Key clinical point: Higher levels of circulating adiponectin and leptin were associated with an increased risk for all-cause and cardiovascular mortality in patients with rheumatoid arthritis (RA).

Major finding: Patients in the highest vs. lowest quartile of adiponectin were at a 46% higher risk for all-cause mortality (hazard ratio [HR] 1.46; P = .009) and an 85% higher risk for cardiovascular mortality (HR 1.85; P = .003). Patients in the highest vs. lowest quartile of both adiponectin and leptin were at a 73% higher risk for all-cause mortality (HR 1.73; P = .002).

Study details: This was a longitudinal study including 2583 patients with RA.

Disclosures: This study did not declare any source of funding. JF Baker and TR MIkuls reported receiving consulting fees and research support from various sources.

Source: Baker JF et al. Elevations in adipocytokines and mortality in rheumatoid arthritis. Rheumatology (Oxford). 2022 Mar 23. Doi: 10.1093/rheumatology/keac191

Key clinical point: Higher levels of circulating adiponectin and leptin were associated with an increased risk for all-cause and cardiovascular mortality in patients with rheumatoid arthritis (RA).

Major finding: Patients in the highest vs. lowest quartile of adiponectin were at a 46% higher risk for all-cause mortality (hazard ratio [HR] 1.46; P = .009) and an 85% higher risk for cardiovascular mortality (HR 1.85; P = .003). Patients in the highest vs. lowest quartile of both adiponectin and leptin were at a 73% higher risk for all-cause mortality (HR 1.73; P = .002).

Study details: This was a longitudinal study including 2583 patients with RA.

Disclosures: This study did not declare any source of funding. JF Baker and TR MIkuls reported receiving consulting fees and research support from various sources.

Source: Baker JF et al. Elevations in adipocytokines and mortality in rheumatoid arthritis. Rheumatology (Oxford). 2022 Mar 23. Doi: 10.1093/rheumatology/keac191

Key clinical point: Higher levels of circulating adiponectin and leptin were associated with an increased risk for all-cause and cardiovascular mortality in patients with rheumatoid arthritis (RA).

Major finding: Patients in the highest vs. lowest quartile of adiponectin were at a 46% higher risk for all-cause mortality (hazard ratio [HR] 1.46; P = .009) and an 85% higher risk for cardiovascular mortality (HR 1.85; P = .003). Patients in the highest vs. lowest quartile of both adiponectin and leptin were at a 73% higher risk for all-cause mortality (HR 1.73; P = .002).

Study details: This was a longitudinal study including 2583 patients with RA.

Disclosures: This study did not declare any source of funding. JF Baker and TR MIkuls reported receiving consulting fees and research support from various sources.

Source: Baker JF et al. Elevations in adipocytokines and mortality in rheumatoid arthritis. Rheumatology (Oxford). 2022 Mar 23. Doi: 10.1093/rheumatology/keac191

Key clinical point: Frailty may be partially reversible with treatment in early rheumatoid arthritis (RA) and is associated with a greater risk for hospitalization and all-cause mortality in early and established RA.

Major finding: Patients with early RA improved from moderate/severe frailty to mild (33%) and robust (13%) states in the first 6 months of treatment with disease-modifying antirheumatic drugs. In early and established RA, the moderate/severe vs. robust frailty level was associated with unscheduled hospitalization (incidence rate ratio [IRR] 2.88; 95% CI 1.97-4.20, and IRR 2.74; 95% CI 2.29-3.29, respectively) and all-cause mortality (hazard ratio [HR] 4.41; 95% CI 1.85-10.49 and HR 1.68; 95% CI 1.26-2.13, respectively).

Study details: This was a longitudinal analysis of two cohorts including 899 and 3605 patients with early and established RA, respectively.

Disclosures: No information on funding was reported. No conflicts of interest were declared.

Source: Hanlon P et al. Frailty in rheumatoid arthritis and its relationship with disease activity, hospitalisation and mortality: a longitudinal analysis of the Scottish Early Rheumatoid Arthritis cohort and UK Biobank. RMD Open. 2022;8:e002111 (Mar 15). Doi: 10.1136/rmdopen-2021-002111

Key clinical point: Frailty may be partially reversible with treatment in early rheumatoid arthritis (RA) and is associated with a greater risk for hospitalization and all-cause mortality in early and established RA.

