The nation’s population is quickly diversifying, making racial/ethnic disparities in health care outcomes even more apparent. Minority and non-English-speaking populations have grown and may become a majority in the next generation.¹ A proposed strategy to reduce disparities in health care is to recruit more practitioners who better reflect the patient populations.² Improved access to care with racial concordance between physicians and patients has been reported.³

Being increasingly aware of access-to-care data, more patients are advocating and asking for physicians of color to be their providers.⁴ Despite progress (ie, more women entering the medical profession), the proportion of physicians who are underrepresented in medicine (URiM—eg, Black, Hispanic, and Native American) still lags US population demographics.³

Why diversity in medicine matters

In addition to improving access to care, diversity in medicine offers other benefits. Working within diverse learning environments has demonstrated educational advantages.^5,6 Medical students and residents from diverse backgrounds are less likely to report depression symptoms, regardless of their race. Diversity may accelerate advancements in health care as well, since it is well-established that diverse teams outperform nondiverse teams when it comes to innovation and productivity.⁷ Finally, as a profession committed to equity, advocacy, and justice, physicians are positioned to lead the way toward racial equity.

Overall, racial and gender diversity in all clinical specialties is improving, but not at the same pace. While the diversity of US medical students and residents by sex and race/ethnicity is greater than among faculty, change in racial diversity has been slow for all 3 groups.⁸ During the past 40 years the number of full-time faculty has increased 6-fold for females and more than tripled for males.⁸ However, this rise has not favored URiM faculty, because their proportion is still underrepresented relative to their group in the general population. Clinical departments that are making the most progress in recruiting URiM residents and faculty are often primary or preventive care specialties rather than surgical or service or hospital-based specialties.^8,9 ObGyn has consistently had a proportion of URiM residents (18%) that is highest in the surgical specialties and comparable to family medicine and pediatrics.¹⁰

When examining physician workforce diversity, it is important to “drill down” to individual specialties to obtain a clearer understanding of trends. The continued need for increased resident and faculty diversity prompted us to examine ObGyn departments. The most recent nationwide data were gathered about full-time faculty from the 2021 AAMC Faculty Roster, residents from the 2021 Accreditation Counsel for Graduate Medical Education (ACGME) Data Resource Book, medical student matriculants from 2021 AAMC, and US adult women (defined arbitrarily as 15 years or older) from the 2019 American Community Survey.^11-13

Increase in female faculty and residents

The expanding numbers of faculty and residents over a 40-year period (from 1973 to 2012) led to more women and underrepresented minorities in ObGyn than in other major clinical departments.^14,15 Women now constitute two-thirds of all ObGyn faculty and are more likely to be junior rather than senior faculty.⁹ When looking at junior faculty, a higher proportion of junior faculty who are URiM are female. While more junior faculty and residents are female, male faculty are also racially and ethnically diverse.⁹

Continue to: Growth of URiM physicians in ObGyn...

Growth of URiM physicians in ObGyn

The distribution of racial/ethnic groups in 2021 were compared between senior and junior ObGyn faculty and residents with the US adult female population.⁹ As shown in the FIGURE, the proportion of ObGyn faculty who are White approximates the White US adult female population. The most rapidly growing racial/ethnic group in the US population is Hispanic. Although Hispanic is the best represented ethnicity among junior faculty, the proportions of Hispanics among faculty and residents lag well behind the US population. The proportion of ObGyn faculty who are Black has consistently been less than in the US adult female population. ObGyns who are Asian constitute higher proportions of faculty and residents than in the US adult female population. This finding about Asians is consistent across all clinical specialties.⁷

Recruiting URiM students into ObGyn is important. Racial and ethnic representation in surgical and nonsurgical residency programs has not substantially improved in the past decade and continues to lag the changing demographics of the US population.¹⁰ More students than residents and faculty are Hispanic, which represents a much-needed opportunity for recruitment. By contrast, junior ObGyn faculty are more likely to be Black than residents and students. Native Americans constitute less than 1% of all faculty, residents, students, and US adult females.⁹ Lastly, race/ethnicity being self-reported as “other” or “unknown” is most common among students and residents, which perhaps represents greater diversity.

Looking back

Increasing diversity in medicine and in ObGyn has not happened by accident. Transformational change requires rectifying any factors that detrimentally affect the racial/ethnic diversity of our medical students, residents, and faculty. For example, biases inherent in key residency application metrics are being recognized, and use of holistic review is increasing. Change is also accelerated by an explicit and public commitment from national organizations. In 2009, the Liaison Committee of Medical Education (LCME) mandated that medical schools engage in practices that focus on recruitment and retention of a diverse workforce. Increases in Black and Hispanic medical students were noted after implementation of this new mandate.¹⁶ The ACGME followed suit with similar guidelines in 2019.¹⁰

Diversity is one of the foundational strengths of the ObGyn specialty. Important aspects of the specialty are built upon the contributions of women of color, some voluntary and some not. One example is the knowledge of gynecology that was gained through the involuntary and nonanesthetized surgeries performed on Anarcha Westcott.¹⁷ Beyond that painful legacy, several Black physicians re-shaped our specialty, including Helen Octavia Dickens, MD, the first Black woman to receive ObGyn board certification, and Georgia Rooks Dwelled, MD, who established the first obstetrical “lying-in” hospital for African American women in Atlanta.¹⁸ Similarly, Helen Rodriguez-Trias, MD, was one of the most important advocates for the passage of the 1973 national guideline that established the requirement for a woman’s written consent for sterilization.¹⁸ Guarding and enhancing the legacy of diversity in ObGyn will require intentionality on all our parts.

Moving forward

Advancing diversity in ObGyn offers advantages: better representation of patient populations, improving public health by better access to care, enhancing learning in medical education, building more comprehensive research agendas, and driving institutional excellence. While progress has been made, significant work is still to be done. We must continue to critically examine the role of biases and structural racism that are embedded in evaluating medical students, screening of residency applicants, and selecting and retaining faculty. In future work, we should explore the hypothesis that continued change in racial/ethnic diversity of faculty will only occur once more URiM students, especially the growing number of Hispanics, are admitted into medical schools and recruited for residency positions. We should also examine whether further diversity improves patient outcomes.

