Key clinical point: Janus kinase inhibitors (JAKi) ameliorated the signs and symptoms of rheumatoid arthritis (RA) and improved the health-related quality of life more effectively than placebo; however, safety concerns should be addressed.

Major finding: JAKi vs placebo significantly improved the American College of Rheumatology ≥20% improvement response rate (risk ratio [RR] 2.03; P < .001) and Health Assessment Questionnaire-Disability Index (mean difference −0.31; P < .001), but were associated with a higher risk for ≥1 adverse events (RR 1.10; P < .001) and infections (RR 1.29; P < .001).

Study details: Findings are from a systematic review and meta-analysis of pooled data from 37 randomized controlled trials that evaluated JAKi for RA and included a total of 15,174 participants.

Disclosures: This study was supported by the National Natural Science Foundation of China, West China Hospital, and others. The authors declared no conflicts of interest.

Source: Wang F et al. Efficacy and safety of JAK inhibitors for rheumatoid arthritis: A meta-analysis. J Clin Med. 2022;11(15):4459 (Jul 30). Doi: 10.3390/jcm11154459

Key clinical point: Janus kinase inhibitors (JAKi) ameliorated the signs and symptoms of rheumatoid arthritis (RA) and improved the health-related quality of life more effectively than placebo; however, safety concerns should be addressed.

Major finding: JAKi vs placebo significantly improved the American College of Rheumatology ≥20% improvement response rate (risk ratio [RR] 2.03; P < .001) and Health Assessment Questionnaire-Disability Index (mean difference −0.31; P < .001), but were associated with a higher risk for ≥1 adverse events (RR 1.10; P < .001) and infections (RR 1.29; P < .001).

Study details: Findings are from a systematic review and meta-analysis of pooled data from 37 randomized controlled trials that evaluated JAKi for RA and included a total of 15,174 participants.

Disclosures: This study was supported by the National Natural Science Foundation of China, West China Hospital, and others. The authors declared no conflicts of interest.

Source: Wang F et al. Efficacy and safety of JAK inhibitors for rheumatoid arthritis: A meta-analysis. J Clin Med. 2022;11(15):4459 (Jul 30). Doi: 10.3390/jcm11154459

Key clinical point: Janus kinase inhibitors (JAKi) ameliorated the signs and symptoms of rheumatoid arthritis (RA) and improved the health-related quality of life more effectively than placebo; however, safety concerns should be addressed.

Major finding: JAKi vs placebo significantly improved the American College of Rheumatology ≥20% improvement response rate (risk ratio [RR] 2.03; P < .001) and Health Assessment Questionnaire-Disability Index (mean difference −0.31; P < .001), but were associated with a higher risk for ≥1 adverse events (RR 1.10; P < .001) and infections (RR 1.29; P < .001).

Study details: Findings are from a systematic review and meta-analysis of pooled data from 37 randomized controlled trials that evaluated JAKi for RA and included a total of 15,174 participants.

Disclosures: This study was supported by the National Natural Science Foundation of China, West China Hospital, and others. The authors declared no conflicts of interest.

Source: Wang F et al. Efficacy and safety of JAK inhibitors for rheumatoid arthritis: A meta-analysis. J Clin Med. 2022;11(15):4459 (Jul 30). Doi: 10.3390/jcm11154459

Key clinical point: Discontinuation of biologic disease-modifying antirheumatic drugs (bDMARD) upon testing positive for pregnancy is associated with and a major risk factor for disease flare during pregnancy in a large proportion of women with rheumatoid arthritis (RA) and good disease control prior to conception.

Major finding: Overall, flare was reported by 37% of patients during pregnancy and was associated with discontinuing bDMARD upon testing positive for pregnancy (odds ratio [OR] 2.857; P  =  .034) and previous use of >1 bDMARD (OR 4.1; P  =  .019). Patients with vs without disease flare during pregnancy were more likely to report preterm delivery (27% vs 7%; OR 4.625; P  =  .034).

Study details: This study analyzed the retrospectively collected data of 73 pregnancies in 63 women with RA and good disease control during conception who were prospectively followed through their pregnancies.

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

Source: Gerardi MC et al. Stopping bDMARDs at the beginning of pregnancy is associated with disease flares and preterm delivery in women with rheumatoid arthritis. Front Pharmacol. 2022 (Aug 3). Doi: 10.3389/fphar.2022.887462

Key clinical point: Discontinuation of biologic disease-modifying antirheumatic drugs (bDMARD) upon testing positive for pregnancy is associated with and a major risk factor for disease flare during pregnancy in a large proportion of women with rheumatoid arthritis (RA) and good disease control prior to conception.

