Article

Key clinical point: Dihydroergotamine (DHE) nasal powder was well tolerated over the long term for the acute treatment of migraine.

Major findings: Treatment-emergent adverse events were reported in 48.5% of the participants, with nasal discomfort being the most common (11.3%). No deaths were reported. A serious adverse event related to treatment occurred in only one participant who did not disclose contraindications to DHE, and 4.4% of the participants discontinued the use of DHE. There were no new safety concerns.

Study details: The ASCEND trial involved 344 adults aged 18-65 years with a history of 4-12 migraine attacks per month for at least 1 year. Participants self-administered DHE (5.2 mg) as needed, with a maximum of 12 doses per month, for 1 year.

Disclosure: This study was funded by Satsuma Pharmaceuticals, Inc. Two authors declared being employees and stockholders of Satsuma, and others declared having ties with various sources, including Satsuma.

Sources: Tepper SJ, Albrecht D, Ailani J. Kirby L, Strom S, Rapoport AM. Long-term (12-Month) safety and tolerability of STS101 (dihydroergotamine nasal powder) in the acute treatment of migraine: Data from the phase 3 open-label ASCEND study. CNS Drugs. Published online October 7, 2024. Source

Key clinical point: Dihydroergotamine (DHE) nasal powder was well tolerated over the long term for the acute treatment of migraine.

Major findings: Treatment-emergent adverse events were reported in 48.5% of the participants, with nasal discomfort being the most common (11.3%). No deaths were reported. A serious adverse event related to treatment occurred in only one participant who did not disclose contraindications to DHE, and 4.4% of the participants discontinued the use of DHE. There were no new safety concerns.

Study details: The ASCEND trial involved 344 adults aged 18-65 years with a history of 4-12 migraine attacks per month for at least 1 year. Participants self-administered DHE (5.2 mg) as needed, with a maximum of 12 doses per month, for 1 year.

Disclosure: This study was funded by Satsuma Pharmaceuticals, Inc. Two authors declared being employees and stockholders of Satsuma, and others declared having ties with various sources, including Satsuma.

Sources: Tepper SJ, Albrecht D, Ailani J. Kirby L, Strom S, Rapoport AM. Long-term (12-Month) safety and tolerability of STS101 (dihydroergotamine nasal powder) in the acute treatment of migraine: Data from the phase 3 open-label ASCEND study. CNS Drugs. Published online October 7, 2024. Source

Key clinical point: Dihydroergotamine (DHE) nasal powder was well tolerated over the long term for the acute treatment of migraine.

Major findings: Treatment-emergent adverse events were reported in 48.5% of the participants, with nasal discomfort being the most common (11.3%). No deaths were reported. A serious adverse event related to treatment occurred in only one participant who did not disclose contraindications to DHE, and 4.4% of the participants discontinued the use of DHE. There were no new safety concerns.

Study details: The ASCEND trial involved 344 adults aged 18-65 years with a history of 4-12 migraine attacks per month for at least 1 year. Participants self-administered DHE (5.2 mg) as needed, with a maximum of 12 doses per month, for 1 year.

Disclosure: This study was funded by Satsuma Pharmaceuticals, Inc. Two authors declared being employees and stockholders of Satsuma, and others declared having ties with various sources, including Satsuma.

Sources: Tepper SJ, Albrecht D, Ailani J. Kirby L, Strom S, Rapoport AM. Long-term (12-Month) safety and tolerability of STS101 (dihydroergotamine nasal powder) in the acute treatment of migraine: Data from the phase 3 open-label ASCEND study. CNS Drugs. Published online October 7, 2024. Source

Key clinical point: Patients with migraine who received calcitonin gene-related peptide inhibitors (CGRPi) showed improved pain reduction compared with those on other preventative medications.