It is encouraging to realize that ObGyn departments are leaders in racial/ethnic diversity at US medical schools. It is also critical that the specialty commits to the progress that still needs to be made, including increasing diversity among faculty and institutional leadership. To maintain diversity that mirrors the US adult female population, the specialty of ObGyn will require active surveillance and continued recruitment of Black and, especially Hispanic, faculty and residents.¹⁹ The national strategies aimed at building medical student and residency diversity are beginning to yield results. For those gains to help faculty diversity, institutional and departmental leaders will need to implement best practices for recruiting, retaining, and advancing URiM faculty.¹⁹ Those practices would include making workforce diversity an explicit priority, building diverse applicant pools, and establishing infrastructure and mentorship to advance URiM faculty to senior leadership positions.²⁰

In conclusion

Building a physician workforce that is more representative of the US population should aid in addressing inequalities in health and health care. Significant strides have been made in racial/ethnic diversity in ObGyn. This has resulted in a specialty that is among the most diverse in academic medicine. At the same time, there is more work to be done. For example, the specialty is far from reaching racial equity for Hispanic physicians. Also, continued efforts are necessary to advance URiM faculty to leadership positions. The legacy of racial/ethnic diversity in ObGyn did not happen by accident and will not be maintained without intention. ●

The nation’s population is quickly diversifying, making racial/ethnic disparities in health care outcomes even more apparent. Minority and non-English-speaking populations have grown and may become a majority in the next generation.¹ A proposed strategy to reduce disparities in health care is to recruit more practitioners who better reflect the patient populations.² Improved access to care with racial concordance between physicians and patients has been reported.³

Being increasingly aware of access-to-care data, more patients are advocating and asking for physicians of color to be their providers.⁴ Despite progress (ie, more women entering the medical profession), the proportion of physicians who are underrepresented in medicine (URiM—eg, Black, Hispanic, and Native American) still lags US population demographics.³

Why diversity in medicine matters

In addition to improving access to care, diversity in medicine offers other benefits. Working within diverse learning environments has demonstrated educational advantages.^5,6 Medical students and residents from diverse backgrounds are less likely to report depression symptoms, regardless of their race. Diversity may accelerate advancements in health care as well, since it is well-established that diverse teams outperform nondiverse teams when it comes to innovation and productivity.⁷ Finally, as a profession committed to equity, advocacy, and justice, physicians are positioned to lead the way toward racial equity.

Overall, racial and gender diversity in all clinical specialties is improving, but not at the same pace. While the diversity of US medical students and residents by sex and race/ethnicity is greater than among faculty, change in racial diversity has been slow for all 3 groups.⁸ During the past 40 years the number of full-time faculty has increased 6-fold for females and more than tripled for males.⁸ However, this rise has not favored URiM faculty, because their proportion is still underrepresented relative to their group in the general population. Clinical departments that are making the most progress in recruiting URiM residents and faculty are often primary or preventive care specialties rather than surgical or service or hospital-based specialties.^8,9 ObGyn has consistently had a proportion of URiM residents (18%) that is highest in the surgical specialties and comparable to family medicine and pediatrics.¹⁰

When examining physician workforce diversity, it is important to “drill down” to individual specialties to obtain a clearer understanding of trends. The continued need for increased resident and faculty diversity prompted us to examine ObGyn departments. The most recent nationwide data were gathered about full-time faculty from the 2021 AAMC Faculty Roster, residents from the 2021 Accreditation Counsel for Graduate Medical Education (ACGME) Data Resource Book, medical student matriculants from 2021 AAMC, and US adult women (defined arbitrarily as 15 years or older) from the 2019 American Community Survey.^11-13

Increase in female faculty and residents

The expanding numbers of faculty and residents over a 40-year period (from 1973 to 2012) led to more women and underrepresented minorities in ObGyn than in other major clinical departments.^14,15 Women now constitute two-thirds of all ObGyn faculty and are more likely to be junior rather than senior faculty.⁹ When looking at junior faculty, a higher proportion of junior faculty who are URiM are female. While more junior faculty and residents are female, male faculty are also racially and ethnically diverse.⁹

Continue to: Growth of URiM physicians in ObGyn...

Growth of URiM physicians in ObGyn

The distribution of racial/ethnic groups in 2021 were compared between senior and junior ObGyn faculty and residents with the US adult female population.⁹ As shown in the FIGURE, the proportion of ObGyn faculty who are White approximates the White US adult female population. The most rapidly growing racial/ethnic group in the US population is Hispanic. Although Hispanic is the best represented ethnicity among junior faculty, the proportions of Hispanics among faculty and residents lag well behind the US population. The proportion of ObGyn faculty who are Black has consistently been less than in the US adult female population. ObGyns who are Asian constitute higher proportions of faculty and residents than in the US adult female population. This finding about Asians is consistent across all clinical specialties.⁷

Recruiting URiM students into ObGyn is important. Racial and ethnic representation in surgical and nonsurgical residency programs has not substantially improved in the past decade and continues to lag the changing demographics of the US population.¹⁰ More students than residents and faculty are Hispanic, which represents a much-needed opportunity for recruitment. By contrast, junior ObGyn faculty are more likely to be Black than residents and students. Native Americans constitute less than 1% of all faculty, residents, students, and US adult females.⁹ Lastly, race/ethnicity being self-reported as “other” or “unknown” is most common among students and residents, which perhaps represents greater diversity.

Looking back

Increasing diversity in medicine and in ObGyn has not happened by accident. Transformational change requires rectifying any factors that detrimentally affect the racial/ethnic diversity of our medical students, residents, and faculty. For example, biases inherent in key residency application metrics are being recognized, and use of holistic review is increasing. Change is also accelerated by an explicit and public commitment from national organizations. In 2009, the Liaison Committee of Medical Education (LCME) mandated that medical schools engage in practices that focus on recruitment and retention of a diverse workforce. Increases in Black and Hispanic medical students were noted after implementation of this new mandate.¹⁶ The ACGME followed suit with similar guidelines in 2019.¹⁰

Diversity is one of the foundational strengths of the ObGyn specialty. Important aspects of the specialty are built upon the contributions of women of color, some voluntary and some not. One example is the knowledge of gynecology that was gained through the involuntary and nonanesthetized surgeries performed on Anarcha Westcott.¹⁷ Beyond that painful legacy, several Black physicians re-shaped our specialty, including Helen Octavia Dickens, MD, the first Black woman to receive ObGyn board certification, and Georgia Rooks Dwelled, MD, who established the first obstetrical “lying-in” hospital for African American women in Atlanta.¹⁸ Similarly, Helen Rodriguez-Trias, MD, was one of the most important advocates for the passage of the 1973 national guideline that established the requirement for a woman’s written consent for sterilization.¹⁸ Guarding and enhancing the legacy of diversity in ObGyn will require intentionality on all our parts.