Major finding: Patients with early RA improved from moderate/severe frailty to mild (33%) and robust (13%) states in the first 6 months of treatment with disease-modifying antirheumatic drugs. In early and established RA, the moderate/severe vs. robust frailty level was associated with unscheduled hospitalization (incidence rate ratio [IRR] 2.88; 95% CI 1.97-4.20, and IRR 2.74; 95% CI 2.29-3.29, respectively) and all-cause mortality (hazard ratio [HR] 4.41; 95% CI 1.85-10.49 and HR 1.68; 95% CI 1.26-2.13, respectively).

Study details: This was a longitudinal analysis of two cohorts including 899 and 3605 patients with early and established RA, respectively.

Disclosures: No information on funding was reported. No conflicts of interest were declared.

Source: Hanlon P et al. Frailty in rheumatoid arthritis and its relationship with disease activity, hospitalisation and mortality: a longitudinal analysis of the Scottish Early Rheumatoid Arthritis cohort and UK Biobank. RMD Open. 2022;8:e002111 (Mar 15). Doi: 10.1136/rmdopen-2021-002111

Key clinical point: Frailty may be partially reversible with treatment in early rheumatoid arthritis (RA) and is associated with a greater risk for hospitalization and all-cause mortality in early and established RA.

Major finding: Patients with early RA improved from moderate/severe frailty to mild (33%) and robust (13%) states in the first 6 months of treatment with disease-modifying antirheumatic drugs. In early and established RA, the moderate/severe vs. robust frailty level was associated with unscheduled hospitalization (incidence rate ratio [IRR] 2.88; 95% CI 1.97-4.20, and IRR 2.74; 95% CI 2.29-3.29, respectively) and all-cause mortality (hazard ratio [HR] 4.41; 95% CI 1.85-10.49 and HR 1.68; 95% CI 1.26-2.13, respectively).

Study details: This was a longitudinal analysis of two cohorts including 899 and 3605 patients with early and established RA, respectively.

Disclosures: No information on funding was reported. No conflicts of interest were declared.

Source: Hanlon P et al. Frailty in rheumatoid arthritis and its relationship with disease activity, hospitalisation and mortality: a longitudinal analysis of the Scottish Early Rheumatoid Arthritis cohort and UK Biobank. RMD Open. 2022;8:e002111 (Mar 15). Doi: 10.1136/rmdopen-2021-002111

Key clinical point: An ultralow dose (200 mg) of rituximab infusion and an increased time interval between COVID-19 vaccination and rituximab infusion significantly improved humoral response to COVID-19 vaccine in patients with rheumatoid arthritis (RA).

Major finding: Positive vaccination response was more frequently observed in the 200 mg vs. 1000 mg rituximab infusion group (odds ratio [OR] 3.07; P = .03) and improved with greater time interval between rituximab infusion and COVID-19 vaccination (per month OR 1.67; P < .0001).

Study details: This was a prospective cohort study, RTX-COVAC, including 196 patients with RA who received at least one dose of rituximab (200, 500, or 1000 mg) in the year prior to their first dose of COVID-19 vaccination.

Disclosures: This study did not receive any specific funding. AA den Broeder reported receiving personal fees, congress invitations, and grants outside the submitted work from various sources. Other authors declared no conflicts of interest.

Source: van der Togt CJT et al. Humoral response to Coronavirus Disease-19 vaccines is dependent on dosage and timing of rituximab in patients with rheumatoid arthritis. Rheumatology (Oxford). 2022 (Apr 4). Doi: 10.1093/rheumatology/keac206

Key clinical point: An ultralow dose (200 mg) of rituximab infusion and an increased time interval between COVID-19 vaccination and rituximab infusion significantly improved humoral response to COVID-19 vaccine in patients with rheumatoid arthritis (RA).

Major finding: Positive vaccination response was more frequently observed in the 200 mg vs. 1000 mg rituximab infusion group (odds ratio [OR] 3.07; P = .03) and improved with greater time interval between rituximab infusion and COVID-19 vaccination (per month OR 1.67; P < .0001).

Study details: This was a prospective cohort study, RTX-COVAC, including 196 patients with RA who received at least one dose of rituximab (200, 500, or 1000 mg) in the year prior to their first dose of COVID-19 vaccination.

Disclosures: This study did not receive any specific funding. AA den Broeder reported receiving personal fees, congress invitations, and grants outside the submitted work from various sources. Other authors declared no conflicts of interest.