Major findings: Patients who received only CGRPi or switched to CGRPi had significant reductions in mean pain scores (−2.0 and −2.7, respectively; both P < .001), whereas those on other migraine-preventative medications did not. Patients adhering to CGRPi, including those who received only CGRPi (−3.1; P = .005) and those who switched from other medications to CGRPi (−3.7; P = .002), had significantly reduced pain scores; however, no reduction in pain scores was noted in patients not adhering to CGRPi.

Study details: This retrospective study analyzed Patient Reported Outcomes Measurement Information System data for adults with migraine over 12 months, including 1245 patients on other preventive medications (antiseizures, antidepressants, or beta-blockers), 148 receiving only CGRPi, and 112 switching to CGRPi.

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

Source: Peasah SK, Soh YH, Huang Y, Nguyen J, Hanmer J, Good C. Patient reported outcomes and the real-world use of calcitonin gene–related peptide medications in migraine. Headache. Published online September 30, 2024. Source

Key clinical point: Patients with migraine who received calcitonin gene-related peptide inhibitors (CGRPi) showed improved pain reduction compared with those on other preventative medications.

Major findings: Patients who received only CGRPi or switched to CGRPi had significant reductions in mean pain scores (−2.0 and −2.7, respectively; both P < .001), whereas those on other migraine-preventative medications did not. Patients adhering to CGRPi, including those who received only CGRPi (−3.1; P = .005) and those who switched from other medications to CGRPi (−3.7; P = .002), had significantly reduced pain scores; however, no reduction in pain scores was noted in patients not adhering to CGRPi.

Study details: This retrospective study analyzed Patient Reported Outcomes Measurement Information System data for adults with migraine over 12 months, including 1245 patients on other preventive medications (antiseizures, antidepressants, or beta-blockers), 148 receiving only CGRPi, and 112 switching to CGRPi.

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

Source: Peasah SK, Soh YH, Huang Y, Nguyen J, Hanmer J, Good C. Patient reported outcomes and the real-world use of calcitonin gene–related peptide medications in migraine. Headache. Published online September 30, 2024. Source

Key clinical point: Patients with migraine who received calcitonin gene-related peptide inhibitors (CGRPi) showed improved pain reduction compared with those on other preventative medications.

Major findings: Patients who received only CGRPi or switched to CGRPi had significant reductions in mean pain scores (−2.0 and −2.7, respectively; both P < .001), whereas those on other migraine-preventative medications did not. Patients adhering to CGRPi, including those who received only CGRPi (−3.1; P = .005) and those who switched from other medications to CGRPi (−3.7; P = .002), had significantly reduced pain scores; however, no reduction in pain scores was noted in patients not adhering to CGRPi.

Study details: This retrospective study analyzed Patient Reported Outcomes Measurement Information System data for adults with migraine over 12 months, including 1245 patients on other preventive medications (antiseizures, antidepressants, or beta-blockers), 148 receiving only CGRPi, and 112 switching to CGRPi.

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

Source: Peasah SK, Soh YH, Huang Y, Nguyen J, Hanmer J, Good C. Patient reported outcomes and the real-world use of calcitonin gene–related peptide medications in migraine. Headache. Published online September 30, 2024. Source

Key clinical point: Ubrogepant showed real-world effectiveness for the acute treatment of migraine, with increased treatment satisfaction and a strong intention to continue using the medication.

Major findings: A high proportion of patients reported using ubrogepant for relief from migraine, with satisfaction rates of 75.8% at 2 hours, 83.4% at 4 hours, and 78.5% at 24 hours. Additionally, 85.1% were satisfied with their ability to think clearly and 83.8% were satisfied with returning to normal function. Overall, 90.7% participants intended to continue using ubrogepant and 87.4% reported switching to ubrogepant due to inadequate response to previous migraine treatments.

Study details: This observational cross-sectional study included 302 adults who had received ubrogepant for the acute treatment of migraine within the preceding 14 days; 120 participants reported taking 50 mg ubrogepant and 182 reported taking 100 mg ubrogepant.

