Article

Key clinical point: The anti-calcitonin gene-related peptide (CGRP) monoclonal antibodies (mAb) fremanezumab, erenumab, and galcanezumab demonstrated similar efficacy during the first year of therapy in patients with chronic and high-frequency episodic migraine, and galcanezumab demonstrated a higher response rate than the other two mAb during the 1-month suspension period in patients with chronic migraine.

Major finding: The three anti-CGRP mAb significantly reduced overall migraine frequency and intensity and symptomatic medication intake per month with similar efficacy across all follow-ups up to 12 months. Patients with chronic migraine receiving galcanezumab vs fremanezumab or erenumab showed higher response rates during the 1-month suspension period (57% vs 39% or 17%, respectively; P = .009).

Study details: This retrospective longitudinal single-center study included 160 patients with chronic and high-frequency episodic migraine who were treated with an anti-CGRP mAb (fremanezumab, erenumab, or galcanezumab) for 12 months.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interests.

Source: Tereshko Y et al. Comparative study of the efficacy of anti-CGRP mAbs on migraineurs: Analysis of the first year of therapy, 1-month suspension period, and reprisal. J Clin Med. 2023;12(23):7329 (Nov 26). doi: 10.3390/jcm12237329

Key clinical point: The anti-calcitonin gene-related peptide (CGRP) monoclonal antibodies (mAb) fremanezumab, erenumab, and galcanezumab demonstrated similar efficacy during the first year of therapy in patients with chronic and high-frequency episodic migraine, and galcanezumab demonstrated a higher response rate than the other two mAb during the 1-month suspension period in patients with chronic migraine.

Major finding: The three anti-CGRP mAb significantly reduced overall migraine frequency and intensity and symptomatic medication intake per month with similar efficacy across all follow-ups up to 12 months. Patients with chronic migraine receiving galcanezumab vs fremanezumab or erenumab showed higher response rates during the 1-month suspension period (57% vs 39% or 17%, respectively; P = .009).

Study details: This retrospective longitudinal single-center study included 160 patients with chronic and high-frequency episodic migraine who were treated with an anti-CGRP mAb (fremanezumab, erenumab, or galcanezumab) for 12 months.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interests.

Source: Tereshko Y et al. Comparative study of the efficacy of anti-CGRP mAbs on migraineurs: Analysis of the first year of therapy, 1-month suspension period, and reprisal. J Clin Med. 2023;12(23):7329 (Nov 26). doi: 10.3390/jcm12237329

Key clinical point: The anti-calcitonin gene-related peptide (CGRP) monoclonal antibodies (mAb) fremanezumab, erenumab, and galcanezumab demonstrated similar efficacy during the first year of therapy in patients with chronic and high-frequency episodic migraine, and galcanezumab demonstrated a higher response rate than the other two mAb during the 1-month suspension period in patients with chronic migraine.

Major finding: The three anti-CGRP mAb significantly reduced overall migraine frequency and intensity and symptomatic medication intake per month with similar efficacy across all follow-ups up to 12 months. Patients with chronic migraine receiving galcanezumab vs fremanezumab or erenumab showed higher response rates during the 1-month suspension period (57% vs 39% or 17%, respectively; P = .009).

Study details: This retrospective longitudinal single-center study included 160 patients with chronic and high-frequency episodic migraine who were treated with an anti-CGRP mAb (fremanezumab, erenumab, or galcanezumab) for 12 months.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interests.

Source: Tereshko Y et al. Comparative study of the efficacy of anti-CGRP mAbs on migraineurs: Analysis of the first year of therapy, 1-month suspension period, and reprisal. J Clin Med. 2023;12(23):7329 (Nov 26). doi: 10.3390/jcm12237329

Key clinical point: Prior treatment with onabotulinumtoxin-A may improve subsequent clinical response to preventive treatment with anti-calcitonin gene-related peptide (anti-CGRP) monoclonal antibodies (mAb) in patients with chronic migraine.

Major finding: At 3 months of treatment with anti-CGRP mAb, patients who received vs did not receive prior onabotulinumtoxin-A had fewer mean monthly migraine days (3.3 days vs 5.2 days; P = .017), lower pain intensity (Numerical Rating Scale scores: 5.9 vs 6.6; P = .013), and a lower mean Migraine Disability Assessment score (23.2 vs 37.4; P = .013).

Study details: The data come from a retrospective observational study including 128 patients with chronic migraine who received treatment with anti-CGRP mAb, of whom 39.9% received prior treatment with onabotulinumtoxin-A.

Disclosures: This study did not receive any external funding. Three authors declared receiving speaker honoraria from or serving as consultants or scientific advisory board members for various sources.