Major finding: Overall, flare was reported by 37% of patients during pregnancy and was associated with discontinuing bDMARD upon testing positive for pregnancy (odds ratio [OR] 2.857; P  =  .034) and previous use of >1 bDMARD (OR 4.1; P  =  .019). Patients with vs without disease flare during pregnancy were more likely to report preterm delivery (27% vs 7%; OR 4.625; P  =  .034).

Study details: This study analyzed the retrospectively collected data of 73 pregnancies in 63 women with RA and good disease control during conception who were prospectively followed through their pregnancies.

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

Source: Gerardi MC et al. Stopping bDMARDs at the beginning of pregnancy is associated with disease flares and preterm delivery in women with rheumatoid arthritis. Front Pharmacol. 2022 (Aug 3). Doi: 10.3389/fphar.2022.887462

Key clinical point: Discontinuation of biologic disease-modifying antirheumatic drugs (bDMARD) upon testing positive for pregnancy is associated with and a major risk factor for disease flare during pregnancy in a large proportion of women with rheumatoid arthritis (RA) and good disease control prior to conception.

Major finding: Overall, flare was reported by 37% of patients during pregnancy and was associated with discontinuing bDMARD upon testing positive for pregnancy (odds ratio [OR] 2.857; P  =  .034) and previous use of >1 bDMARD (OR 4.1; P  =  .019). Patients with vs without disease flare during pregnancy were more likely to report preterm delivery (27% vs 7%; OR 4.625; P  =  .034).

Study details: This study analyzed the retrospectively collected data of 73 pregnancies in 63 women with RA and good disease control during conception who were prospectively followed through their pregnancies.

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

Source: Gerardi MC et al. Stopping bDMARDs at the beginning of pregnancy is associated with disease flares and preterm delivery in women with rheumatoid arthritis. Front Pharmacol. 2022 (Aug 3). Doi: 10.3389/fphar.2022.887462

Key clinical point: Patients with seropositive rheumatoid arthritis (RA) treated with first-line biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARD), particularly tofacitinib, were at an increased risk for herpes zoster (HZ).

Major finding: Overall, the risk for HZ was significantly higher in patients receiving tofacitinib (adjusted hazard ratio [aHR] 2.46; P < .001), infliximab (aHR 1.36; P  =  .017), or adalimumab (aHR 1.29; P  =  .032) vs abatacept, with tofacitinib also increasing the risk for incident (aHR 1.99; P  =  .011) and recurrent (aHR 3.69; P < .001) HZ in patients without prior history of HZ.

Study details: This was a cohort study including 11,720 patients with seropositive RA who received first-line bDMARD or tsDMARD.

Disclosures: This study was supported by the Ministry of Health Welfare, Republic of Korea. The authors declared no conflicts of interest.

Source: Jeong S et al. Incident and recurrent herpes zoster for first-line bDMARD and tsDMARD users in seropositive rheumatoid arthritis patients: a nationwide cohort study. Arthritis Res Ther. 2022;24:180 (Jul 28). Doi: 10.1186/s13075-022-02871-1

Key clinical point: Patients with seropositive rheumatoid arthritis (RA) treated with first-line biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARD), particularly tofacitinib, were at an increased risk for herpes zoster (HZ).

Major finding: Overall, the risk for HZ was significantly higher in patients receiving tofacitinib (adjusted hazard ratio [aHR] 2.46; P < .001), infliximab (aHR 1.36; P  =  .017), or adalimumab (aHR 1.29; P  =  .032) vs abatacept, with tofacitinib also increasing the risk for incident (aHR 1.99; P  =  .011) and recurrent (aHR 3.69; P < .001) HZ in patients without prior history of HZ.

Study details: This was a cohort study including 11,720 patients with seropositive RA who received first-line bDMARD or tsDMARD.

Disclosures: This study was supported by the Ministry of Health Welfare, Republic of Korea. The authors declared no conflicts of interest.

Source: Jeong S et al. Incident and recurrent herpes zoster for first-line bDMARD and tsDMARD users in seropositive rheumatoid arthritis patients: a nationwide cohort study. Arthritis Res Ther. 2022;24:180 (Jul 28). Doi: 10.1186/s13075-022-02871-1

Key clinical point: Patients with seropositive rheumatoid arthritis (RA) treated with first-line biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARD), particularly tofacitinib, were at an increased risk for herpes zoster (HZ).