Disclosure: The study was funded by AbbVie. Four authors declared being current or former employees of AbbVie and may hold stock in the company. Several authors reported having ties with various sources.

Source: Shewale AR, Poh W, Reed ML, et al. Ubrogepant users' real-world experience: Patients on ubrogepant, characteristics, and outcomes (UNIVERSE) study. Headache. Published online September 26, 2024. Source

Key clinical point: Ubrogepant showed real-world effectiveness for the acute treatment of migraine, with increased treatment satisfaction and a strong intention to continue using the medication.

Major findings: A high proportion of patients reported using ubrogepant for relief from migraine, with satisfaction rates of 75.8% at 2 hours, 83.4% at 4 hours, and 78.5% at 24 hours. Additionally, 85.1% were satisfied with their ability to think clearly and 83.8% were satisfied with returning to normal function. Overall, 90.7% participants intended to continue using ubrogepant and 87.4% reported switching to ubrogepant due to inadequate response to previous migraine treatments.

Study details: This observational cross-sectional study included 302 adults who had received ubrogepant for the acute treatment of migraine within the preceding 14 days; 120 participants reported taking 50 mg ubrogepant and 182 reported taking 100 mg ubrogepant.

Disclosure: The study was funded by AbbVie. Four authors declared being current or former employees of AbbVie and may hold stock in the company. Several authors reported having ties with various sources.

Source: Shewale AR, Poh W, Reed ML, et al. Ubrogepant users' real-world experience: Patients on ubrogepant, characteristics, and outcomes (UNIVERSE) study. Headache. Published online September 26, 2024. Source

Key clinical point: Ubrogepant showed real-world effectiveness for the acute treatment of migraine, with increased treatment satisfaction and a strong intention to continue using the medication.

Major findings: A high proportion of patients reported using ubrogepant for relief from migraine, with satisfaction rates of 75.8% at 2 hours, 83.4% at 4 hours, and 78.5% at 24 hours. Additionally, 85.1% were satisfied with their ability to think clearly and 83.8% were satisfied with returning to normal function. Overall, 90.7% participants intended to continue using ubrogepant and 87.4% reported switching to ubrogepant due to inadequate response to previous migraine treatments.

Study details: This observational cross-sectional study included 302 adults who had received ubrogepant for the acute treatment of migraine within the preceding 14 days; 120 participants reported taking 50 mg ubrogepant and 182 reported taking 100 mg ubrogepant.

Disclosure: The study was funded by AbbVie. Four authors declared being current or former employees of AbbVie and may hold stock in the company. Several authors reported having ties with various sources.

Source: Shewale AR, Poh W, Reed ML, et al. Ubrogepant users' real-world experience: Patients on ubrogepant, characteristics, and outcomes (UNIVERSE) study. Headache. Published online September 26, 2024. Source

Key clinical point: Patients with rheumatoid arthritis (RA) had a higher risk for migraine than those without RA, irrespective of the RA serologic status.

 Major findings: Patients with vs without RA had a 1.2-fold higher risk for migraine (adjusted hazard ratio (aHR), 1.21; 95% CI, 1.17-1.26). Both seropositive RA (aHR 1.20; 95% CI, 1.15-1.24) and seronegative RA (aHR, 1.26; 95% CI, 1.20-1.34) were associated with an increased risk for migraine. However, the risk was not significantly different between patients with seropositive RA and those with seronegative RA.

Study details: This longitudinal retrospective cohort study included 42,674 patients with RA (29,774 with seropositive RA and 12,900 with seronegative RA) and 213,370 age- and sex-matched control individuals without RA. Overall, 22,294 new migraine cases were reported during a mean follow-up of 4.4 years, following a 1-year lag period.

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

Source: Kang S, Eun Y, Han K, et al. Heightened migraine risk in patients with rheumatoid arthritis: A national retrospective cohort study. Headache. Published online September 13, 2024. Source

Key clinical point: Patients with rheumatoid arthritis (RA) had a higher risk for migraine than those without RA, irrespective of the RA serologic status.