Moving forward

Advancing diversity in ObGyn offers advantages: better representation of patient populations, improving public health by better access to care, enhancing learning in medical education, building more comprehensive research agendas, and driving institutional excellence. While progress has been made, significant work is still to be done. We must continue to critically examine the role of biases and structural racism that are embedded in evaluating medical students, screening of residency applicants, and selecting and retaining faculty. In future work, we should explore the hypothesis that continued change in racial/ethnic diversity of faculty will only occur once more URiM students, especially the growing number of Hispanics, are admitted into medical schools and recruited for residency positions. We should also examine whether further diversity improves patient outcomes.

It is encouraging to realize that ObGyn departments are leaders in racial/ethnic diversity at US medical schools. It is also critical that the specialty commits to the progress that still needs to be made, including increasing diversity among faculty and institutional leadership. To maintain diversity that mirrors the US adult female population, the specialty of ObGyn will require active surveillance and continued recruitment of Black and, especially Hispanic, faculty and residents.¹⁹ The national strategies aimed at building medical student and residency diversity are beginning to yield results. For those gains to help faculty diversity, institutional and departmental leaders will need to implement best practices for recruiting, retaining, and advancing URiM faculty.¹⁹ Those practices would include making workforce diversity an explicit priority, building diverse applicant pools, and establishing infrastructure and mentorship to advance URiM faculty to senior leadership positions.²⁰

In conclusion

Building a physician workforce that is more representative of the US population should aid in addressing inequalities in health and health care. Significant strides have been made in racial/ethnic diversity in ObGyn. This has resulted in a specialty that is among the most diverse in academic medicine. At the same time, there is more work to be done. For example, the specialty is far from reaching racial equity for Hispanic physicians. Also, continued efforts are necessary to advance URiM faculty to leadership positions. The legacy of racial/ethnic diversity in ObGyn did not happen by accident and will not be maintained without intention. ●

The nation’s population is quickly diversifying, making racial/ethnic disparities in health care outcomes even more apparent. Minority and non-English-speaking populations have grown and may become a majority in the next generation.¹ A proposed strategy to reduce disparities in health care is to recruit more practitioners who better reflect the patient populations.² Improved access to care with racial concordance between physicians and patients has been reported.³

Being increasingly aware of access-to-care data, more patients are advocating and asking for physicians of color to be their providers.⁴ Despite progress (ie, more women entering the medical profession), the proportion of physicians who are underrepresented in medicine (URiM—eg, Black, Hispanic, and Native American) still lags US population demographics.³

Why diversity in medicine matters

In addition to improving access to care, diversity in medicine offers other benefits. Working within diverse learning environments has demonstrated educational advantages.^5,6 Medical students and residents from diverse backgrounds are less likely to report depression symptoms, regardless of their race. Diversity may accelerate advancements in health care as well, since it is well-established that diverse teams outperform nondiverse teams when it comes to innovation and productivity.⁷ Finally, as a profession committed to equity, advocacy, and justice, physicians are positioned to lead the way toward racial equity.

Overall, racial and gender diversity in all clinical specialties is improving, but not at the same pace. While the diversity of US medical students and residents by sex and race/ethnicity is greater than among faculty, change in racial diversity has been slow for all 3 groups.⁸ During the past 40 years the number of full-time faculty has increased 6-fold for females and more than tripled for males.⁸ However, this rise has not favored URiM faculty, because their proportion is still underrepresented relative to their group in the general population. Clinical departments that are making the most progress in recruiting URiM residents and faculty are often primary or preventive care specialties rather than surgical or service or hospital-based specialties.^8,9 ObGyn has consistently had a proportion of URiM residents (18%) that is highest in the surgical specialties and comparable to family medicine and pediatrics.¹⁰

When examining physician workforce diversity, it is important to “drill down” to individual specialties to obtain a clearer understanding of trends. The continued need for increased resident and faculty diversity prompted us to examine ObGyn departments. The most recent nationwide data were gathered about full-time faculty from the 2021 AAMC Faculty Roster, residents from the 2021 Accreditation Counsel for Graduate Medical Education (ACGME) Data Resource Book, medical student matriculants from 2021 AAMC, and US adult women (defined arbitrarily as 15 years or older) from the 2019 American Community Survey.^11-13

Increase in female faculty and residents

The expanding numbers of faculty and residents over a 40-year period (from 1973 to 2012) led to more women and underrepresented minorities in ObGyn than in other major clinical departments.^14,15 Women now constitute two-thirds of all ObGyn faculty and are more likely to be junior rather than senior faculty.⁹ When looking at junior faculty, a higher proportion of junior faculty who are URiM are female. While more junior faculty and residents are female, male faculty are also racially and ethnically diverse.⁹

Continue to: Growth of URiM physicians in ObGyn...

Growth of URiM physicians in ObGyn

The distribution of racial/ethnic groups in 2021 were compared between senior and junior ObGyn faculty and residents with the US adult female population.⁹ As shown in the FIGURE, the proportion of ObGyn faculty who are White approximates the White US adult female population. The most rapidly growing racial/ethnic group in the US population is Hispanic. Although Hispanic is the best represented ethnicity among junior faculty, the proportions of Hispanics among faculty and residents lag well behind the US population. The proportion of ObGyn faculty who are Black has consistently been less than in the US adult female population. ObGyns who are Asian constitute higher proportions of faculty and residents than in the US adult female population. This finding about Asians is consistent across all clinical specialties.⁷

Recruiting URiM students into ObGyn is important. Racial and ethnic representation in surgical and nonsurgical residency programs has not substantially improved in the past decade and continues to lag the changing demographics of the US population.¹⁰ More students than residents and faculty are Hispanic, which represents a much-needed opportunity for recruitment. By contrast, junior ObGyn faculty are more likely to be Black than residents and students. Native Americans constitute less than 1% of all faculty, residents, students, and US adult females.⁹ Lastly, race/ethnicity being self-reported as “other” or “unknown” is most common among students and residents, which perhaps represents greater diversity.