Source: Ceccardi G et al. Onabotulinumtoxin-A: Previous prophylactic treatment might improve subsequent anti-CGRP monoclonal antibodies response in patients with chronic migraine. Toxins. 2023;15(12):677 (Nov 30). doi: 10.3390/toxins15120677

Key clinical point: Prior treatment with onabotulinumtoxin-A may improve subsequent clinical response to preventive treatment with anti-calcitonin gene-related peptide (anti-CGRP) monoclonal antibodies (mAb) in patients with chronic migraine.

Major finding: At 3 months of treatment with anti-CGRP mAb, patients who received vs did not receive prior onabotulinumtoxin-A had fewer mean monthly migraine days (3.3 days vs 5.2 days; P = .017), lower pain intensity (Numerical Rating Scale scores: 5.9 vs 6.6; P = .013), and a lower mean Migraine Disability Assessment score (23.2 vs 37.4; P = .013).

Study details: The data come from a retrospective observational study including 128 patients with chronic migraine who received treatment with anti-CGRP mAb, of whom 39.9% received prior treatment with onabotulinumtoxin-A.

Disclosures: This study did not receive any external funding. Three authors declared receiving speaker honoraria from or serving as consultants or scientific advisory board members for various sources.

Source: Ceccardi G et al. Onabotulinumtoxin-A: Previous prophylactic treatment might improve subsequent anti-CGRP monoclonal antibodies response in patients with chronic migraine. Toxins. 2023;15(12):677 (Nov 30). doi: 10.3390/toxins15120677

Key clinical point: Prior treatment with onabotulinumtoxin-A may improve subsequent clinical response to preventive treatment with anti-calcitonin gene-related peptide (anti-CGRP) monoclonal antibodies (mAb) in patients with chronic migraine.

Major finding: At 3 months of treatment with anti-CGRP mAb, patients who received vs did not receive prior onabotulinumtoxin-A had fewer mean monthly migraine days (3.3 days vs 5.2 days; P = .017), lower pain intensity (Numerical Rating Scale scores: 5.9 vs 6.6; P = .013), and a lower mean Migraine Disability Assessment score (23.2 vs 37.4; P = .013).

Study details: The data come from a retrospective observational study including 128 patients with chronic migraine who received treatment with anti-CGRP mAb, of whom 39.9% received prior treatment with onabotulinumtoxin-A.

Disclosures: This study did not receive any external funding. Three authors declared receiving speaker honoraria from or serving as consultants or scientific advisory board members for various sources.

Source: Ceccardi G et al. Onabotulinumtoxin-A: Previous prophylactic treatment might improve subsequent anti-CGRP monoclonal antibodies response in patients with chronic migraine. Toxins. 2023;15(12):677 (Nov 30). doi: 10.3390/toxins15120677

Key clinical point: Galcanezumab effectively reduced the effect of menstrually related migraine (MRM) and led to improved functioning in women with episodic migraine.

Major finding: Across months 4 through 6, galcanezumab vs placebo led to greater mean reduction in the monthly migraine headache days (MHD; least squares mean change from baseline [Δ] −5.1 vs −3.2), monthly perimenstrual MHD (Δ −0.75 vs −0.49), non-perimenstrual MHD (Δ −4.6 vs −2.8), and greater improvement in Role Function-Restrictive domain scores of the Migraine-Specific Quality of Life Questionnaire (Δ 30.9 vs 22.3 points; all P < .001).

Study details: This post hoc analysis of the EVOLVE-1 and EVOLVE-2 trials included 1133 women with episodic migraine who received either 120 mg galcanezumab per month or placebo, of whom 40.8% met the criteria for MRM.

Disclosures: This study was sponsored by Eli Lilly and Company. Four authors declared being current or former employees and stockowners of Eli Lilly and Company. Two authors declared receiving consulting honoraria from various sources including Eli Lilly.

Source: MacGregor EA et al. Effect of galcanezumab in women with episodic migraine meeting criteria for menstrually related migraine: A post hoc analysis of EVOLVE-1 and EVOLVE-2. Headache. 2023 (Nov 28). doi: 10.1111/head.14652

Key clinical point: Galcanezumab effectively reduced the effect of menstrually related migraine (MRM) and led to improved functioning in women with episodic migraine.

Major finding: Across months 4 through 6, galcanezumab vs placebo led to greater mean reduction in the monthly migraine headache days (MHD; least squares mean change from baseline [Δ] −5.1 vs −3.2), monthly perimenstrual MHD (Δ −0.75 vs −0.49), non-perimenstrual MHD (Δ −4.6 vs −2.8), and greater improvement in Role Function-Restrictive domain scores of the Migraine-Specific Quality of Life Questionnaire (Δ 30.9 vs 22.3 points; all P < .001).