 Major findings: Patients with vs without RA had a 1.2-fold higher risk for migraine (adjusted hazard ratio (aHR), 1.21; 95% CI, 1.17-1.26). Both seropositive RA (aHR 1.20; 95% CI, 1.15-1.24) and seronegative RA (aHR, 1.26; 95% CI, 1.20-1.34) were associated with an increased risk for migraine. However, the risk was not significantly different between patients with seropositive RA and those with seronegative RA.

Study details: This longitudinal retrospective cohort study included 42,674 patients with RA (29,774 with seropositive RA and 12,900 with seronegative RA) and 213,370 age- and sex-matched control individuals without RA. Overall, 22,294 new migraine cases were reported during a mean follow-up of 4.4 years, following a 1-year lag period.

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

Source: Kang S, Eun Y, Han K, et al. Heightened migraine risk in patients with rheumatoid arthritis: A national retrospective cohort study. Headache. Published online September 13, 2024. Source

Key clinical point: Patients with rheumatoid arthritis (RA) had a higher risk for migraine than those without RA, irrespective of the RA serologic status.

 Major findings: Patients with vs without RA had a 1.2-fold higher risk for migraine (adjusted hazard ratio (aHR), 1.21; 95% CI, 1.17-1.26). Both seropositive RA (aHR 1.20; 95% CI, 1.15-1.24) and seronegative RA (aHR, 1.26; 95% CI, 1.20-1.34) were associated with an increased risk for migraine. However, the risk was not significantly different between patients with seropositive RA and those with seronegative RA.

Study details: This longitudinal retrospective cohort study included 42,674 patients with RA (29,774 with seropositive RA and 12,900 with seronegative RA) and 213,370 age- and sex-matched control individuals without RA. Overall, 22,294 new migraine cases were reported during a mean follow-up of 4.4 years, following a 1-year lag period.

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

Source: Kang S, Eun Y, Han K, et al. Heightened migraine risk in patients with rheumatoid arthritis: A national retrospective cohort study. Headache. Published online September 13, 2024. Source

Key clinical point: Patients with epilepsy showed no significant increase in the overall prevalence of migraine or non-migraine headaches, but those with epilepsy and migraine had an increased frequency of headaches.

Major findings: Compared with individuals without epilepsy, patients with epilepsy had no significant increase in the overall prevalence of migraine (odds ratio [OR], 0.95; P = .78) or non-migraine headaches (OR, 1.18; P = .17). However, among patients with migraine, those with epilepsy were more likely to experience highly frequent headaches than those without epilepsy (OR, 1.73; P = .024).

Study details: This population-based case-control study included 63,622 participants (age, ≥ 20 years); 364 had epilepsy, including 210 without headaches, 46 with migraine, and 108 with non-migraine headaches.

Disclosure: The study was funded by the Norwegian Research Council. The authors declared no conflicts of interest.

Source: Engstrand H, Revdal E, Argren MB, et al. Relationship between migraine and epilepsy in a large population-based cohort: The HUNT Study. Eur J Neurol. Published online September 27, 2024. Source

Key clinical point: Patients with epilepsy showed no significant increase in the overall prevalence of migraine or non-migraine headaches, but those with epilepsy and migraine had an increased frequency of headaches.

Major findings: Compared with individuals without epilepsy, patients with epilepsy had no significant increase in the overall prevalence of migraine (odds ratio [OR], 0.95; P = .78) or non-migraine headaches (OR, 1.18; P = .17). However, among patients with migraine, those with epilepsy were more likely to experience highly frequent headaches than those without epilepsy (OR, 1.73; P = .024).

Study details: This population-based case-control study included 63,622 participants (age, ≥ 20 years); 364 had epilepsy, including 210 without headaches, 46 with migraine, and 108 with non-migraine headaches.

Disclosure: The study was funded by the Norwegian Research Council. The authors declared no conflicts of interest.