Looking back

Increasing diversity in medicine and in ObGyn has not happened by accident. Transformational change requires rectifying any factors that detrimentally affect the racial/ethnic diversity of our medical students, residents, and faculty. For example, biases inherent in key residency application metrics are being recognized, and use of holistic review is increasing. Change is also accelerated by an explicit and public commitment from national organizations. In 2009, the Liaison Committee of Medical Education (LCME) mandated that medical schools engage in practices that focus on recruitment and retention of a diverse workforce. Increases in Black and Hispanic medical students were noted after implementation of this new mandate.¹⁶ The ACGME followed suit with similar guidelines in 2019.¹⁰

Diversity is one of the foundational strengths of the ObGyn specialty. Important aspects of the specialty are built upon the contributions of women of color, some voluntary and some not. One example is the knowledge of gynecology that was gained through the involuntary and nonanesthetized surgeries performed on Anarcha Westcott.¹⁷ Beyond that painful legacy, several Black physicians re-shaped our specialty, including Helen Octavia Dickens, MD, the first Black woman to receive ObGyn board certification, and Georgia Rooks Dwelled, MD, who established the first obstetrical “lying-in” hospital for African American women in Atlanta.¹⁸ Similarly, Helen Rodriguez-Trias, MD, was one of the most important advocates for the passage of the 1973 national guideline that established the requirement for a woman’s written consent for sterilization.¹⁸ Guarding and enhancing the legacy of diversity in ObGyn will require intentionality on all our parts.

Moving forward

Advancing diversity in ObGyn offers advantages: better representation of patient populations, improving public health by better access to care, enhancing learning in medical education, building more comprehensive research agendas, and driving institutional excellence. While progress has been made, significant work is still to be done. We must continue to critically examine the role of biases and structural racism that are embedded in evaluating medical students, screening of residency applicants, and selecting and retaining faculty. In future work, we should explore the hypothesis that continued change in racial/ethnic diversity of faculty will only occur once more URiM students, especially the growing number of Hispanics, are admitted into medical schools and recruited for residency positions. We should also examine whether further diversity improves patient outcomes.

It is encouraging to realize that ObGyn departments are leaders in racial/ethnic diversity at US medical schools. It is also critical that the specialty commits to the progress that still needs to be made, including increasing diversity among faculty and institutional leadership. To maintain diversity that mirrors the US adult female population, the specialty of ObGyn will require active surveillance and continued recruitment of Black and, especially Hispanic, faculty and residents.¹⁹ The national strategies aimed at building medical student and residency diversity are beginning to yield results. For those gains to help faculty diversity, institutional and departmental leaders will need to implement best practices for recruiting, retaining, and advancing URiM faculty.¹⁹ Those practices would include making workforce diversity an explicit priority, building diverse applicant pools, and establishing infrastructure and mentorship to advance URiM faculty to senior leadership positions.²⁰

In conclusion

Building a physician workforce that is more representative of the US population should aid in addressing inequalities in health and health care. Significant strides have been made in racial/ethnic diversity in ObGyn. This has resulted in a specialty that is among the most diverse in academic medicine. At the same time, there is more work to be done. For example, the specialty is far from reaching racial equity for Hispanic physicians. Also, continued efforts are necessary to advance URiM faculty to leadership positions. The legacy of racial/ethnic diversity in ObGyn did not happen by accident and will not be maintained without intention. ●

Key clinical point: This real-world analysis confirms the benefits of anticalcitonin gene-related peptide (anti-CGRP) drugs, erenumab, galcanezumab, and fremanezumab, in drug-resistant chronic migraine; however, intensified erenumab regimen showed limited benefits.

Major finding: At week 12, all patients treated with erenumab (P < .001), galcanezumab (P < .001), or fremanezumab (P = .028) achieved a significant reduction in mean monthly migraine headache days, with treatment-associated toxicity being higher with erenumab vs galcanezumab and fremanezumab (P  =  .04). An intensified erenumab regimen demonstrated similar efficacy but with more severe grade 3/4 toxicity (140 vs 70 mg: 14.8% vs 0%; P  =  .038).

Study details: This was a retrospective study including 104 patients with drug-resistant chronic migraine who had failed >3 conventional migraine preventive treatments and received erenumab, galcanezumab, or fremanezumab.

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

Source: Cantarelli L et al. Efficacy and safety of erenumab, galcanezumab, and fremanezumab in the treatment of drug-resistant chronic migraine: Experience in real clinical practice. Ann Pharmacother. 2022 (Aug 18). Doi: 10.1177/10600280221118402

Key clinical point: This real-world analysis confirms the benefits of anticalcitonin gene-related peptide (anti-CGRP) drugs, erenumab, galcanezumab, and fremanezumab, in drug-resistant chronic migraine; however, intensified erenumab regimen showed limited benefits.

Major finding: At week 12, all patients treated with erenumab (P < .001), galcanezumab (P < .001), or fremanezumab (P = .028) achieved a significant reduction in mean monthly migraine headache days, with treatment-associated toxicity being higher with erenumab vs galcanezumab and fremanezumab (P  =  .04). An intensified erenumab regimen demonstrated similar efficacy but with more severe grade 3/4 toxicity (140 vs 70 mg: 14.8% vs 0%; P  =  .038).

Study details: This was a retrospective study including 104 patients with drug-resistant chronic migraine who had failed >3 conventional migraine preventive treatments and received erenumab, galcanezumab, or fremanezumab.

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

Source: Cantarelli L et al. Efficacy and safety of erenumab, galcanezumab, and fremanezumab in the treatment of drug-resistant chronic migraine: Experience in real clinical practice. Ann Pharmacother. 2022 (Aug 18). Doi: 10.1177/10600280221118402

Key clinical point: This real-world analysis confirms the benefits of anticalcitonin gene-related peptide (anti-CGRP) drugs, erenumab, galcanezumab, and fremanezumab, in drug-resistant chronic migraine; however, intensified erenumab regimen showed limited benefits.

Major finding: At week 12, all patients treated with erenumab (P < .001), galcanezumab (P < .001), or fremanezumab (P = .028) achieved a significant reduction in mean monthly migraine headache days, with treatment-associated toxicity being higher with erenumab vs galcanezumab and fremanezumab (P  =  .04). An intensified erenumab regimen demonstrated similar efficacy but with more severe grade 3/4 toxicity (140 vs 70 mg: 14.8% vs 0%; P  =  .038).

Study details: This was a retrospective study including 104 patients with drug-resistant chronic migraine who had failed >3 conventional migraine preventive treatments and received erenumab, galcanezumab, or fremanezumab.

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

Source: Cantarelli L et al. Efficacy and safety of erenumab, galcanezumab, and fremanezumab in the treatment of drug-resistant chronic migraine: Experience in real clinical practice. Ann Pharmacother. 2022 (Aug 18). Doi: 10.1177/10600280221118402

Key clinical point: Erenumab vs placebo demonstrated a similar safety profile across all age groups of patients with chronic or episodic migraine, with no increase in adverse events because of age.