Study details: This post hoc analysis of the EVOLVE-1 and EVOLVE-2 trials included 1133 women with episodic migraine who received either 120 mg galcanezumab per month or placebo, of whom 40.8% met the criteria for MRM.

Disclosures: This study was sponsored by Eli Lilly and Company. Four authors declared being current or former employees and stockowners of Eli Lilly and Company. Two authors declared receiving consulting honoraria from various sources including Eli Lilly.

Source: MacGregor EA et al. Effect of galcanezumab in women with episodic migraine meeting criteria for menstrually related migraine: A post hoc analysis of EVOLVE-1 and EVOLVE-2. Headache. 2023 (Nov 28). doi: 10.1111/head.14652

Key clinical point: Galcanezumab effectively reduced the effect of menstrually related migraine (MRM) and led to improved functioning in women with episodic migraine.

Major finding: Across months 4 through 6, galcanezumab vs placebo led to greater mean reduction in the monthly migraine headache days (MHD; least squares mean change from baseline [Δ] −5.1 vs −3.2), monthly perimenstrual MHD (Δ −0.75 vs −0.49), non-perimenstrual MHD (Δ −4.6 vs −2.8), and greater improvement in Role Function-Restrictive domain scores of the Migraine-Specific Quality of Life Questionnaire (Δ 30.9 vs 22.3 points; all P < .001).

Study details: This post hoc analysis of the EVOLVE-1 and EVOLVE-2 trials included 1133 women with episodic migraine who received either 120 mg galcanezumab per month or placebo, of whom 40.8% met the criteria for MRM.

Disclosures: This study was sponsored by Eli Lilly and Company. Four authors declared being current or former employees and stockowners of Eli Lilly and Company. Two authors declared receiving consulting honoraria from various sources including Eli Lilly.

Source: MacGregor EA et al. Effect of galcanezumab in women with episodic migraine meeting criteria for menstrually related migraine: A post hoc analysis of EVOLVE-1 and EVOLVE-2. Headache. 2023 (Nov 28). doi: 10.1111/head.14652

Key clinical point: Monthly fremanezumab appeared to be effective and well-tolerated for ≤ 12 months in patients with high-frequency episodic migraine (HFEM) or chronic migraine (CM) and multiple failures to previous preventive treatments.

Major finding: At 12 months of fremanezumab treatment, the monthly headache days (MHD) were reduced significantly (median reduction −9.0; P < .001), with 76.5% of patients achieving ≥ 50% response rate. Acute medication use, disability scores, and the percentage of patients with medication overuse reduced significantly from baseline (all P < .001). No severe treatment-related adverse events were reported.

Study details: Findings are from a prospective multicenter long-term study including 83 patients with HFEM (n = 16) or CM (n = 67) and multiple preventive treatment failures who received monthly fremanezumab.

Disclosures: This study was funded by Università degli Studi di Firenze, Italy, within the CRUI-CARE Agreement. Several authors declared receiving travel or research grants, personal fees as speakers or advisors, or honoraria for scientific presentations from various sources.

Source: Caponnetto V et al for The Italian Headache Registry (RICe) Study Group. Long-term treatment over 52 weeks with monthly fremanezumab in drug-resistant migraine: A prospective multicenter cohort study. CNS Drugs. 2023;37:1069-1080 (Nov 24). doi: 10.1007/s40263-023-01050-3

Key clinical point: Monthly fremanezumab appeared to be effective and well-tolerated for ≤ 12 months in patients with high-frequency episodic migraine (HFEM) or chronic migraine (CM) and multiple failures to previous preventive treatments.

Major finding: At 12 months of fremanezumab treatment, the monthly headache days (MHD) were reduced significantly (median reduction −9.0; P < .001), with 76.5% of patients achieving ≥ 50% response rate. Acute medication use, disability scores, and the percentage of patients with medication overuse reduced significantly from baseline (all P < .001). No severe treatment-related adverse events were reported.

Study details: Findings are from a prospective multicenter long-term study including 83 patients with HFEM (n = 16) or CM (n = 67) and multiple preventive treatment failures who received monthly fremanezumab.

Disclosures: This study was funded by Università degli Studi di Firenze, Italy, within the CRUI-CARE Agreement. Several authors declared receiving travel or research grants, personal fees as speakers or advisors, or honoraria for scientific presentations from various sources.