Source: Engstrand H, Revdal E, Argren MB, et al. Relationship between migraine and epilepsy in a large population-based cohort: The HUNT Study. Eur J Neurol. Published online September 27, 2024. Source

Key clinical point: Patients with epilepsy showed no significant increase in the overall prevalence of migraine or non-migraine headaches, but those with epilepsy and migraine had an increased frequency of headaches.

Major findings: Compared with individuals without epilepsy, patients with epilepsy had no significant increase in the overall prevalence of migraine (odds ratio [OR], 0.95; P = .78) or non-migraine headaches (OR, 1.18; P = .17). However, among patients with migraine, those with epilepsy were more likely to experience highly frequent headaches than those without epilepsy (OR, 1.73; P = .024).

Study details: This population-based case-control study included 63,622 participants (age, ≥ 20 years); 364 had epilepsy, including 210 without headaches, 46 with migraine, and 108 with non-migraine headaches.

Disclosure: The study was funded by the Norwegian Research Council. The authors declared no conflicts of interest.

Source: Engstrand H, Revdal E, Argren MB, et al. Relationship between migraine and epilepsy in a large population-based cohort: The HUNT Study. Eur J Neurol. Published online September 27, 2024. Source

Key clinical point: Galcanezumab, a calcitonin gene-related peptide monoclonal antibody targeting the peripheral nervous system, led to early improvement in the severity of symptoms associated with central sensitization in patients with migraine.

Major findings: The Central Sensitization Inventory score significantly decreased from 36.0 at baseline to 29.7 at 3 months and 29.3 at 6 months after galcanezumab treatment (P < .001). The Allodynia Symptom Checklist score decreased from 5.55 at baseline to 4.09 at 3 months (P < .01) and 4.26 at 6 months (P < .01) with galcanezumab treatment.

Study details: This prospective real-world study included 86 patients with migraine (age, 20-65 years) who were treated with galcanezumab (240 mg administered initially, followed by 120 mg monthly) for 6 months.

Disclosure: This study was funded by the Ministry of Health, Labor and Welfare, Japan. Several authors reported having ties with various sources.

Source: Danno D, Imai N, Kitamura S, Ishizaki K, Kikui S, Takeshima T. Efficacy of galcanezumab in migraine central sensitization. Sci Rep. 2024; 14:21824. Source

Key clinical point: Galcanezumab, a calcitonin gene-related peptide monoclonal antibody targeting the peripheral nervous system, led to early improvement in the severity of symptoms associated with central sensitization in patients with migraine.

Major findings: The Central Sensitization Inventory score significantly decreased from 36.0 at baseline to 29.7 at 3 months and 29.3 at 6 months after galcanezumab treatment (P < .001). The Allodynia Symptom Checklist score decreased from 5.55 at baseline to 4.09 at 3 months (P < .01) and 4.26 at 6 months (P < .01) with galcanezumab treatment.

Study details: This prospective real-world study included 86 patients with migraine (age, 20-65 years) who were treated with galcanezumab (240 mg administered initially, followed by 120 mg monthly) for 6 months.

Disclosure: This study was funded by the Ministry of Health, Labor and Welfare, Japan. Several authors reported having ties with various sources.

Source: Danno D, Imai N, Kitamura S, Ishizaki K, Kikui S, Takeshima T. Efficacy of galcanezumab in migraine central sensitization. Sci Rep. 2024; 14:21824. Source

Key clinical point: Galcanezumab, a calcitonin gene-related peptide monoclonal antibody targeting the peripheral nervous system, led to early improvement in the severity of symptoms associated with central sensitization in patients with migraine.

Major findings: The Central Sensitization Inventory score significantly decreased from 36.0 at baseline to 29.7 at 3 months and 29.3 at 6 months after galcanezumab treatment (P < .001). The Allodynia Symptom Checklist score decreased from 5.55 at baseline to 4.09 at 3 months (P < .01) and 4.26 at 6 months (P < .01) with galcanezumab treatment.