Major finding: Overall, the risk for HZ was significantly higher in patients receiving tofacitinib (adjusted hazard ratio [aHR] 2.46; P < .001), infliximab (aHR 1.36; P  =  .017), or adalimumab (aHR 1.29; P  =  .032) vs abatacept, with tofacitinib also increasing the risk for incident (aHR 1.99; P  =  .011) and recurrent (aHR 3.69; P < .001) HZ in patients without prior history of HZ.

Study details: This was a cohort study including 11,720 patients with seropositive RA who received first-line bDMARD or tsDMARD.

Disclosures: This study was supported by the Ministry of Health Welfare, Republic of Korea. The authors declared no conflicts of interest.

Source: Jeong S et al. Incident and recurrent herpes zoster for first-line bDMARD and tsDMARD users in seropositive rheumatoid arthritis patients: a nationwide cohort study. Arthritis Res Ther. 2022;24:180 (Jul 28). Doi: 10.1186/s13075-022-02871-1

Key clinical point: In women with well-controlled rheumatoid arthritis (RA), the use of a tumor necrosis factor inhibitor (TNFi) during pregnancy was associated with increased birth weight of the offspring and the birth of fewer small-for-gestational age (SGA) children without an increase in adverse pregnancy outcomes.

Major finding: Compared with non-use of TNFi, the use of TNFi during pregnancy significantly increased the mean birth weight of the offspring (absolute difference 173 g; P  =  .03) and led to fewer SGA children being born (9.8% vs 20.0%; P  =  .05) without increasing the risk for large-for-gestational age and adverse pregnancy outcomes, such as prematurity, low birth weight of offspring, cesarean section, and hypertensive disorders.

Study details: Findings are from a prospective cohort study including 188 women with RA, of which 92 used TNFi during pregnancy.

Disclosures: This study was supported by the Dutch Arthritis Foundation and UCB. No competing interests were declared.

Source: Smeele HTW et al. Tumour necrosis factor inhibitor use during pregnancy is associated with increased birth weight of rheumatoid arthritis patients’ offspring. Ann Rheum Dis. 2022 (Jul 11). Doi: 10.1136/ard-2022-222679

Key clinical point: In women with well-controlled rheumatoid arthritis (RA), the use of a tumor necrosis factor inhibitor (TNFi) during pregnancy was associated with increased birth weight of the offspring and the birth of fewer small-for-gestational age (SGA) children without an increase in adverse pregnancy outcomes.

Major finding: Compared with non-use of TNFi, the use of TNFi during pregnancy significantly increased the mean birth weight of the offspring (absolute difference 173 g; P  =  .03) and led to fewer SGA children being born (9.8% vs 20.0%; P  =  .05) without increasing the risk for large-for-gestational age and adverse pregnancy outcomes, such as prematurity, low birth weight of offspring, cesarean section, and hypertensive disorders.

Study details: Findings are from a prospective cohort study including 188 women with RA, of which 92 used TNFi during pregnancy.

Disclosures: This study was supported by the Dutch Arthritis Foundation and UCB. No competing interests were declared.

Source: Smeele HTW et al. Tumour necrosis factor inhibitor use during pregnancy is associated with increased birth weight of rheumatoid arthritis patients’ offspring. Ann Rheum Dis. 2022 (Jul 11). Doi: 10.1136/ard-2022-222679

Key clinical point: In women with well-controlled rheumatoid arthritis (RA), the use of a tumor necrosis factor inhibitor (TNFi) during pregnancy was associated with increased birth weight of the offspring and the birth of fewer small-for-gestational age (SGA) children without an increase in adverse pregnancy outcomes.

Major finding: Compared with non-use of TNFi, the use of TNFi during pregnancy significantly increased the mean birth weight of the offspring (absolute difference 173 g; P  =  .03) and led to fewer SGA children being born (9.8% vs 20.0%; P  =  .05) without increasing the risk for large-for-gestational age and adverse pregnancy outcomes, such as prematurity, low birth weight of offspring, cesarean section, and hypertensive disorders.

Study details: Findings are from a prospective cohort study including 188 women with RA, of which 92 used TNFi during pregnancy.

Disclosures: This study was supported by the Dutch Arthritis Foundation and UCB. No competing interests were declared.