Source: Caponnetto V et al for The Italian Headache Registry (RICe) Study Group. Long-term treatment over 52 weeks with monthly fremanezumab in drug-resistant migraine: A prospective multicenter cohort study. CNS Drugs. 2023;37:1069-1080 (Nov 24). doi: 10.1007/s40263-023-01050-3

Key clinical point: Monthly fremanezumab appeared to be effective and well-tolerated for ≤ 12 months in patients with high-frequency episodic migraine (HFEM) or chronic migraine (CM) and multiple failures to previous preventive treatments.

Major finding: At 12 months of fremanezumab treatment, the monthly headache days (MHD) were reduced significantly (median reduction −9.0; P < .001), with 76.5% of patients achieving ≥ 50% response rate. Acute medication use, disability scores, and the percentage of patients with medication overuse reduced significantly from baseline (all P < .001). No severe treatment-related adverse events were reported.

Study details: Findings are from a prospective multicenter long-term study including 83 patients with HFEM (n = 16) or CM (n = 67) and multiple preventive treatment failures who received monthly fremanezumab.

Disclosures: This study was funded by Università degli Studi di Firenze, Italy, within the CRUI-CARE Agreement. Several authors declared receiving travel or research grants, personal fees as speakers or advisors, or honoraria for scientific presentations from various sources.

Source: Caponnetto V et al for The Italian Headache Registry (RICe) Study Group. Long-term treatment over 52 weeks with monthly fremanezumab in drug-resistant migraine: A prospective multicenter cohort study. CNS Drugs. 2023;37:1069-1080 (Nov 24). doi: 10.1007/s40263-023-01050-3

Key clinical point: The interim analysis of this real-world study confirmed the effectiveness and safety of fremanezumab for the prevention of both chronic migraine (CM) and episodic migraine (EM) attacks.

Major finding: The majority of patients (55.9%) with migraine achieved ≥50% reduction in monthly migraine days (MMD) during 6 months after fremanezumab initiation, with 69.4% and 51.9% of participants with EM and CM, respectively, achieving ≥50% MMD reduction. Very few patients (2.2%) discontinued treatment due to adverse events.

Study details: This interim analysis of the pan-European Real Life study, an ongoing phase 4 study, included 574 patients with EM (25.8%) or CM (74.2%) who initiated fremanezumab on a monthly or quarterly basis.

Disclosures: This study was funded by Teva Pharmaceuticals. Four authors declared being current or former employees or shareholders of Teva Pharmaceuticals. Other authors declared receiving personal fees, research grants, travel grants, honoraria, or research support from or having other ties with various sources, including Teva.

Source: Ashina M et al. Real-world effectiveness of fremanezumab for the preventive treatment of migraine: Interim analysis of the pan-European, prospective, observational, phase 4 PEARL study. Cephalalgia. 2023;43(11):3331024231214987 (Nov 21). doi: 10.1177/03331024231214987

Key clinical point: The interim analysis of this real-world study confirmed the effectiveness and safety of fremanezumab for the prevention of both chronic migraine (CM) and episodic migraine (EM) attacks.

Major finding: The majority of patients (55.9%) with migraine achieved ≥50% reduction in monthly migraine days (MMD) during 6 months after fremanezumab initiation, with 69.4% and 51.9% of participants with EM and CM, respectively, achieving ≥50% MMD reduction. Very few patients (2.2%) discontinued treatment due to adverse events.

Study details: This interim analysis of the pan-European Real Life study, an ongoing phase 4 study, included 574 patients with EM (25.8%) or CM (74.2%) who initiated fremanezumab on a monthly or quarterly basis.

Disclosures: This study was funded by Teva Pharmaceuticals. Four authors declared being current or former employees or shareholders of Teva Pharmaceuticals. Other authors declared receiving personal fees, research grants, travel grants, honoraria, or research support from or having other ties with various sources, including Teva.

Source: Ashina M et al. Real-world effectiveness of fremanezumab for the preventive treatment of migraine: Interim analysis of the pan-European, prospective, observational, phase 4 PEARL study. Cephalalgia. 2023;43(11):3331024231214987 (Nov 21). doi: 10.1177/03331024231214987

Key clinical point: The interim analysis of this real-world study confirmed the effectiveness and safety of fremanezumab for the prevention of both chronic migraine (CM) and episodic migraine (EM) attacks.

Major finding: The majority of patients (55.9%) with migraine achieved ≥50% reduction in monthly migraine days (MMD) during 6 months after fremanezumab initiation, with 69.4% and 51.9% of participants with EM and CM, respectively, achieving ≥50% MMD reduction. Very few patients (2.2%) discontinued treatment due to adverse events.