Study details: This prospective real-world study included 86 patients with migraine (age, 20-65 years) who were treated with galcanezumab (240 mg administered initially, followed by 120 mg monthly) for 6 months.

Disclosure: This study was funded by the Ministry of Health, Labor and Welfare, Japan. Several authors reported having ties with various sources.

Source: Danno D, Imai N, Kitamura S, Ishizaki K, Kikui S, Takeshima T. Efficacy of galcanezumab in migraine central sensitization. Sci Rep. 2024; 14:21824. Source

Key clinical point: In American adults aged 20-50 years, a shorter telomere length was associated with an increased risk for migraine; however, no such association was found in adults older than 50 years.

 Major findings: In adults aged 20-50 years, a decrease in the ratio of telomeric repeats to single-copy genes was associated with an increased risk for migraine (odds ratio [OR], 1.48; P = .047). Those with the shortest telomeres were at a greater risk for migraine than those with the longest telomeres (OR, 1.35; P = .043). Such an association was not observed in adults older than 50 years.

Study details: This cross-sectional study analyzed data from the US National Health and Nutrition Examination Survey (1999-2002) on migraine and leukocyte telomere length in 6169 adults with or without migraine.

 Disclosure: The study was supported by the Natural Science Foundation of Hebei Province and the Central Government Guides Local Funds for Science and Technology Development. The authors declared no conflicts of interest.

Source: Geng D, Liu H, Wang H, et al. Telomere length exhibits inverse association with migraine among Americans aged 20–50 years, without implications beyond age 50: A cross-sectional study. Sci Rep. 2024;14:22597. Source

Key clinical point: In American adults aged 20-50 years, a shorter telomere length was associated with an increased risk for migraine; however, no such association was found in adults older than 50 years.

 Major findings: In adults aged 20-50 years, a decrease in the ratio of telomeric repeats to single-copy genes was associated with an increased risk for migraine (odds ratio [OR], 1.48; P = .047). Those with the shortest telomeres were at a greater risk for migraine than those with the longest telomeres (OR, 1.35; P = .043). Such an association was not observed in adults older than 50 years.

Study details: This cross-sectional study analyzed data from the US National Health and Nutrition Examination Survey (1999-2002) on migraine and leukocyte telomere length in 6169 adults with or without migraine.

 Disclosure: The study was supported by the Natural Science Foundation of Hebei Province and the Central Government Guides Local Funds for Science and Technology Development. The authors declared no conflicts of interest.

Source: Geng D, Liu H, Wang H, et al. Telomere length exhibits inverse association with migraine among Americans aged 20–50 years, without implications beyond age 50: A cross-sectional study. Sci Rep. 2024;14:22597. Source

Key clinical point: In American adults aged 20-50 years, a shorter telomere length was associated with an increased risk for migraine; however, no such association was found in adults older than 50 years.

 Major findings: In adults aged 20-50 years, a decrease in the ratio of telomeric repeats to single-copy genes was associated with an increased risk for migraine (odds ratio [OR], 1.48; P = .047). Those with the shortest telomeres were at a greater risk for migraine than those with the longest telomeres (OR, 1.35; P = .043). Such an association was not observed in adults older than 50 years.

Study details: This cross-sectional study analyzed data from the US National Health and Nutrition Examination Survey (1999-2002) on migraine and leukocyte telomere length in 6169 adults with or without migraine.

 Disclosure: The study was supported by the Natural Science Foundation of Hebei Province and the Central Government Guides Local Funds for Science and Technology Development. The authors declared no conflicts of interest.

Source: Geng D, Liu H, Wang H, et al. Telomere length exhibits inverse association with migraine among Americans aged 20–50 years, without implications beyond age 50: A cross-sectional study. Sci Rep. 2024;14:22597. Source

Key clinical point: Erenumab was effective in achieving and sustaining the remission of medication overuse headache (MOH) in adults with chronic migraine (CM) and nonopioid MOH, with adverse events reflecting the known safety profile of erenumab.