Major finding: Incidence of treatment-emergent adverse events was similar with 70 and 140 mg erenumab vs placebo across age groups: <40 (44.2% and 43.7% vs 44.4%, respectively), 40-49 (42.1% and 42.9% vs 49.2%, respectively), 50-59 (43.5% and 50.6% vs 41.6%, respectively), and ≥60 (39.5% and 48.6% vs 59.4%, respectively) years. The age-stratified incidence of treatment-emergent serious adverse events was low with both erenumab doses, with none reported among patients aged ≥60 years.

Study details: Findings are from a pooled and age-stratified analysis of five phase 2 and 3 randomized controlled trials including 3345 patients with chronic or episodic migraine with or without aura who were randomly assigned to receive erenumab (70 or 140 mg) or placebo.

Disclosures: This study was funded by Novartis Pharma AG, Switzerland. Erenumab was co-developed by Novartis and Amgen. Six authors declared being current or former employees or stockholders of Novartis or Amgen. C Lampl declared receiving honoraria from Novartis.

Source: Lampl C et al. Safety and tolerability of erenumab in individuals with episodic or chronic migraine across age groups: A pooled analysis of placebo-controlled trials. J Headache Pain. 2022;23:104 (Aug 18). Doi: 10.1186/s10194-022-01470-4

Key clinical point: Erenumab vs placebo demonstrated a similar safety profile across all age groups of patients with chronic or episodic migraine, with no increase in adverse events because of age.

Major finding: Incidence of treatment-emergent adverse events was similar with 70 and 140 mg erenumab vs placebo across age groups: <40 (44.2% and 43.7% vs 44.4%, respectively), 40-49 (42.1% and 42.9% vs 49.2%, respectively), 50-59 (43.5% and 50.6% vs 41.6%, respectively), and ≥60 (39.5% and 48.6% vs 59.4%, respectively) years. The age-stratified incidence of treatment-emergent serious adverse events was low with both erenumab doses, with none reported among patients aged ≥60 years.

Study details: Findings are from a pooled and age-stratified analysis of five phase 2 and 3 randomized controlled trials including 3345 patients with chronic or episodic migraine with or without aura who were randomly assigned to receive erenumab (70 or 140 mg) or placebo.

Disclosures: This study was funded by Novartis Pharma AG, Switzerland. Erenumab was co-developed by Novartis and Amgen. Six authors declared being current or former employees or stockholders of Novartis or Amgen. C Lampl declared receiving honoraria from Novartis.

Source: Lampl C et al. Safety and tolerability of erenumab in individuals with episodic or chronic migraine across age groups: A pooled analysis of placebo-controlled trials. J Headache Pain. 2022;23:104 (Aug 18). Doi: 10.1186/s10194-022-01470-4

Key clinical point: Erenumab vs placebo demonstrated a similar safety profile across all age groups of patients with chronic or episodic migraine, with no increase in adverse events because of age.

Major finding: Incidence of treatment-emergent adverse events was similar with 70 and 140 mg erenumab vs placebo across age groups: <40 (44.2% and 43.7% vs 44.4%, respectively), 40-49 (42.1% and 42.9% vs 49.2%, respectively), 50-59 (43.5% and 50.6% vs 41.6%, respectively), and ≥60 (39.5% and 48.6% vs 59.4%, respectively) years. The age-stratified incidence of treatment-emergent serious adverse events was low with both erenumab doses, with none reported among patients aged ≥60 years.

Study details: Findings are from a pooled and age-stratified analysis of five phase 2 and 3 randomized controlled trials including 3345 patients with chronic or episodic migraine with or without aura who were randomly assigned to receive erenumab (70 or 140 mg) or placebo.

Disclosures: This study was funded by Novartis Pharma AG, Switzerland. Erenumab was co-developed by Novartis and Amgen. Six authors declared being current or former employees or stockholders of Novartis or Amgen. C Lampl declared receiving honoraria from Novartis.

Source: Lampl C et al. Safety and tolerability of erenumab in individuals with episodic or chronic migraine across age groups: A pooled analysis of placebo-controlled trials. J Headache Pain. 2022;23:104 (Aug 18). Doi: 10.1186/s10194-022-01470-4

Key clinical point: Eptinezumab vs placebo significantly reduced the number of headache days with acute headache medication (AHM) use in patients with chronic migraine (CM), with the effect being greatest among those with medication-overuse headache and ≥50% response.

Major finding: Eptinezumab vs placebo resulted in a greater percentage-point reductions in the number of headache days with AHM use in the overall cohort of patients with CM (percentage-point reduction −25.1% vs −17.0%) and in patients with CM and medication-overuse headache who experienced ≥50% response (percentage-point reduction −38.3% vs −31.5%) over 24 weeks.

Study details: Findings are from a post hoc analysis of a phase 3 study, PROMISE-2, including 1072 patients with CM, of which 40.2% were diagnosed with medication-overuse headache and were randomly assigned to receive eptinezumab (100 or 300 mg) or placebo.

Disclosures: This study was funded by Lundbeck Seattle BioPharmaceuticals, Inc., USA. Four authors declared being current or former employees of Lundbeck or a subsidiary company or a company contracted by Lundbeck or owning stocks or stock options in Alder/Lundbeck. Several authors reported ties with Lundbeck or other sources.

Source: Cowan RP et al. Quantity changes in acute headache medication use among patients with chronic migraine treated with eptinezumab: Subanalysis of the PROMISE‑2 study. J Headache Pain. 2022;23:115 (Sep 6). Doi: 10.1186/s10194-022-01482-0

Key clinical point: Eptinezumab vs placebo significantly reduced the number of headache days with acute headache medication (AHM) use in patients with chronic migraine (CM), with the effect being greatest among those with medication-overuse headache and ≥50% response.

Major finding: Eptinezumab vs placebo resulted in a greater percentage-point reductions in the number of headache days with AHM use in the overall cohort of patients with CM (percentage-point reduction −25.1% vs −17.0%) and in patients with CM and medication-overuse headache who experienced ≥50% response (percentage-point reduction −38.3% vs −31.5%) over 24 weeks.

Study details: Findings are from a post hoc analysis of a phase 3 study, PROMISE-2, including 1072 patients with CM, of which 40.2% were diagnosed with medication-overuse headache and were randomly assigned to receive eptinezumab (100 or 300 mg) or placebo.

Disclosures: This study was funded by Lundbeck Seattle BioPharmaceuticals, Inc., USA. Four authors declared being current or former employees of Lundbeck or a subsidiary company or a company contracted by Lundbeck or owning stocks or stock options in Alder/Lundbeck. Several authors reported ties with Lundbeck or other sources.