Source: Smeele HTW et al. Tumour necrosis factor inhibitor use during pregnancy is associated with increased birth weight of rheumatoid arthritis patients’ offspring. Ann Rheum Dis. 2022 (Jul 11). Doi: 10.1136/ard-2022-222679

Key clinical point: Early initiation of a single glucocorticoid injection with 1-year methotrexate treatment in patients with arthralgia at risk for rheumatoid arthritis (RA) did not prevent clinical arthritis but improved overall disease burden.

Major finding: At 2 years, the risk of developing clinical arthritis persisting for ≥2 weeks was similar (hazard ratio 0.81; 95% CI 0.45-1.48). However, methotrexate vs placebo showed sustained decrease in magnetic resonance imaging-detected joint inflammation (mean difference [MD] −1.4 points; P < .0001) and improvement in physical functioning (MD −0.09; P  =  .0042), pain (MD −8; P < .0001) and morning stiffness of joints (MD −12; P < .0001). No new adverse events were reported.

Study details: Findings are from TREAT-EARLIER, a randomized controlled proof-of-concept trial, including 236 patients with arthralgia clinically predisposed to RA who were randomly assigned to receive single glucocorticoid injection+methotrexate or placebo for 1 year.

Disclosures: This study was funded by the Dutch Research Council, supported by the Dutch Arthritis Society. The authors declared no conflicts of interest.

Source: Krijbolder DI et al. Intervention with methotrexate in patients with arthralgia at risk of rheumatoid arthritis to reduce the development of persistent arthritis and its disease burden (TREAT EARLIER): A randomised, double-blind, placebo-controlled, proof-of-concept trial. Lancet. 2022;400(10348):283-294 (Jul 23). Doi: 10.1016/S0140-6736(22)01193-X

Key clinical point: Early initiation of a single glucocorticoid injection with 1-year methotrexate treatment in patients with arthralgia at risk for rheumatoid arthritis (RA) did not prevent clinical arthritis but improved overall disease burden.

Major finding: At 2 years, the risk of developing clinical arthritis persisting for ≥2 weeks was similar (hazard ratio 0.81; 95% CI 0.45-1.48). However, methotrexate vs placebo showed sustained decrease in magnetic resonance imaging-detected joint inflammation (mean difference [MD] −1.4 points; P < .0001) and improvement in physical functioning (MD −0.09; P  =  .0042), pain (MD −8; P < .0001) and morning stiffness of joints (MD −12; P < .0001). No new adverse events were reported.

Study details: Findings are from TREAT-EARLIER, a randomized controlled proof-of-concept trial, including 236 patients with arthralgia clinically predisposed to RA who were randomly assigned to receive single glucocorticoid injection+methotrexate or placebo for 1 year.

Disclosures: This study was funded by the Dutch Research Council, supported by the Dutch Arthritis Society. The authors declared no conflicts of interest.

Source: Krijbolder DI et al. Intervention with methotrexate in patients with arthralgia at risk of rheumatoid arthritis to reduce the development of persistent arthritis and its disease burden (TREAT EARLIER): A randomised, double-blind, placebo-controlled, proof-of-concept trial. Lancet. 2022;400(10348):283-294 (Jul 23). Doi: 10.1016/S0140-6736(22)01193-X

Key clinical point: Early initiation of a single glucocorticoid injection with 1-year methotrexate treatment in patients with arthralgia at risk for rheumatoid arthritis (RA) did not prevent clinical arthritis but improved overall disease burden.

Major finding: At 2 years, the risk of developing clinical arthritis persisting for ≥2 weeks was similar (hazard ratio 0.81; 95% CI 0.45-1.48). However, methotrexate vs placebo showed sustained decrease in magnetic resonance imaging-detected joint inflammation (mean difference [MD] −1.4 points; P < .0001) and improvement in physical functioning (MD −0.09; P  =  .0042), pain (MD −8; P < .0001) and morning stiffness of joints (MD −12; P < .0001). No new adverse events were reported.

Study details: Findings are from TREAT-EARLIER, a randomized controlled proof-of-concept trial, including 236 patients with arthralgia clinically predisposed to RA who were randomly assigned to receive single glucocorticoid injection+methotrexate or placebo for 1 year.

Disclosures: This study was funded by the Dutch Research Council, supported by the Dutch Arthritis Society. The authors declared no conflicts of interest.