Major findings: At 6 months, 140 mg erenumab was significantly more effective than placebo in achieving increased MOH remission (odds ratio [OR], 2.01; P < .001) and sustained MOH remission (OR, 2.63; P < .001). The most common treatment-emergent adverse events in both erunumab groups were constipation (15.2%) and COVID-19 (13.9%); no new adverse events were reported.

Study details: This phase 4 randomized controlled trial included 584 adults with CM and MOH in the nonopioid-treated cohort who did not respond to one or more preventive treatments. Participants were randomly assigned to receive monthly injections of erenumab (70 mg or 140 mg) or placebo for 24 weeks.

Disclosures: This study was funded by Amgen. Some authors declared being employees or stockholders of Amgen, and others declared having ties with various sources, including Amgen.

Source: Tepper SJ, Dodick DW, Lanteri-Minet M, et al. Efficacy and safety of erenumab for nonopioid medication overuse headache in chronic migraine: A phase 4, randomized, placebo-controlled trial. JAMA Neurol. Published online September 16, 2024. Source

Key clinical point: Erenumab was effective in achieving and sustaining the remission of medication overuse headache (MOH) in adults with chronic migraine (CM) and nonopioid MOH, with adverse events reflecting the known safety profile of erenumab.

Major findings: At 6 months, 140 mg erenumab was significantly more effective than placebo in achieving increased MOH remission (odds ratio [OR], 2.01; P < .001) and sustained MOH remission (OR, 2.63; P < .001). The most common treatment-emergent adverse events in both erunumab groups were constipation (15.2%) and COVID-19 (13.9%); no new adverse events were reported.

Study details: This phase 4 randomized controlled trial included 584 adults with CM and MOH in the nonopioid-treated cohort who did not respond to one or more preventive treatments. Participants were randomly assigned to receive monthly injections of erenumab (70 mg or 140 mg) or placebo for 24 weeks.

Disclosures: This study was funded by Amgen. Some authors declared being employees or stockholders of Amgen, and others declared having ties with various sources, including Amgen.

Source: Tepper SJ, Dodick DW, Lanteri-Minet M, et al. Efficacy and safety of erenumab for nonopioid medication overuse headache in chronic migraine: A phase 4, randomized, placebo-controlled trial. JAMA Neurol. Published online September 16, 2024. Source

Key clinical point: Erenumab was effective in achieving and sustaining the remission of medication overuse headache (MOH) in adults with chronic migraine (CM) and nonopioid MOH, with adverse events reflecting the known safety profile of erenumab.

Major findings: At 6 months, 140 mg erenumab was significantly more effective than placebo in achieving increased MOH remission (odds ratio [OR], 2.01; P < .001) and sustained MOH remission (OR, 2.63; P < .001). The most common treatment-emergent adverse events in both erunumab groups were constipation (15.2%) and COVID-19 (13.9%); no new adverse events were reported.

Study details: This phase 4 randomized controlled trial included 584 adults with CM and MOH in the nonopioid-treated cohort who did not respond to one or more preventive treatments. Participants were randomly assigned to receive monthly injections of erenumab (70 mg or 140 mg) or placebo for 24 weeks.

Disclosures: This study was funded by Amgen. Some authors declared being employees or stockholders of Amgen, and others declared having ties with various sources, including Amgen.

Source: Tepper SJ, Dodick DW, Lanteri-Minet M, et al. Efficacy and safety of erenumab for nonopioid medication overuse headache in chronic migraine: A phase 4, randomized, placebo-controlled trial. JAMA Neurol. Published online September 16, 2024. Source

Key clinical point: Triptans, including eletriptan, rizatriptan, sumatriptan, and zolmitriptan, were more efficacious than newer and more expensive medications, such as lasmiditan and rimegepant, for the acute treatment of migraine.