Source: Cowan RP et al. Quantity changes in acute headache medication use among patients with chronic migraine treated with eptinezumab: Subanalysis of the PROMISE‑2 study. J Headache Pain. 2022;23:115 (Sep 6). Doi: 10.1186/s10194-022-01482-0

Key clinical point: Eptinezumab vs placebo significantly reduced the number of headache days with acute headache medication (AHM) use in patients with chronic migraine (CM), with the effect being greatest among those with medication-overuse headache and ≥50% response.

Major finding: Eptinezumab vs placebo resulted in a greater percentage-point reductions in the number of headache days with AHM use in the overall cohort of patients with CM (percentage-point reduction −25.1% vs −17.0%) and in patients with CM and medication-overuse headache who experienced ≥50% response (percentage-point reduction −38.3% vs −31.5%) over 24 weeks.

Study details: Findings are from a post hoc analysis of a phase 3 study, PROMISE-2, including 1072 patients with CM, of which 40.2% were diagnosed with medication-overuse headache and were randomly assigned to receive eptinezumab (100 or 300 mg) or placebo.

Disclosures: This study was funded by Lundbeck Seattle BioPharmaceuticals, Inc., USA. Four authors declared being current or former employees of Lundbeck or a subsidiary company or a company contracted by Lundbeck or owning stocks or stock options in Alder/Lundbeck. Several authors reported ties with Lundbeck or other sources.

Source: Cowan RP et al. Quantity changes in acute headache medication use among patients with chronic migraine treated with eptinezumab: Subanalysis of the PROMISE‑2 study. J Headache Pain. 2022;23:115 (Sep 6). Doi: 10.1186/s10194-022-01482-0

Key clinical point: Patients with migraine without aura who experienced transient visual disturbance (MwTVD) had worse headache, higher migraine-related disability, more psychiatric comorbidities, and a higher risk for chronic migraine than those with migraine with visual aura (MA).

Major finding: MwTVD vs MA group had a higher prevalence of chronic migraine (41.9% vs 11.8%; P < .001) and higher mean Migraine Disability Assessment, anxiety, and depression scores (all P < .001), with transient visual disturbance being a significant risk factor for chronic migraine even after adjusting for confounding factors (adjusted odds ratio 4.75; P < .001).

Study details: This was a post hoc analysis of previously collected data of 2551 patients with migraine, of which 743 had MA and 1808 had MwTVD.

Disclosures: This study was supported by Brain Research Center, the Ministry of Education in Taiwan, and other sources. The authors declared no conflicts of interest.

Source: Tsao Y-C et al. Non-aura visual disturbance with high visual aura rating scale scores has stronger association with migraine chronification than typical aura. Cephalalgia. 2022 (Sep 6). Doi: 10.1177/03331024221123074

Key clinical point: Patients with migraine without aura who experienced transient visual disturbance (MwTVD) had worse headache, higher migraine-related disability, more psychiatric comorbidities, and a higher risk for chronic migraine than those with migraine with visual aura (MA).

Major finding: MwTVD vs MA group had a higher prevalence of chronic migraine (41.9% vs 11.8%; P < .001) and higher mean Migraine Disability Assessment, anxiety, and depression scores (all P < .001), with transient visual disturbance being a significant risk factor for chronic migraine even after adjusting for confounding factors (adjusted odds ratio 4.75; P < .001).

Study details: This was a post hoc analysis of previously collected data of 2551 patients with migraine, of which 743 had MA and 1808 had MwTVD.

Disclosures: This study was supported by Brain Research Center, the Ministry of Education in Taiwan, and other sources. The authors declared no conflicts of interest.

Source: Tsao Y-C et al. Non-aura visual disturbance with high visual aura rating scale scores has stronger association with migraine chronification than typical aura. Cephalalgia. 2022 (Sep 6). Doi: 10.1177/03331024221123074

Key clinical point: Patients with migraine without aura who experienced transient visual disturbance (MwTVD) had worse headache, higher migraine-related disability, more psychiatric comorbidities, and a higher risk for chronic migraine than those with migraine with visual aura (MA).

Major finding: MwTVD vs MA group had a higher prevalence of chronic migraine (41.9% vs 11.8%; P < .001) and higher mean Migraine Disability Assessment, anxiety, and depression scores (all P < .001), with transient visual disturbance being a significant risk factor for chronic migraine even after adjusting for confounding factors (adjusted odds ratio 4.75; P < .001).

Study details: This was a post hoc analysis of previously collected data of 2551 patients with migraine, of which 743 had MA and 1808 had MwTVD.

Disclosures: This study was supported by Brain Research Center, the Ministry of Education in Taiwan, and other sources. The authors declared no conflicts of interest.

Source: Tsao Y-C et al. Non-aura visual disturbance with high visual aura rating scale scores has stronger association with migraine chronification than typical aura. Cephalalgia. 2022 (Sep 6). Doi: 10.1177/03331024221123074

Key clinical point: Poor sleep quality significantly increased the risk of developing migraine and migraine-related burden.

Major finding: Poor sleep quality was more prevalent in patients with migraine vs healthy controls (66.9% vs 24.3%; P < .001), with the risk for migraine being 3.981-times higher in those with poor vs good sleep quality (P  =  .001). Poor sleep quality in patients with migraine was significantly associated with increases in total pain burden, decreased quality of life, and increased anxiety and depression (all P_trend < .05).

Study details: Findings are from a case-control and cross-sectional analysis including 134 patients with migraine with or without aura and 70 sex- and age-matched healthy controls.

Disclosures: This study was supported by the Elite Medical Professionals project of China-Japan Friendship Hospital. The authors declared no conflicts of interest.

Source: Duan S et al. Association between sleep quality, migraine and migraine burden. Front Neurol. 2022 (Aug 26). Doi: 10.3389/fneur.2022.955298

Key clinical point: Poor sleep quality significantly increased the risk of developing migraine and migraine-related burden.

Major finding: Poor sleep quality was more prevalent in patients with migraine vs healthy controls (66.9% vs 24.3%; P < .001), with the risk for migraine being 3.981-times higher in those with poor vs good sleep quality (P  =  .001). Poor sleep quality in patients with migraine was significantly associated with increases in total pain burden, decreased quality of life, and increased anxiety and depression (all P_trend < .05).

Study details: Findings are from a case-control and cross-sectional analysis including 134 patients with migraine with or without aura and 70 sex- and age-matched healthy controls.

Disclosures: This study was supported by the Elite Medical Professionals project of China-Japan Friendship Hospital. The authors declared no conflicts of interest.