Source: Krijbolder DI et al. Intervention with methotrexate in patients with arthralgia at risk of rheumatoid arthritis to reduce the development of persistent arthritis and its disease burden (TREAT EARLIER): A randomised, double-blind, placebo-controlled, proof-of-concept trial. Lancet. 2022;400(10348):283-294 (Jul 23). Doi: 10.1016/S0140-6736(22)01193-X

Key clinical point: Monoclonal antibodies inhibiting calcitonin gene-related peptide (CGRP) effectively reduced monthly headache days, symptomatic drug consumption, and headache severity consistently over 12 months in patients with chronic migraine complicated by medication overuse headache (MOH).

Major finding: Overall, 80% of patients showed both ≥50% reduction in monthly headache days and ≥50% reduction in analgesics intake at the 3-month follow-up visit and 78.8% continued to show the improvements at the 6-month follow-up visit. The mean Migraine Impact and Disability Assessment Scale score decreased from 56.5 (range 27-63) at baseline to 13.1 (range 11-37) at 9 months, with 71% of patients being responders even at 1 year.

Study details: The data come from a prospective study of 303 patients with chronic migraine complicated by MOH who received CGRP antagonists for at least 6 months up to 1 year.

Disclosures: No source of funding was declared. The authors declared no competing interests.

Source: Curone M et al. Overview on effectiveness of erenumab, fremanezumab, and galcanezumab in reducing medication overuse headache in chronic migraine patients. Neurol Sci. 2022 (Jul 14). Doi: 10.1007/s10072-022-06265-8

Key clinical point: Monoclonal antibodies inhibiting calcitonin gene-related peptide (CGRP) effectively reduced monthly headache days, symptomatic drug consumption, and headache severity consistently over 12 months in patients with chronic migraine complicated by medication overuse headache (MOH).

Major finding: Overall, 80% of patients showed both ≥50% reduction in monthly headache days and ≥50% reduction in analgesics intake at the 3-month follow-up visit and 78.8% continued to show the improvements at the 6-month follow-up visit. The mean Migraine Impact and Disability Assessment Scale score decreased from 56.5 (range 27-63) at baseline to 13.1 (range 11-37) at 9 months, with 71% of patients being responders even at 1 year.

Study details: The data come from a prospective study of 303 patients with chronic migraine complicated by MOH who received CGRP antagonists for at least 6 months up to 1 year.

Disclosures: No source of funding was declared. The authors declared no competing interests.

Source: Curone M et al. Overview on effectiveness of erenumab, fremanezumab, and galcanezumab in reducing medication overuse headache in chronic migraine patients. Neurol Sci. 2022 (Jul 14). Doi: 10.1007/s10072-022-06265-8

Key clinical point: Monoclonal antibodies inhibiting calcitonin gene-related peptide (CGRP) effectively reduced monthly headache days, symptomatic drug consumption, and headache severity consistently over 12 months in patients with chronic migraine complicated by medication overuse headache (MOH).

Major finding: Overall, 80% of patients showed both ≥50% reduction in monthly headache days and ≥50% reduction in analgesics intake at the 3-month follow-up visit and 78.8% continued to show the improvements at the 6-month follow-up visit. The mean Migraine Impact and Disability Assessment Scale score decreased from 56.5 (range 27-63) at baseline to 13.1 (range 11-37) at 9 months, with 71% of patients being responders even at 1 year.

Study details: The data come from a prospective study of 303 patients with chronic migraine complicated by MOH who received CGRP antagonists for at least 6 months up to 1 year.

Disclosures: No source of funding was declared. The authors declared no competing interests.

Source: Curone M et al. Overview on effectiveness of erenumab, fremanezumab, and galcanezumab in reducing medication overuse headache in chronic migraine patients. Neurol Sci. 2022 (Jul 14). Doi: 10.1007/s10072-022-06265-8

Key clinical point: The occurrence of unclear days, defined as headache-free but not crystal-clear days, is prevalent in migraine, with the number of crystal-clear days being significantly lower and unclear days being significantly higher in participants with migraine vs non-migraine headache.

Major finding: Overall, 97.1% of participants had unclear days, with the number of crystal-clear days per 30 days being significantly lower (median, 20.0 vs 25.0) and the number of severe headache days (2.0 vs 1.0), days with acute medications (2.0 vs 1.0), and unclear days (4.0 vs 1.0) per 30 days being significantly higher in participants with vs without migraine headache (all P < .001).

Study details: The data come from a cross-sectional and case-control analysis of longitudinally collected data from 170 and 1768 participants with migraine and nonmigraine headaches, respectively.