Source: van der Togt CJT et al. Humoral response to Coronavirus Disease-19 vaccines is dependent on dosage and timing of rituximab in patients with rheumatoid arthritis. Rheumatology (Oxford). 2022 (Apr 4). Doi: 10.1093/rheumatology/keac206

Key clinical point: An ultralow dose (200 mg) of rituximab infusion and an increased time interval between COVID-19 vaccination and rituximab infusion significantly improved humoral response to COVID-19 vaccine in patients with rheumatoid arthritis (RA).

Major finding: Positive vaccination response was more frequently observed in the 200 mg vs. 1000 mg rituximab infusion group (odds ratio [OR] 3.07; P = .03) and improved with greater time interval between rituximab infusion and COVID-19 vaccination (per month OR 1.67; P < .0001).

Study details: This was a prospective cohort study, RTX-COVAC, including 196 patients with RA who received at least one dose of rituximab (200, 500, or 1000 mg) in the year prior to their first dose of COVID-19 vaccination.

Disclosures: This study did not receive any specific funding. AA den Broeder reported receiving personal fees, congress invitations, and grants outside the submitted work from various sources. Other authors declared no conflicts of interest.

Source: van der Togt CJT et al. Humoral response to Coronavirus Disease-19 vaccines is dependent on dosage and timing of rituximab in patients with rheumatoid arthritis. Rheumatology (Oxford). 2022 (Apr 4). Doi: 10.1093/rheumatology/keac206

Key clinical point: Patients with chronic migraine (CM) or episodic migraine (EM) show a clinically significant improvement in headache characteristics after prophylactic transcutaneous nerve stimulation.

Major finding: Transcutaneous nerve stimulation reduced the headache frequency (mean monthly headache days) by 2.81 (95% CI 2.18-3.43) days in EM and by 2.97 (95% CI 1.66-4.28) days in CM and the pain severity by 2.23 (95% CI 1.64-2.81) pain scale points in EM.

Study details: The data come from a meta-analysis of 14 studies that included 995 patients with EM or CM treated with transcutaneous stimulation of a single nerve.

Disclosures: The study received no financial support. The authors declared no conflicts of interest.

Source: Evans AG et al. Outcomes of transcutaneous nerve stimulation for migraine headaches: a systematic review and meta-analysis. J Neurol. 2022 (Mar 16). Doi: 10.1007/s00415-022-11059-1

Key clinical point: Patients with chronic migraine (CM) or episodic migraine (EM) show a clinically significant improvement in headache characteristics after prophylactic transcutaneous nerve stimulation.

Major finding: Transcutaneous nerve stimulation reduced the headache frequency (mean monthly headache days) by 2.81 (95% CI 2.18-3.43) days in EM and by 2.97 (95% CI 1.66-4.28) days in CM and the pain severity by 2.23 (95% CI 1.64-2.81) pain scale points in EM.

Study details: The data come from a meta-analysis of 14 studies that included 995 patients with EM or CM treated with transcutaneous stimulation of a single nerve.

Disclosures: The study received no financial support. The authors declared no conflicts of interest.

Source: Evans AG et al. Outcomes of transcutaneous nerve stimulation for migraine headaches: a systematic review and meta-analysis. J Neurol. 2022 (Mar 16). Doi: 10.1007/s00415-022-11059-1

Key clinical point: Patients with chronic migraine (CM) or episodic migraine (EM) show a clinically significant improvement in headache characteristics after prophylactic transcutaneous nerve stimulation.

Major finding: Transcutaneous nerve stimulation reduced the headache frequency (mean monthly headache days) by 2.81 (95% CI 2.18-3.43) days in EM and by 2.97 (95% CI 1.66-4.28) days in CM and the pain severity by 2.23 (95% CI 1.64-2.81) pain scale points in EM.

Study details: The data come from a meta-analysis of 14 studies that included 995 patients with EM or CM treated with transcutaneous stimulation of a single nerve.

Disclosures: The study received no financial support. The authors declared no conflicts of interest.

Source: Evans AG et al. Outcomes of transcutaneous nerve stimulation for migraine headaches: a systematic review and meta-analysis. J Neurol. 2022 (Mar 16). Doi: 10.1007/s00415-022-11059-1

Key clinical point: Fremanezumab is effective and well-tolerated in real-life patients with difficult-to-treat high-frequency episodic migraine (HFEM) or chronic migraine (CM).