Study details: This interim analysis of the pan-European Real Life study, an ongoing phase 4 study, included 574 patients with EM (25.8%) or CM (74.2%) who initiated fremanezumab on a monthly or quarterly basis.

Disclosures: This study was funded by Teva Pharmaceuticals. Four authors declared being current or former employees or shareholders of Teva Pharmaceuticals. Other authors declared receiving personal fees, research grants, travel grants, honoraria, or research support from or having other ties with various sources, including Teva.

Source: Ashina M et al. Real-world effectiveness of fremanezumab for the preventive treatment of migraine: Interim analysis of the pan-European, prospective, observational, phase 4 PEARL study. Cephalalgia. 2023;43(11):3331024231214987 (Nov 21). doi: 10.1177/03331024231214987

Key clinical point: Eptinezumab vs placebo reduced the monthly migraine days by ≥30% in a significantly higher proportion of patients with migraine during the first infusion (weeks 1-12), with further improvements in migraine response following the second infusion (weeks 13-24).

Major finding: A significantly higher proportion of patients receiving 100 mg and 300 mg eptinezumab vs placebo achieved ≥30% reduction in monthly migraine days during weeks 1-12 (65.9% and 71.0% vs 36.9%, respectively; P < .0001) and weeks 13-24 (70.4% and 74.5% vs 43.1%, respectively; P < .0001).

Study details: This post hoc analysis of the DELIVER trial included 890 patients with migraine who had experienced 2-4 prior preventive treatment failures and were randomly assigned to receive 100 mg or 300 mg eptinezumab or placebo every 12 weeks.

Disclosures: This study was funded by H. Lundbeck A/S. Three authors declared being full-time employees of H. Lundbeck A/S or one of its subsidiary companies. Other authors declared having ties with various sources including H. Lundbeck A/S.

Source: Ashina M et al. Responder rates with eptinezumab over 24 weeks in patients with prior preventive migraine treatment failures: Post hoc analysis of the DELIVER randomized clinical trial. Eur J Neurol. 2023 (Nov 13). doi: 10.1111/ene.16131

Key clinical point: Eptinezumab vs placebo reduced the monthly migraine days by ≥30% in a significantly higher proportion of patients with migraine during the first infusion (weeks 1-12), with further improvements in migraine response following the second infusion (weeks 13-24).

Major finding: A significantly higher proportion of patients receiving 100 mg and 300 mg eptinezumab vs placebo achieved ≥30% reduction in monthly migraine days during weeks 1-12 (65.9% and 71.0% vs 36.9%, respectively; P < .0001) and weeks 13-24 (70.4% and 74.5% vs 43.1%, respectively; P < .0001).

Study details: This post hoc analysis of the DELIVER trial included 890 patients with migraine who had experienced 2-4 prior preventive treatment failures and were randomly assigned to receive 100 mg or 300 mg eptinezumab or placebo every 12 weeks.

Disclosures: This study was funded by H. Lundbeck A/S. Three authors declared being full-time employees of H. Lundbeck A/S or one of its subsidiary companies. Other authors declared having ties with various sources including H. Lundbeck A/S.

Source: Ashina M et al. Responder rates with eptinezumab over 24 weeks in patients with prior preventive migraine treatment failures: Post hoc analysis of the DELIVER randomized clinical trial. Eur J Neurol. 2023 (Nov 13). doi: 10.1111/ene.16131

Key clinical point: Eptinezumab vs placebo reduced the monthly migraine days by ≥30% in a significantly higher proportion of patients with migraine during the first infusion (weeks 1-12), with further improvements in migraine response following the second infusion (weeks 13-24).

Major finding: A significantly higher proportion of patients receiving 100 mg and 300 mg eptinezumab vs placebo achieved ≥30% reduction in monthly migraine days during weeks 1-12 (65.9% and 71.0% vs 36.9%, respectively; P < .0001) and weeks 13-24 (70.4% and 74.5% vs 43.1%, respectively; P < .0001).

Study details: This post hoc analysis of the DELIVER trial included 890 patients with migraine who had experienced 2-4 prior preventive treatment failures and were randomly assigned to receive 100 mg or 300 mg eptinezumab or placebo every 12 weeks.

Disclosures: This study was funded by H. Lundbeck A/S. Three authors declared being full-time employees of H. Lundbeck A/S or one of its subsidiary companies. Other authors declared having ties with various sources including H. Lundbeck A/S.