Disclosures: This study was funded by the National Research Foundation of Korea. S-J Cho and MK Chu declared being site investigators of a multicenter trial or an advisory board members or receiving lecture honoraria or grants from various sources.

Source: Lee W et al. Crystal-clear days and unclear days in migraine: A population-based study. Headache. 2022;62: 818- 827 (Jul 14). Doi: 10.1111/head.14359

Key clinical point: The occurrence of unclear days, defined as headache-free but not crystal-clear days, is prevalent in migraine, with the number of crystal-clear days being significantly lower and unclear days being significantly higher in participants with migraine vs non-migraine headache.

Major finding: Overall, 97.1% of participants had unclear days, with the number of crystal-clear days per 30 days being significantly lower (median, 20.0 vs 25.0) and the number of severe headache days (2.0 vs 1.0), days with acute medications (2.0 vs 1.0), and unclear days (4.0 vs 1.0) per 30 days being significantly higher in participants with vs without migraine headache (all P < .001).

Study details: The data come from a cross-sectional and case-control analysis of longitudinally collected data from 170 and 1768 participants with migraine and nonmigraine headaches, respectively.

Disclosures: This study was funded by the National Research Foundation of Korea. S-J Cho and MK Chu declared being site investigators of a multicenter trial or an advisory board members or receiving lecture honoraria or grants from various sources.

Source: Lee W et al. Crystal-clear days and unclear days in migraine: A population-based study. Headache. 2022;62: 818- 827 (Jul 14). Doi: 10.1111/head.14359

Key clinical point: The occurrence of unclear days, defined as headache-free but not crystal-clear days, is prevalent in migraine, with the number of crystal-clear days being significantly lower and unclear days being significantly higher in participants with migraine vs non-migraine headache.

Major finding: Overall, 97.1% of participants had unclear days, with the number of crystal-clear days per 30 days being significantly lower (median, 20.0 vs 25.0) and the number of severe headache days (2.0 vs 1.0), days with acute medications (2.0 vs 1.0), and unclear days (4.0 vs 1.0) per 30 days being significantly higher in participants with vs without migraine headache (all P < .001).

Study details: The data come from a cross-sectional and case-control analysis of longitudinally collected data from 170 and 1768 participants with migraine and nonmigraine headaches, respectively.

Disclosures: This study was funded by the National Research Foundation of Korea. S-J Cho and MK Chu declared being site investigators of a multicenter trial or an advisory board members or receiving lecture honoraria or grants from various sources.

Source: Lee W et al. Crystal-clear days and unclear days in migraine: A population-based study. Headache. 2022;62: 818- 827 (Jul 14). Doi: 10.1111/head.14359

Key clinical point: Erenumab was effective and generally well tolerated over the 3 months of follow-up in a real-world population of patients with difficult-to-treat chronic migraine.

Major finding: At 3 months follow-up, the median total and severe monthly migraine days reduced significantly from 28 to 20 and from 15 to 5, respectively (both P < .0001), with 39.8%, 22.3%, and 7.8% of patients achieving at least 30%, 50%, and 75% reductions in mean monthly headache days, respectively. Overall, 43% of patients reported ≥1 adverse event, with constipation being the most common adverse event.

Study details: The data come from a prospective clinical audit of a treatment-resistant population of 103 patients with chronic migraine, high prevalence of medication overuse, and high headache burden who received 140 mg erenumab monthly for 3 months.

Disclosures: This study did not receive any funding. Some authors declared serving on advisory boards or as principal investigators for clinical trials or receiving speaker honoraria, conference sponsorship, or grants from various sources.

Source: Lowe M et al. Efficacy of erenumab and factors predicting response after 3 months in treatment resistant chronic migraine: A clinical service evaluation. J Headache Pain. 2022;23:86 (Jul 22). Doi: 10.1186/s10194-022-01456-2

Key clinical point: Erenumab was effective and generally well tolerated over the 3 months of follow-up in a real-world population of patients with difficult-to-treat chronic migraine.

Major finding: At 3 months follow-up, the median total and severe monthly migraine days reduced significantly from 28 to 20 and from 15 to 5, respectively (both P < .0001), with 39.8%, 22.3%, and 7.8% of patients achieving at least 30%, 50%, and 75% reductions in mean monthly headache days, respectively. Overall, 43% of patients reported ≥1 adverse event, with constipation being the most common adverse event.