Major finding: At week 12, fremanezumab significantly decreased monthly migraine days (−4.6 days; P < .05) in patients with HFEM and monthly headache days (−9.4 days; P < .001) in patients with CM. The rate of treatment-emergent adverse events, graded mild and transient, was only 5.7%.

Study details: This was a multicenter, prospective, real-life study including 53 patients with HFEM (8-14 days/month) or CM who had multiple therapeutic failures and received subcutaneous fremanezumab (225 mg monthly or 675 mg quarterly) for 12 weeks.

Disclosures: The study was partially sponsored by the Italian Ministry of Health (Ricerca Corrente). Some authors declared receiving travel grants or honoraria for advisory boards, speaker panels, consultation, or clinical investigation studies from various sources. M Filippi is the Editor-in-Chief of the Journal of Neurology.

Source: Barbanti P et al. Fremanezumab in the prevention of high-frequency episodic and chronic migraine: a 12-week, multicenter, real-life, cohort study (the FRIEND study). J Headache Pain. 2022;23:46 (Apr 9). Doi: 10.1186/s10194-022-01396-x

Key clinical point: Fremanezumab is effective and well-tolerated in real-life patients with difficult-to-treat high-frequency episodic migraine (HFEM) or chronic migraine (CM).

Major finding: At week 12, fremanezumab significantly decreased monthly migraine days (−4.6 days; P < .05) in patients with HFEM and monthly headache days (−9.4 days; P < .001) in patients with CM. The rate of treatment-emergent adverse events, graded mild and transient, was only 5.7%.

Study details: This was a multicenter, prospective, real-life study including 53 patients with HFEM (8-14 days/month) or CM who had multiple therapeutic failures and received subcutaneous fremanezumab (225 mg monthly or 675 mg quarterly) for 12 weeks.

Disclosures: The study was partially sponsored by the Italian Ministry of Health (Ricerca Corrente). Some authors declared receiving travel grants or honoraria for advisory boards, speaker panels, consultation, or clinical investigation studies from various sources. M Filippi is the Editor-in-Chief of the Journal of Neurology.

Source: Barbanti P et al. Fremanezumab in the prevention of high-frequency episodic and chronic migraine: a 12-week, multicenter, real-life, cohort study (the FRIEND study). J Headache Pain. 2022;23:46 (Apr 9). Doi: 10.1186/s10194-022-01396-x

Key clinical point: Fremanezumab is effective and well-tolerated in real-life patients with difficult-to-treat high-frequency episodic migraine (HFEM) or chronic migraine (CM).

Major finding: At week 12, fremanezumab significantly decreased monthly migraine days (−4.6 days; P < .05) in patients with HFEM and monthly headache days (−9.4 days; P < .001) in patients with CM. The rate of treatment-emergent adverse events, graded mild and transient, was only 5.7%.

Study details: This was a multicenter, prospective, real-life study including 53 patients with HFEM (8-14 days/month) or CM who had multiple therapeutic failures and received subcutaneous fremanezumab (225 mg monthly or 675 mg quarterly) for 12 weeks.

Disclosures: The study was partially sponsored by the Italian Ministry of Health (Ricerca Corrente). Some authors declared receiving travel grants or honoraria for advisory boards, speaker panels, consultation, or clinical investigation studies from various sources. M Filippi is the Editor-in-Chief of the Journal of Neurology.

Source: Barbanti P et al. Fremanezumab in the prevention of high-frequency episodic and chronic migraine: a 12-week, multicenter, real-life, cohort study (the FRIEND study). J Headache Pain. 2022;23:46 (Apr 9). Doi: 10.1186/s10194-022-01396-x

Key clinical point: Patients with migraine show higher treatment adherence and persistence to calcitonin gene-related peptide (CGRP) monoclonal antibodies (mAb), specifically to galcanezumab, over standard-of-care (SOC) migraine preventive treatments.

Major finding: At 12 months of follow-up, CGRP mAb vs. SOC initiators had significantly higher mean adherence (proportion of days covered: 55.1% vs. 35.2%; P < .001) and persistence (212.5 vs. 131.9 days; P < .001). Similarly, galcanezumab vs. SOC initiators showed significantly higher adherence (63.7% vs. 33.7%; P < .001) and persistence (252.3 vs. 127.3 days; P < .001).

