose M Sanchez, Maria Rico, Maria Castanon, Elena Ameijide Hospital Universitario Central de Asturias, Neurology, Oviedo, Spain Correspondence: Jose M Sanchez ([email protected]) The Journal of Headache and Discomfort 2017, 18(Suppl 1):P13 Background Despite present preventive treatments virtually 20 of pat.