Study details: The data come from a prospective clinical audit of a treatment-resistant population of 103 patients with chronic migraine, high prevalence of medication overuse, and high headache burden who received 140 mg erenumab monthly for 3 months.

Disclosures: This study did not receive any funding. Some authors declared serving on advisory boards or as principal investigators for clinical trials or receiving speaker honoraria, conference sponsorship, or grants from various sources.

Source: Lowe M et al. Efficacy of erenumab and factors predicting response after 3 months in treatment resistant chronic migraine: A clinical service evaluation. J Headache Pain. 2022;23:86 (Jul 22). Doi: 10.1186/s10194-022-01456-2

Key clinical point: Erenumab was effective and generally well tolerated over the 3 months of follow-up in a real-world population of patients with difficult-to-treat chronic migraine.

Major finding: At 3 months follow-up, the median total and severe monthly migraine days reduced significantly from 28 to 20 and from 15 to 5, respectively (both P < .0001), with 39.8%, 22.3%, and 7.8% of patients achieving at least 30%, 50%, and 75% reductions in mean monthly headache days, respectively. Overall, 43% of patients reported ≥1 adverse event, with constipation being the most common adverse event.

Study details: The data come from a prospective clinical audit of a treatment-resistant population of 103 patients with chronic migraine, high prevalence of medication overuse, and high headache burden who received 140 mg erenumab monthly for 3 months.

Disclosures: This study did not receive any funding. Some authors declared serving on advisory boards or as principal investigators for clinical trials or receiving speaker honoraria, conference sponsorship, or grants from various sources.

Source: Lowe M et al. Efficacy of erenumab and factors predicting response after 3 months in treatment resistant chronic migraine: A clinical service evaluation. J Headache Pain. 2022;23:86 (Jul 22). Doi: 10.1186/s10194-022-01456-2

Key clinical point: Meta-analysis demonstrated lower general cognitive and language functions in patients with migraine, along with a significant association between migraine and risk for all-cause dementia.

Major finding: General cognitive (standard mean difference [SMD] −0.40; 95% CI −0.66 to −0.15) and language (SMD −0.14; 95% CI −0.27 to −0.00) functions were lower in the group of participants with vs without migraine, and no significant between-group differences were observed for visuospatial, attention, executive, and memory functions. Moreover, migraine was significantly associated with the risk for dementia (odds ratio/relative risk 1.30; 95% CI 1.11-1.52).

Study details: Findings are from a meta-analysis of 22 studies (including 3295 patients with migraine) that assessed cognitive function and 11 studies (including 12,871 patients with dementia, 56,365 participants without dementia, 47,942 patients with migraine, and 190,024 healthy controls) that assessed the association between migraine and risk for dementia.

Disclosures: This study was supported by the National Natural Science Foundation of China. The authors declared no conflicts of interest.

Source: Gu L et al. Association between migraine and cognitive impairment. J Headache Pain. 2022;23:88 (Jul 26). Doi: 10.1186/s10194-022-01462-4

Key clinical point: Meta-analysis demonstrated lower general cognitive and language functions in patients with migraine, along with a significant association between migraine and risk for all-cause dementia.

Major finding: General cognitive (standard mean difference [SMD] −0.40; 95% CI −0.66 to −0.15) and language (SMD −0.14; 95% CI −0.27 to −0.00) functions were lower in the group of participants with vs without migraine, and no significant between-group differences were observed for visuospatial, attention, executive, and memory functions. Moreover, migraine was significantly associated with the risk for dementia (odds ratio/relative risk 1.30; 95% CI 1.11-1.52).

Study details: Findings are from a meta-analysis of 22 studies (including 3295 patients with migraine) that assessed cognitive function and 11 studies (including 12,871 patients with dementia, 56,365 participants without dementia, 47,942 patients with migraine, and 190,024 healthy controls) that assessed the association between migraine and risk for dementia.

Disclosures: This study was supported by the National Natural Science Foundation of China. The authors declared no conflicts of interest.

Source: Gu L et al. Association between migraine and cognitive impairment. J Headache Pain. 2022;23:88 (Jul 26). Doi: 10.1186/s10194-022-01462-4

Key clinical point: Meta-analysis demonstrated lower general cognitive and language functions in patients with migraine, along with a significant association between migraine and risk for all-cause dementia.