Source: Ashina M et al. Responder rates with eptinezumab over 24 weeks in patients with prior preventive migraine treatment failures: Post hoc analysis of the DELIVER randomized clinical trial. Eur J Neurol. 2023 (Nov 13). doi: 10.1111/ene.16131

Key clinical point: When taken during the prodrome, ubrogepant was more effective than placebo in reducing headaches in patients with a ≥1-year history of migraine and had a tolerable safety profile.

Major finding: A significantly higher proportion of patients reported the absence of moderate or severe headaches within 24 hours of receiving ubrogepant vs placebo (46% vs 29%; odds ratio 2.09; P < .0001). Nausea, fatigue, dizziness, and somnolence were reported by ≤5% of patients receiving ubrogepant.

Study details: The PRODROME trial included 518 patients with migraine who were randomly assigned to receive placebo followed by 100 mg ubrogepant to treat the first and second qualifying prodrome events, respectively, or 100 mg ubrogepant followed by placebo to treat the first and second qualifying prodrome events, respectively.

Disclosures: This study was funded by AbbVie. Six authors declared being current or former employees of or holding stocks in AbbVie. Other authors declared having ties with various sources including AbbVie.

Source: Dodick DW et al. Ubrogepant for the treatment of migraine attacks during the prodrome: A phase 3, multicentre, randomised, double-blind, placebo-controlled, crossover trial in the USA. Lancet. 2023 (Nov 15). doi: 10.1016/S0140-6736(23)01683-5

Key clinical point: When taken during the prodrome, ubrogepant was more effective than placebo in reducing headaches in patients with a ≥1-year history of migraine and had a tolerable safety profile.

Major finding: A significantly higher proportion of patients reported the absence of moderate or severe headaches within 24 hours of receiving ubrogepant vs placebo (46% vs 29%; odds ratio 2.09; P < .0001). Nausea, fatigue, dizziness, and somnolence were reported by ≤5% of patients receiving ubrogepant.

Study details: The PRODROME trial included 518 patients with migraine who were randomly assigned to receive placebo followed by 100 mg ubrogepant to treat the first and second qualifying prodrome events, respectively, or 100 mg ubrogepant followed by placebo to treat the first and second qualifying prodrome events, respectively.

Disclosures: This study was funded by AbbVie. Six authors declared being current or former employees of or holding stocks in AbbVie. Other authors declared having ties with various sources including AbbVie.

Source: Dodick DW et al. Ubrogepant for the treatment of migraine attacks during the prodrome: A phase 3, multicentre, randomised, double-blind, placebo-controlled, crossover trial in the USA. Lancet. 2023 (Nov 15). doi: 10.1016/S0140-6736(23)01683-5

Key clinical point: When taken during the prodrome, ubrogepant was more effective than placebo in reducing headaches in patients with a ≥1-year history of migraine and had a tolerable safety profile.

Major finding: A significantly higher proportion of patients reported the absence of moderate or severe headaches within 24 hours of receiving ubrogepant vs placebo (46% vs 29%; odds ratio 2.09; P < .0001). Nausea, fatigue, dizziness, and somnolence were reported by ≤5% of patients receiving ubrogepant.

Study details: The PRODROME trial included 518 patients with migraine who were randomly assigned to receive placebo followed by 100 mg ubrogepant to treat the first and second qualifying prodrome events, respectively, or 100 mg ubrogepant followed by placebo to treat the first and second qualifying prodrome events, respectively.

Disclosures: This study was funded by AbbVie. Six authors declared being current or former employees of or holding stocks in AbbVie. Other authors declared having ties with various sources including AbbVie.

Source: Dodick DW et al. Ubrogepant for the treatment of migraine attacks during the prodrome: A phase 3, multicentre, randomised, double-blind, placebo-controlled, crossover trial in the USA. Lancet. 2023 (Nov 15). doi: 10.1016/S0140-6736(23)01683-5

Key clinical point: Joint space narrowing, and bone proliferation were the most frequently observed radiological alterations in patients having psoriatic arthritis (PsA), with male sex, older age, higher disease activity, and initial polyarticular involvement being significant predictors of bone damage.

Major finding: At a mean follow-up period of ~12.9 years, patients presented with a significantly greater burden of joint space narrowing and bone proliferation in the hands (both P = .001) and joint space narrowing in the feet (P = .047). Male sex (P = .030), older age (P < .05), high initial scores of the Disease Activity Index for PsA (P = .032), and symmetrical polyarticular involvement (P = .025) were significant predictors of bone damage.