Study details: This retrospective, observational, claims database study created two separate 1:1 propensity-score-matched cohorts of adult patients with migraine initiating SOC or a CGRP mAb (n = 3082 pairs) and SOC or galcanezumab (n = 421 pairs).

Disclosures: The study was funded by Eli Lilly and Company. All authors declared being current/former employees or minor shareholders of Eli Lilly or a company contracted by Eli Lilly.

Source: Varnado OJ et al. Treatment patterns for calcitonin gene-related peptide monoclonal antibodies including galcanezumab versus conventional preventive treatments for migraine: A retrospective us claims study, Patient Prefer Adherence. 2022;16:821-839 (Mar 29). Doi: 10.2147/PPA.S346660

Key clinical point: Patients with migraine show higher treatment adherence and persistence to calcitonin gene-related peptide (CGRP) monoclonal antibodies (mAb), specifically to galcanezumab, over standard-of-care (SOC) migraine preventive treatments.

Major finding: At 12 months of follow-up, CGRP mAb vs. SOC initiators had significantly higher mean adherence (proportion of days covered: 55.1% vs. 35.2%; P < .001) and persistence (212.5 vs. 131.9 days; P < .001). Similarly, galcanezumab vs. SOC initiators showed significantly higher adherence (63.7% vs. 33.7%; P < .001) and persistence (252.3 vs. 127.3 days; P < .001).

Study details: This retrospective, observational, claims database study created two separate 1:1 propensity-score-matched cohorts of adult patients with migraine initiating SOC or a CGRP mAb (n = 3082 pairs) and SOC or galcanezumab (n = 421 pairs).

Disclosures: The study was funded by Eli Lilly and Company. All authors declared being current/former employees or minor shareholders of Eli Lilly or a company contracted by Eli Lilly.

Source: Varnado OJ et al. Treatment patterns for calcitonin gene-related peptide monoclonal antibodies including galcanezumab versus conventional preventive treatments for migraine: A retrospective us claims study, Patient Prefer Adherence. 2022;16:821-839 (Mar 29). Doi: 10.2147/PPA.S346660

Key clinical point: Patients with migraine show higher treatment adherence and persistence to calcitonin gene-related peptide (CGRP) monoclonal antibodies (mAb), specifically to galcanezumab, over standard-of-care (SOC) migraine preventive treatments.

Major finding: At 12 months of follow-up, CGRP mAb vs. SOC initiators had significantly higher mean adherence (proportion of days covered: 55.1% vs. 35.2%; P < .001) and persistence (212.5 vs. 131.9 days; P < .001). Similarly, galcanezumab vs. SOC initiators showed significantly higher adherence (63.7% vs. 33.7%; P < .001) and persistence (252.3 vs. 127.3 days; P < .001).

Study details: This retrospective, observational, claims database study created two separate 1:1 propensity-score-matched cohorts of adult patients with migraine initiating SOC or a CGRP mAb (n = 3082 pairs) and SOC or galcanezumab (n = 421 pairs).

Disclosures: The study was funded by Eli Lilly and Company. All authors declared being current/former employees or minor shareholders of Eli Lilly or a company contracted by Eli Lilly.

Source: Varnado OJ et al. Treatment patterns for calcitonin gene-related peptide monoclonal antibodies including galcanezumab versus conventional preventive treatments for migraine: A retrospective us claims study, Patient Prefer Adherence. 2022;16:821-839 (Mar 29). Doi: 10.2147/PPA.S346660

Key clinical point: Real-time ultrasound-guided stellate ganglion block (SGB) can effectively ameliorate migraine pain and disability without causing any serious complications, thus improving the quality of life of patients.

Major finding: After 3 months of SGB administration, the numerical rating scale score decreased from 7.0 to 2.0 (P < .01), Migraine Disability Assessment Scale total score from 14.0 to 7.0 (P < .001), and analgesic use frequency from 6.2 ± 2.8 to 1.9 ± 1.8. No serious complications were observed.

Study details: The study enrolled 81 patients aged >18 years with migraine who received SGB on the affected side with 0.15% ropivacaine weekly 4 times.

Disclosures: The study was sponsored by a grant from the Shanghai Municipal Health Commission. The authors reported no conflicts of interest.