Major finding: General cognitive (standard mean difference [SMD] −0.40; 95% CI −0.66 to −0.15) and language (SMD −0.14; 95% CI −0.27 to −0.00) functions were lower in the group of participants with vs without migraine, and no significant between-group differences were observed for visuospatial, attention, executive, and memory functions. Moreover, migraine was significantly associated with the risk for dementia (odds ratio/relative risk 1.30; 95% CI 1.11-1.52).

Study details: Findings are from a meta-analysis of 22 studies (including 3295 patients with migraine) that assessed cognitive function and 11 studies (including 12,871 patients with dementia, 56,365 participants without dementia, 47,942 patients with migraine, and 190,024 healthy controls) that assessed the association between migraine and risk for dementia.

Disclosures: This study was supported by the National Natural Science Foundation of China. The authors declared no conflicts of interest.

Source: Gu L et al. Association between migraine and cognitive impairment. J Headache Pain. 2022;23:88 (Jul 26). Doi: 10.1186/s10194-022-01462-4

Key clinical point: Increased dietary niacin intake may have a beneficial effect on migraine outcomes in adults with inadequate niacin consumption and the effect seems to peak in patients with adequate niacin intake, with the threshold level being approximately 21.0 mg/day.

Major finding: The risk for migraine was lower among adults in the higher (18.4-26.2 mg/day: odds ratio [OR] 0.78; P  =  .004, and ≥26.3 mg/day: OR 0.74; P  =  .006) vs lower (≤12.3 mg/day) quartile of daily niacin intake, with the risk of developing migraine reducing by 2.5% with every 1 mg increase in daily dietary niacin consumption (OR 0.975; P  =  .011) in those with dietary niacin intake of <21 mg/day, but no such association was observed in those with dietary niacin intake of ≥21 mg/day.

Study details: This was a cross-sectional study including 10,246 participants aged ≥20 years, of whom 20.1% experienced migraine.

Disclosures: This study was supported by the National Natural Science Foundation of China. The authors declared no conflicts of interest.

Source: Liu H et al. Association between dietary niacin intake and migraine among american adults: National Health and Nutrition Examination Survey. Nutrients. 2022;14(15):3052 (Jul 25). Doi: 10.3390/nu14153052

Key clinical point: Increased dietary niacin intake may have a beneficial effect on migraine outcomes in adults with inadequate niacin consumption and the effect seems to peak in patients with adequate niacin intake, with the threshold level being approximately 21.0 mg/day.

Major finding: The risk for migraine was lower among adults in the higher (18.4-26.2 mg/day: odds ratio [OR] 0.78; P  =  .004, and ≥26.3 mg/day: OR 0.74; P  =  .006) vs lower (≤12.3 mg/day) quartile of daily niacin intake, with the risk of developing migraine reducing by 2.5% with every 1 mg increase in daily dietary niacin consumption (OR 0.975; P  =  .011) in those with dietary niacin intake of <21 mg/day, but no such association was observed in those with dietary niacin intake of ≥21 mg/day.

Study details: This was a cross-sectional study including 10,246 participants aged ≥20 years, of whom 20.1% experienced migraine.

Disclosures: This study was supported by the National Natural Science Foundation of China. The authors declared no conflicts of interest.

Source: Liu H et al. Association between dietary niacin intake and migraine among american adults: National Health and Nutrition Examination Survey. Nutrients. 2022;14(15):3052 (Jul 25). Doi: 10.3390/nu14153052

Key clinical point: Increased dietary niacin intake may have a beneficial effect on migraine outcomes in adults with inadequate niacin consumption and the effect seems to peak in patients with adequate niacin intake, with the threshold level being approximately 21.0 mg/day.

Major finding: The risk for migraine was lower among adults in the higher (18.4-26.2 mg/day: odds ratio [OR] 0.78; P  =  .004, and ≥26.3 mg/day: OR 0.74; P  =  .006) vs lower (≤12.3 mg/day) quartile of daily niacin intake, with the risk of developing migraine reducing by 2.5% with every 1 mg increase in daily dietary niacin consumption (OR 0.975; P  =  .011) in those with dietary niacin intake of <21 mg/day, but no such association was observed in those with dietary niacin intake of ≥21 mg/day.

Study details: This was a cross-sectional study including 10,246 participants aged ≥20 years, of whom 20.1% experienced migraine.

Disclosures: This study was supported by the National Natural Science Foundation of China. The authors declared no conflicts of interest.

Source: Liu H et al. Association between dietary niacin intake and migraine among american adults: National Health and Nutrition Examination Survey. Nutrients. 2022;14(15):3052 (Jul 25). Doi: 10.3390/nu14153052