Source: Duan S et al. Association between sleep quality, migraine and migraine burden. Front Neurol. 2022 (Aug 26). Doi: 10.3389/fneur.2022.955298

Key clinical point: Poor sleep quality significantly increased the risk of developing migraine and migraine-related burden.

Major finding: Poor sleep quality was more prevalent in patients with migraine vs healthy controls (66.9% vs 24.3%; P < .001), with the risk for migraine being 3.981-times higher in those with poor vs good sleep quality (P  =  .001). Poor sleep quality in patients with migraine was significantly associated with increases in total pain burden, decreased quality of life, and increased anxiety and depression (all P_trend < .05).

Study details: Findings are from a case-control and cross-sectional analysis including 134 patients with migraine with or without aura and 70 sex- and age-matched healthy controls.

Disclosures: This study was supported by the Elite Medical Professionals project of China-Japan Friendship Hospital. The authors declared no conflicts of interest.

Source: Duan S et al. Association between sleep quality, migraine and migraine burden. Front Neurol. 2022 (Aug 26). Doi: 10.3389/fneur.2022.955298

Key clinical point: Participants, especially women and those aged 50-85 years, who had a high intake of dietary thiamine were less likely to develop severe headache or migraine.

Major finding: Dietary thiamine intake was associated with a reduced risk for migraine or headache (adjusted odds ratio [aOR] 0.93; P  =  .046), particularly among women (aOR 0.90; P  =  .022) and those aged 50-85 years (aOR 0.86; P  =  .023).

Study details: Findings are from a cross-sectional study including 13,439 American adults, of which 2745 experienced migraine or severe headache in the past 3 months.

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

Source: Li D et al. Dietary intake of thiamine and riboflavin in relation to severe headache or migraine: A cross-sectional survey. Headache. 2022 (Sep 1). Doi: 10.1111/head.14384

Key clinical point: Participants, especially women and those aged 50-85 years, who had a high intake of dietary thiamine were less likely to develop severe headache or migraine.

Major finding: Dietary thiamine intake was associated with a reduced risk for migraine or headache (adjusted odds ratio [aOR] 0.93; P  =  .046), particularly among women (aOR 0.90; P  =  .022) and those aged 50-85 years (aOR 0.86; P  =  .023).

Study details: Findings are from a cross-sectional study including 13,439 American adults, of which 2745 experienced migraine or severe headache in the past 3 months.

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

Source: Li D et al. Dietary intake of thiamine and riboflavin in relation to severe headache or migraine: A cross-sectional survey. Headache. 2022 (Sep 1). Doi: 10.1111/head.14384

Key clinical point: Participants, especially women and those aged 50-85 years, who had a high intake of dietary thiamine were less likely to develop severe headache or migraine.

Major finding: Dietary thiamine intake was associated with a reduced risk for migraine or headache (adjusted odds ratio [aOR] 0.93; P  =  .046), particularly among women (aOR 0.90; P  =  .022) and those aged 50-85 years (aOR 0.86; P  =  .023).

Study details: Findings are from a cross-sectional study including 13,439 American adults, of which 2745 experienced migraine or severe headache in the past 3 months.

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

Source: Li D et al. Dietary intake of thiamine and riboflavin in relation to severe headache or migraine: A cross-sectional survey. Headache. 2022 (Sep 1). Doi: 10.1111/head.14384

Key clinical point: Fremanezumab vs placebo demonstrated significant and clinically meaningful improvements in migraine- and headache-related disability in patients with chronic and episodic migraine, including those with difficult-to-treat migraine.

Major finding: At 12 weeks of treatment, a significantly higher proportion of patients receiving quarterly and monthly fremanezumab vs placebo reported ≥5-point reduction in 6-item Headache Impact Test scores (53% and 55% vs 39%, respectively; both P < .0001) and ≥30% reduction in Migraine Disability Assessment scores among patients with severe disability (69% and 79% vs 58%, respectively; both P < .001).

Study details: Findings are from a pooled analysis of three phase 3 trials including 3660 patients with episodic or chronic migraine with or without aura who were randomly assigned to receive quarterly or monthly fremanezumab or placebo.

Disclosures: This study was funded by Teva Pharmaceuticals. Five authors declared being current or former employees of Teva Pharmaceuticals. P McAllister reported receiving research support and serving as a consultant for Teva Pharmaceuticals and other sources.

Source: McAllister P et al. Impact of fremanezumab on disability outcomes in patients with episodic and chronic migraine: A pooled analysis of phase 3 studies. J Headache Pain. 2022;23:112 (Aug 29). Doi: 10.1186/s10194-022-01438-4

Key clinical point: Fremanezumab vs placebo demonstrated significant and clinically meaningful improvements in migraine- and headache-related disability in patients with chronic and episodic migraine, including those with difficult-to-treat migraine.

Major finding: At 12 weeks of treatment, a significantly higher proportion of patients receiving quarterly and monthly fremanezumab vs placebo reported ≥5-point reduction in 6-item Headache Impact Test scores (53% and 55% vs 39%, respectively; both P < .0001) and ≥30% reduction in Migraine Disability Assessment scores among patients with severe disability (69% and 79% vs 58%, respectively; both P < .001).

Study details: Findings are from a pooled analysis of three phase 3 trials including 3660 patients with episodic or chronic migraine with or without aura who were randomly assigned to receive quarterly or monthly fremanezumab or placebo.

Disclosures: This study was funded by Teva Pharmaceuticals. Five authors declared being current or former employees of Teva Pharmaceuticals. P McAllister reported receiving research support and serving as a consultant for Teva Pharmaceuticals and other sources.

Source: McAllister P et al. Impact of fremanezumab on disability outcomes in patients with episodic and chronic migraine: A pooled analysis of phase 3 studies. J Headache Pain. 2022;23:112 (Aug 29). Doi: 10.1186/s10194-022-01438-4

Key clinical point: Fremanezumab vs placebo demonstrated significant and clinically meaningful improvements in migraine- and headache-related disability in patients with chronic and episodic migraine, including those with difficult-to-treat migraine.

Major finding: At 12 weeks of treatment, a significantly higher proportion of patients receiving quarterly and monthly fremanezumab vs placebo reported ≥5-point reduction in 6-item Headache Impact Test scores (53% and 55% vs 39%, respectively; both P < .0001) and ≥30% reduction in Migraine Disability Assessment scores among patients with severe disability (69% and 79% vs 58%, respectively; both P < .001).

Study details: Findings are from a pooled analysis of three phase 3 trials including 3660 patients with episodic or chronic migraine with or without aura who were randomly assigned to receive quarterly or monthly fremanezumab or placebo.