Source: Hou J et al. Real-time ultrasound-guided stellate ganglion block for migraine: an observational study. BMC Anesthesiol. 2022;22:78 (Mar 24). Doi: 10.1186/s12871-022-01622-8

Key clinical point: Real-time ultrasound-guided stellate ganglion block (SGB) can effectively ameliorate migraine pain and disability without causing any serious complications, thus improving the quality of life of patients.

Major finding: After 3 months of SGB administration, the numerical rating scale score decreased from 7.0 to 2.0 (P < .01), Migraine Disability Assessment Scale total score from 14.0 to 7.0 (P < .001), and analgesic use frequency from 6.2 ± 2.8 to 1.9 ± 1.8. No serious complications were observed.

Study details: The study enrolled 81 patients aged >18 years with migraine who received SGB on the affected side with 0.15% ropivacaine weekly 4 times.

Disclosures: The study was sponsored by a grant from the Shanghai Municipal Health Commission. The authors reported no conflicts of interest.

Source: Hou J et al. Real-time ultrasound-guided stellate ganglion block for migraine: an observational study. BMC Anesthesiol. 2022;22:78 (Mar 24). Doi: 10.1186/s12871-022-01622-8

Key clinical point: Real-time ultrasound-guided stellate ganglion block (SGB) can effectively ameliorate migraine pain and disability without causing any serious complications, thus improving the quality of life of patients.

Major finding: After 3 months of SGB administration, the numerical rating scale score decreased from 7.0 to 2.0 (P < .01), Migraine Disability Assessment Scale total score from 14.0 to 7.0 (P < .001), and analgesic use frequency from 6.2 ± 2.8 to 1.9 ± 1.8. No serious complications were observed.

Study details: The study enrolled 81 patients aged >18 years with migraine who received SGB on the affected side with 0.15% ropivacaine weekly 4 times.

Disclosures: The study was sponsored by a grant from the Shanghai Municipal Health Commission. The authors reported no conflicts of interest.

Source: Hou J et al. Real-time ultrasound-guided stellate ganglion block for migraine: an observational study. BMC Anesthesiol. 2022;22:78 (Mar 24). Doi: 10.1186/s12871-022-01622-8

Key clinical point: Migraine frequency decreases significantly in most patients with migraine on resuming preventive treatment with the same calcitonin gene-related peptide-receptor (CGRP-[R]) monoclonal antibody (mAb) after a 3-month drug holiday.

Major finding: After 9-12 weeks of therapy resumption, monthly migraine days reduced significantly (−4.5 days, P < .001) and attained a level comparable with that in the 4-week period before therapy discontinuation (P > .999).

Study details: Findings are from a longitudinal cohort study including 39 patients with episodic or chronic migraine who restarted treatment with erenumab (n = 16) or galcanezumab/fremanezumab (n = 23) after a 3-month drug holiday following the first treatment cycle with the same CGRP(-R) mAb.

Disclosures: This study did not receive any financial support. Some authors declared serving on the advisory board of or receiving consulting, speaker, or personal fees from various sources.

Source: Raffaelli B et al. Resumption of migraine preventive treatment with CGRP(-receptor) antibodies after a 3-month drug holiday: A real-world experience. J Headache Pain. 2022;23:40 (Mar 30). Doi:  10.1186/s10194-022-01417-9

Key clinical point: Migraine frequency decreases significantly in most patients with migraine on resuming preventive treatment with the same calcitonin gene-related peptide-receptor (CGRP-[R]) monoclonal antibody (mAb) after a 3-month drug holiday.

Major finding: After 9-12 weeks of therapy resumption, monthly migraine days reduced significantly (−4.5 days, P < .001) and attained a level comparable with that in the 4-week period before therapy discontinuation (P > .999).

Study details: Findings are from a longitudinal cohort study including 39 patients with episodic or chronic migraine who restarted treatment with erenumab (n = 16) or galcanezumab/fremanezumab (n = 23) after a 3-month drug holiday following the first treatment cycle with the same CGRP(-R) mAb.

Disclosures: This study did not receive any financial support. Some authors declared serving on the advisory board of or receiving consulting, speaker, or personal fees from various sources.

Source: Raffaelli B et al. Resumption of migraine preventive treatment with CGRP(-receptor) antibodies after a 3-month drug holiday: A real-world experience. J Headache Pain. 2022;23:40 (Mar 30). Doi:  10.1186/s10194-022-01417-9

Key clinical point: Migraine frequency decreases significantly in most patients with migraine on resuming preventive treatment with the same calcitonin gene-related peptide-receptor (CGRP-[R]) monoclonal antibody (mAb) after a 3-month drug holiday.