Study details: This retrospective cohort study included 50 patients with PsA who were assessed for radiological changes in bone structure and were followed up for ~10 years.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Ozdemir Isik O et al. Radiological progression and predictive factors in psoriatic arthritis: Insights from a decade-long retrospective cohort study. Clin Rheumatol. 2023 (Dec 3). doi: 10.1007/s10067-023-06839-7

Key clinical point: Joint space narrowing, and bone proliferation were the most frequently observed radiological alterations in patients having psoriatic arthritis (PsA), with male sex, older age, higher disease activity, and initial polyarticular involvement being significant predictors of bone damage.

Major finding: At a mean follow-up period of ~12.9 years, patients presented with a significantly greater burden of joint space narrowing and bone proliferation in the hands (both P = .001) and joint space narrowing in the feet (P = .047). Male sex (P = .030), older age (P < .05), high initial scores of the Disease Activity Index for PsA (P = .032), and symmetrical polyarticular involvement (P = .025) were significant predictors of bone damage.

Study details: This retrospective cohort study included 50 patients with PsA who were assessed for radiological changes in bone structure and were followed up for ~10 years.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Ozdemir Isik O et al. Radiological progression and predictive factors in psoriatic arthritis: Insights from a decade-long retrospective cohort study. Clin Rheumatol. 2023 (Dec 3). doi: 10.1007/s10067-023-06839-7

Key clinical point: Joint space narrowing, and bone proliferation were the most frequently observed radiological alterations in patients having psoriatic arthritis (PsA), with male sex, older age, higher disease activity, and initial polyarticular involvement being significant predictors of bone damage.

Major finding: At a mean follow-up period of ~12.9 years, patients presented with a significantly greater burden of joint space narrowing and bone proliferation in the hands (both P = .001) and joint space narrowing in the feet (P = .047). Male sex (P = .030), older age (P < .05), high initial scores of the Disease Activity Index for PsA (P = .032), and symmetrical polyarticular involvement (P = .025) were significant predictors of bone damage.

Study details: This retrospective cohort study included 50 patients with PsA who were assessed for radiological changes in bone structure and were followed up for ~10 years.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Ozdemir Isik O et al. Radiological progression and predictive factors in psoriatic arthritis: Insights from a decade-long retrospective cohort study. Clin Rheumatol. 2023 (Dec 3). doi: 10.1007/s10067-023-06839-7

Key clinical point: Patients with psoriatic arthritis (PsA) who did not have fibromyalgia but presented with prolonged and persistent pain due to central sensitization (CS) reported a greater impact of disease, higher disease activity, and worsened physical and mental function.

Major finding: CS Inventory scores were positively associated with disease activity (Disease Activity in Psoriatic Arthritis: correlation coefficient [ρ] 0.587; P < .0001) and the impact of disease (PsA Impact of Disease 12 items: ρ 0.670; P < .0001) but were negatively associated with the quality of life (Short Form Survey 36 items [SF-36]-physical component summary: ρ −0.405; and SF-36-mental component summary: ρ −0.483; both P < .0001).

Study details: Findings are from a cross-sectional analysis including 157 patients who had PsA without coexisting fibromyalgia, 45.2% of whom had CS Inventory scores ≥40.

Disclosures: This study did not disclose any funding source. The authors declared no conflicts of interest.

Source: Salaffi F et al. Central sensitization in psoriatic arthritis: Relationship with composite measures of disease activity, functional disability and health-related quality of life. J Rheumatol. 2023 (Nov 15). doi: 10.3899/jrheum.2023-0177

Key clinical point: Patients with psoriatic arthritis (PsA) who did not have fibromyalgia but presented with prolonged and persistent pain due to central sensitization (CS) reported a greater impact of disease, higher disease activity, and worsened physical and mental function.

Major finding: CS Inventory scores were positively associated with disease activity (Disease Activity in Psoriatic Arthritis: correlation coefficient [ρ] 0.587; P < .0001) and the impact of disease (PsA Impact of Disease 12 items: ρ 0.670; P < .0001) but were negatively associated with the quality of life (Short Form Survey 36 items [SF-36]-physical component summary: ρ −0.405; and SF-36-mental component summary: ρ −0.483; both P < .0001).

Study details: Findings are from a cross-sectional analysis including 157 patients who had PsA without coexisting fibromyalgia, 45.2% of whom had CS Inventory scores ≥40.

Disclosures: This study did not disclose any funding source. The authors declared no conflicts of interest.

Source: Salaffi F et al. Central sensitization in psoriatic arthritis: Relationship with composite measures of disease activity, functional disability and health-related quality of life. J Rheumatol. 2023 (Nov 15). doi: 10.3899/jrheum.2023-0177

Key clinical point: Patients with psoriatic arthritis (PsA) who did not have fibromyalgia but presented with prolonged and persistent pain due to central sensitization (CS) reported a greater impact of disease, higher disease activity, and worsened physical and mental function.