Disclosures: This study was funded by Teva Pharmaceuticals. Five authors declared being current or former employees of Teva Pharmaceuticals. P McAllister reported receiving research support and serving as a consultant for Teva Pharmaceuticals and other sources.

Source: McAllister P et al. Impact of fremanezumab on disability outcomes in patients with episodic and chronic migraine: A pooled analysis of phase 3 studies. J Headache Pain. 2022;23:112 (Aug 29). Doi: 10.1186/s10194-022-01438-4

Key clinical point: Treatment of a migraine attack with 50 or 100 mg ubrogepant leads to more favorable treatment outcomes when pain is mild vs moderate or severe.

Major finding: At 2 hours after ubrogepant treatment, the rates of freedom from pain (50 mg: odds ratio [OR] 2.89; 100 mg: OR 3.50; both P < .0001) and migraine symptoms (all P < .001) were higher when pain was mild vs moderate or severe.

Study details: Findings are from a post hoc analysis of a phase 3, long-term extension trial including patients with migraine with or without aura who were randomly assigned to receive 50 mg ubrogepant (n = 401), 100 mg ubrogepant (n = 407), or usual care (n = 417).

Disclosures: This study was sponsored by AbbVie Six authors reported being current or former employees or stockholders of AbbVie. Several authors including the lead author reported serving as consultants or advisory board members or receiving honoraria or research support from various sources.

Source: Lipton RB et al. Efficacy of ubrogepant in the acute treatment of migraine with mild pain versus moderate or severe pain. Neurology. 2022 (Aug 17). Doi:  10.1212/WNL.0000000000201031

Key clinical point: Treatment of a migraine attack with 50 or 100 mg ubrogepant leads to more favorable treatment outcomes when pain is mild vs moderate or severe.

Major finding: At 2 hours after ubrogepant treatment, the rates of freedom from pain (50 mg: odds ratio [OR] 2.89; 100 mg: OR 3.50; both P < .0001) and migraine symptoms (all P < .001) were higher when pain was mild vs moderate or severe.

Study details: Findings are from a post hoc analysis of a phase 3, long-term extension trial including patients with migraine with or without aura who were randomly assigned to receive 50 mg ubrogepant (n = 401), 100 mg ubrogepant (n = 407), or usual care (n = 417).

Disclosures: This study was sponsored by AbbVie Six authors reported being current or former employees or stockholders of AbbVie. Several authors including the lead author reported serving as consultants or advisory board members or receiving honoraria or research support from various sources.

Source: Lipton RB et al. Efficacy of ubrogepant in the acute treatment of migraine with mild pain versus moderate or severe pain. Neurology. 2022 (Aug 17). Doi:  10.1212/WNL.0000000000201031

Key clinical point: Treatment of a migraine attack with 50 or 100 mg ubrogepant leads to more favorable treatment outcomes when pain is mild vs moderate or severe.

Major finding: At 2 hours after ubrogepant treatment, the rates of freedom from pain (50 mg: odds ratio [OR] 2.89; 100 mg: OR 3.50; both P < .0001) and migraine symptoms (all P < .001) were higher when pain was mild vs moderate or severe.

Study details: Findings are from a post hoc analysis of a phase 3, long-term extension trial including patients with migraine with or without aura who were randomly assigned to receive 50 mg ubrogepant (n = 401), 100 mg ubrogepant (n = 407), or usual care (n = 417).

Disclosures: This study was sponsored by AbbVie Six authors reported being current or former employees or stockholders of AbbVie. Several authors including the lead author reported serving as consultants or advisory board members or receiving honoraria or research support from various sources.

Source: Lipton RB et al. Efficacy of ubrogepant in the acute treatment of migraine with mild pain versus moderate or severe pain. Neurology. 2022 (Aug 17). Doi:  10.1212/WNL.0000000000201031

Key clinical point: A combined manual therapeutic approach that included soft-tissue and articulatory manual therapy techniques was more effective in reducing migraine impact than either technique alone.

Major finding: After 4 weeks of intervention, the improvement in pain intensity was greater with combined soft-tissue and articulatory manual therapy vs only soft-tissue (P < .001) or articulatory (P = .014) manual therapy. Reduction in migraine duration was significant with combined vs soft-tissue therapy (P  =  .02), with improvements maintained through a  4-week follow-up. No serious side-effects were reported.

Study details: Findings are from a randomized controlled trial including 75 patients with chronic or episodic migraine who were randomly assigned to receive soft-tissue therapy, articulatory therapy, or combination of both manual therapies.

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

Source: Muñoz-Gómez E et al. Potential add-on effects of manual therapy techniques in migraine patients: A randomised controlled trial. J Clin Med. 2022;11(16):4686 (Aug 11). Doi: 10.3390/jcm11164686

Key clinical point: A combined manual therapeutic approach that included soft-tissue and articulatory manual therapy techniques was more effective in reducing migraine impact than either technique alone.

Major finding: After 4 weeks of intervention, the improvement in pain intensity was greater with combined soft-tissue and articulatory manual therapy vs only soft-tissue (P < .001) or articulatory (P = .014) manual therapy. Reduction in migraine duration was significant with combined vs soft-tissue therapy (P  =  .02), with improvements maintained through a  4-week follow-up. No serious side-effects were reported.

Study details: Findings are from a randomized controlled trial including 75 patients with chronic or episodic migraine who were randomly assigned to receive soft-tissue therapy, articulatory therapy, or combination of both manual therapies.

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

Source: Muñoz-Gómez E et al. Potential add-on effects of manual therapy techniques in migraine patients: A randomised controlled trial. J Clin Med. 2022;11(16):4686 (Aug 11). Doi: 10.3390/jcm11164686

Key clinical point: A combined manual therapeutic approach that included soft-tissue and articulatory manual therapy techniques was more effective in reducing migraine impact than either technique alone.

Major finding: After 4 weeks of intervention, the improvement in pain intensity was greater with combined soft-tissue and articulatory manual therapy vs only soft-tissue (P < .001) or articulatory (P = .014) manual therapy. Reduction in migraine duration was significant with combined vs soft-tissue therapy (P  =  .02), with improvements maintained through a  4-week follow-up. No serious side-effects were reported.

Study details: Findings are from a randomized controlled trial including 75 patients with chronic or episodic migraine who were randomly assigned to receive soft-tissue therapy, articulatory therapy, or combination of both manual therapies.

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

Source: Muñoz-Gómez E et al. Potential add-on effects of manual therapy techniques in migraine patients: A randomised controlled trial. J Clin Med. 2022;11(16):4686 (Aug 11). Doi: 10.3390/jcm11164686