Major finding: After 9-12 weeks of therapy resumption, monthly migraine days reduced significantly (−4.5 days, P < .001) and attained a level comparable with that in the 4-week period before therapy discontinuation (P > .999).

Study details: Findings are from a longitudinal cohort study including 39 patients with episodic or chronic migraine who restarted treatment with erenumab (n = 16) or galcanezumab/fremanezumab (n = 23) after a 3-month drug holiday following the first treatment cycle with the same CGRP(-R) mAb.

Disclosures: This study did not receive any financial support. Some authors declared serving on the advisory board of or receiving consulting, speaker, or personal fees from various sources.

Source: Raffaelli B et al. Resumption of migraine preventive treatment with CGRP(-receptor) antibodies after a 3-month drug holiday: A real-world experience. J Headache Pain. 2022;23:40 (Mar 30). Doi:  10.1186/s10194-022-01417-9

Key clinical point: Topiramate in combination with monthly injections of greater occipital nerve block (GONB) is better at decreasing monthly migraine days (MMD) in chronic migraine (CM) than topiramate monotherapy at month 3 and is equally well tolerated.

Major finding: At month 3, greater reductions in MMD were observed in patients receiving topiramate and GONB with lidocaine+methylprednisolone (−9.6 vs. −7.3 days; P = .003) and topiramate and GONB with only lidocaine (−10.1 vs. −7.3 days; P < .001) compared with patients receiving topiramate monotherapy. Tolerability between the groups was comparable.

Study details: Findings are from a parallel group, three-arm study including 125 adult patients with CM who were randomly assigned to receive topiramate alone (n = 41), topiramate and GONB with lidocaine+methylprednisolone in month 1 followed by monthly lidocaine injections (n = 44), or topiramate and GONB with monthly lidocaine injections (n = 40) for 3 months.

Disclosures: The study received no financial support. The authors declared no conflicts of interest.

Source: Chowdhury D et al. Efficacy and tolerability of combination treatment of topiramate and greater occipital nerve block versus topiramate monotherapy for the preventive treatment of chronic migraine: A randomized controlled trial. Cephalalgia. 2022 (Mar 8). Doi: 10.1177/03331024221082077

Key clinical point: Topiramate in combination with monthly injections of greater occipital nerve block (GONB) is better at decreasing monthly migraine days (MMD) in chronic migraine (CM) than topiramate monotherapy at month 3 and is equally well tolerated.

Major finding: At month 3, greater reductions in MMD were observed in patients receiving topiramate and GONB with lidocaine+methylprednisolone (−9.6 vs. −7.3 days; P = .003) and topiramate and GONB with only lidocaine (−10.1 vs. −7.3 days; P < .001) compared with patients receiving topiramate monotherapy. Tolerability between the groups was comparable.

Study details: Findings are from a parallel group, three-arm study including 125 adult patients with CM who were randomly assigned to receive topiramate alone (n = 41), topiramate and GONB with lidocaine+methylprednisolone in month 1 followed by monthly lidocaine injections (n = 44), or topiramate and GONB with monthly lidocaine injections (n = 40) for 3 months.

Disclosures: The study received no financial support. The authors declared no conflicts of interest.

Source: Chowdhury D et al. Efficacy and tolerability of combination treatment of topiramate and greater occipital nerve block versus topiramate monotherapy for the preventive treatment of chronic migraine: A randomized controlled trial. Cephalalgia. 2022 (Mar 8). Doi: 10.1177/03331024221082077

Key clinical point: Topiramate in combination with monthly injections of greater occipital nerve block (GONB) is better at decreasing monthly migraine days (MMD) in chronic migraine (CM) than topiramate monotherapy at month 3 and is equally well tolerated.

Major finding: At month 3, greater reductions in MMD were observed in patients receiving topiramate and GONB with lidocaine+methylprednisolone (−9.6 vs. −7.3 days; P = .003) and topiramate and GONB with only lidocaine (−10.1 vs. −7.3 days; P < .001) compared with patients receiving topiramate monotherapy. Tolerability between the groups was comparable.