Major findings: All active interventions were superior to placebo in achieving freedom from pain at 2 hours (odds ratio [OR], 1.73) with naratriptan and (OR, 5.19) for eletriptan. Eletriptan was the most effective for pain relief at two hours (OR, 1.46-3.01), followed by rizatriptan (OR, 1.59-2.44), sumatriptan (OR, 1.35-2.04), and zolmitriptan (OR, 1.47-1.96). For sustained pain freedom, eletriptan and ibuprofen were the most effective.

Study details: This network meta-analysis of 137 randomized controlled trials included 89,445 adults with migraine who received one of 17 drugs, including antipyretics, ditans, gepants, nonsteroidal anti-inflammatory drugs, and triptans, or placebo.

Disclosures: This study was funded by the National Institute for Health and Care Research Oxford Health Biomedical Research Centre and the Lundbeck Foundation. Several authors reported having ties with various sources.

Source: Karlsson WK, Ostinelli EG, Zhuang ZA, et al. Comparative effects of drug interventions for the acute management of migraine episodes in adults: Systematic review and network meta-analysis. BMJ. 2024;386:e080107. Source

Key clinical point: Triptans, including eletriptan, rizatriptan, sumatriptan, and zolmitriptan, were more efficacious than newer and more expensive medications, such as lasmiditan and rimegepant, for the acute treatment of migraine.

Major findings: All active interventions were superior to placebo in achieving freedom from pain at 2 hours (odds ratio [OR], 1.73) with naratriptan and (OR, 5.19) for eletriptan. Eletriptan was the most effective for pain relief at two hours (OR, 1.46-3.01), followed by rizatriptan (OR, 1.59-2.44), sumatriptan (OR, 1.35-2.04), and zolmitriptan (OR, 1.47-1.96). For sustained pain freedom, eletriptan and ibuprofen were the most effective.

Study details: This network meta-analysis of 137 randomized controlled trials included 89,445 adults with migraine who received one of 17 drugs, including antipyretics, ditans, gepants, nonsteroidal anti-inflammatory drugs, and triptans, or placebo.

Disclosures: This study was funded by the National Institute for Health and Care Research Oxford Health Biomedical Research Centre and the Lundbeck Foundation. Several authors reported having ties with various sources.

Source: Karlsson WK, Ostinelli EG, Zhuang ZA, et al. Comparative effects of drug interventions for the acute management of migraine episodes in adults: Systematic review and network meta-analysis. BMJ. 2024;386:e080107. Source

Key clinical point: Triptans, including eletriptan, rizatriptan, sumatriptan, and zolmitriptan, were more efficacious than newer and more expensive medications, such as lasmiditan and rimegepant, for the acute treatment of migraine.

Major findings: All active interventions were superior to placebo in achieving freedom from pain at 2 hours (odds ratio [OR], 1.73) with naratriptan and (OR, 5.19) for eletriptan. Eletriptan was the most effective for pain relief at two hours (OR, 1.46-3.01), followed by rizatriptan (OR, 1.59-2.44), sumatriptan (OR, 1.35-2.04), and zolmitriptan (OR, 1.47-1.96). For sustained pain freedom, eletriptan and ibuprofen were the most effective.

Study details: This network meta-analysis of 137 randomized controlled trials included 89,445 adults with migraine who received one of 17 drugs, including antipyretics, ditans, gepants, nonsteroidal anti-inflammatory drugs, and triptans, or placebo.

Disclosures: This study was funded by the National Institute for Health and Care Research Oxford Health Biomedical Research Centre and the Lundbeck Foundation. Several authors reported having ties with various sources.

Source: Karlsson WK, Ostinelli EG, Zhuang ZA, et al. Comparative effects of drug interventions for the acute management of migraine episodes in adults: Systematic review and network meta-analysis. BMJ. 2024;386:e080107. Source

Editor's Note: This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

Editor's Note: This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

Editor's Note: This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.