Major finding: CS Inventory scores were positively associated with disease activity (Disease Activity in Psoriatic Arthritis: correlation coefficient [ρ] 0.587; P < .0001) and the impact of disease (PsA Impact of Disease 12 items: ρ 0.670; P < .0001) but were negatively associated with the quality of life (Short Form Survey 36 items [SF-36]-physical component summary: ρ −0.405; and SF-36-mental component summary: ρ −0.483; both P < .0001).

Study details: Findings are from a cross-sectional analysis including 157 patients who had PsA without coexisting fibromyalgia, 45.2% of whom had CS Inventory scores ≥40.

Disclosures: This study did not disclose any funding source. The authors declared no conflicts of interest.

Source: Salaffi F et al. Central sensitization in psoriatic arthritis: Relationship with composite measures of disease activity, functional disability and health-related quality of life. J Rheumatol. 2023 (Nov 15). doi: 10.3899/jrheum.2023-0177

Key clinical point: The burden of inflammation-independent persistent refractory pain was substantially high in bio-naive patients with psoriatic arthritis (PsA) who received anti-tumor necrosis factor (TNF) therapy.

Major finding: At 12 months of anti-TNF therapy, 39% of patients reported unacceptable pain, the majority (63%) of which was non-inflammatory refractory pain. Higher pain intensity, higher disease activity, and worse health-related quality of life were associated with a higher risk for refractory pain at 12 months (all P < .05) whereas more swollen joints were associated with a lower risk for the same (P = .03).

Study details: This study included 351 bio-naive patients with PsA from the South Swedish Arthritis Treatment Group register who initiated anti-TNF therapy.

Disclosures: This study was funded by grants from Greta och Johan Kocks stiftelser, ALF Region Skåne, and others. Two authors declared receiving research support from or performing consultation tasks for various sources. The other authors declared no conflicts of interest.

Source: Roseman C et al. Persistent pain and its predictors after starting anti-tumour necrosis factor therapy in psoriatic arthritis: What is the role of inflammation control? Scand J Rheumatol. 2023 (Nov 30). doi: 10.1080/03009742.2023.2258644

Key clinical point: The burden of inflammation-independent persistent refractory pain was substantially high in bio-naive patients with psoriatic arthritis (PsA) who received anti-tumor necrosis factor (TNF) therapy.

Major finding: At 12 months of anti-TNF therapy, 39% of patients reported unacceptable pain, the majority (63%) of which was non-inflammatory refractory pain. Higher pain intensity, higher disease activity, and worse health-related quality of life were associated with a higher risk for refractory pain at 12 months (all P < .05) whereas more swollen joints were associated with a lower risk for the same (P = .03).

Study details: This study included 351 bio-naive patients with PsA from the South Swedish Arthritis Treatment Group register who initiated anti-TNF therapy.

Disclosures: This study was funded by grants from Greta och Johan Kocks stiftelser, ALF Region Skåne, and others. Two authors declared receiving research support from or performing consultation tasks for various sources. The other authors declared no conflicts of interest.

Source: Roseman C et al. Persistent pain and its predictors after starting anti-tumour necrosis factor therapy in psoriatic arthritis: What is the role of inflammation control? Scand J Rheumatol. 2023 (Nov 30). doi: 10.1080/03009742.2023.2258644

Key clinical point: The burden of inflammation-independent persistent refractory pain was substantially high in bio-naive patients with psoriatic arthritis (PsA) who received anti-tumor necrosis factor (TNF) therapy.

Major finding: At 12 months of anti-TNF therapy, 39% of patients reported unacceptable pain, the majority (63%) of which was non-inflammatory refractory pain. Higher pain intensity, higher disease activity, and worse health-related quality of life were associated with a higher risk for refractory pain at 12 months (all P < .05) whereas more swollen joints were associated with a lower risk for the same (P = .03).

Study details: This study included 351 bio-naive patients with PsA from the South Swedish Arthritis Treatment Group register who initiated anti-TNF therapy.

Disclosures: This study was funded by grants from Greta och Johan Kocks stiftelser, ALF Region Skåne, and others. Two authors declared receiving research support from or performing consultation tasks for various sources. The other authors declared no conflicts of interest.

Source: Roseman C et al. Persistent pain and its predictors after starting anti-tumour necrosis factor therapy in psoriatic arthritis: What is the role of inflammation control? Scand J Rheumatol. 2023 (Nov 30). doi: 10.1080/03009742.2023.2258644