Study details: Findings are from a parallel group, three-arm study including 125 adult patients with CM who were randomly assigned to receive topiramate alone (n = 41), topiramate and GONB with lidocaine+methylprednisolone in month 1 followed by monthly lidocaine injections (n = 44), or topiramate and GONB with monthly lidocaine injections (n = 40) for 3 months.

Disclosures: The study received no financial support. The authors declared no conflicts of interest.

Source: Chowdhury D et al. Efficacy and tolerability of combination treatment of topiramate and greater occipital nerve block versus topiramate monotherapy for the preventive treatment of chronic migraine: A randomized controlled trial. Cephalalgia. 2022 (Mar 8). Doi: 10.1177/03331024221082077

Key clinical point: External trigeminal nerve stimulation (e-TNS) for 2 consecutive hours is an effective, safe, nonpharmacological, and noninvasive acute treatment option for a migraine attack with or without aura.

Major finding: A significantly higher percentage of patients experienced pain freedom (25.5% vs. 18.3%; P < .05) and showed resolution of the most bothersome migraine symptoms (56.4% vs. 42.3%; P < .01) with e-TNS vs. sham treatment, effectuating a therapeutic gain of 7.2% and 14.1%, respectively.

Study details: The intention-to-treat population in this multicenter, prospective, phase 3 study, TEAM, consisted of 538 adult patients with episodic migraine with or without aura who were randomly assigned to receive active (n = 259) or sham (n = 279) stimulation for 2 hours.

Disclosures: The study was sponsored by Cefaly Technology, Belgium. Some authors reported receiving consulting fees, advisory board honoraria, or research grants from various sources. MAL Johnson is the Global Director of Medical Affairs for Cefaly.

Source: Kuruvilla DE et al. Phase 3 randomized, double-blind, sham-controlled Trial of e-TNS for the Acute treatment of Migraine (TEAM). Sci Rep. 2022;12:5110 (Mar 24). Doi: 10.1038/s41598-022-09071-6

Key clinical point: External trigeminal nerve stimulation (e-TNS) for 2 consecutive hours is an effective, safe, nonpharmacological, and noninvasive acute treatment option for a migraine attack with or without aura.

Major finding: A significantly higher percentage of patients experienced pain freedom (25.5% vs. 18.3%; P < .05) and showed resolution of the most bothersome migraine symptoms (56.4% vs. 42.3%; P < .01) with e-TNS vs. sham treatment, effectuating a therapeutic gain of 7.2% and 14.1%, respectively.

Study details: The intention-to-treat population in this multicenter, prospective, phase 3 study, TEAM, consisted of 538 adult patients with episodic migraine with or without aura who were randomly assigned to receive active (n = 259) or sham (n = 279) stimulation for 2 hours.

Disclosures: The study was sponsored by Cefaly Technology, Belgium. Some authors reported receiving consulting fees, advisory board honoraria, or research grants from various sources. MAL Johnson is the Global Director of Medical Affairs for Cefaly.

Source: Kuruvilla DE et al. Phase 3 randomized, double-blind, sham-controlled Trial of e-TNS for the Acute treatment of Migraine (TEAM). Sci Rep. 2022;12:5110 (Mar 24). Doi: 10.1038/s41598-022-09071-6

Key clinical point: External trigeminal nerve stimulation (e-TNS) for 2 consecutive hours is an effective, safe, nonpharmacological, and noninvasive acute treatment option for a migraine attack with or without aura.

Major finding: A significantly higher percentage of patients experienced pain freedom (25.5% vs. 18.3%; P < .05) and showed resolution of the most bothersome migraine symptoms (56.4% vs. 42.3%; P < .01) with e-TNS vs. sham treatment, effectuating a therapeutic gain of 7.2% and 14.1%, respectively.

Study details: The intention-to-treat population in this multicenter, prospective, phase 3 study, TEAM, consisted of 538 adult patients with episodic migraine with or without aura who were randomly assigned to receive active (n = 259) or sham (n = 279) stimulation for 2 hours.

Disclosures: The study was sponsored by Cefaly Technology, Belgium. Some authors reported receiving consulting fees, advisory board honoraria, or research grants from various sources. MAL Johnson is the Global Director of Medical Affairs for Cefaly.

Source: Kuruvilla DE et al. Phase 3 randomized, double-blind, sham-controlled Trial of e-TNS for the Acute treatment of Migraine (TEAM). Sci Rep. 2022;12:5110 (Mar 24). Doi: 10.1038/s41598-022-09071-6