Key clinical point: Fremanezumab was effective and well tolerated over 12 weeks in older patients with chronic or episodic migraine.

Major finding: Quarterly and monthly fremanezumab vs. placebo showed greater reduction in monthly average migraine days (least-squares mean change from baseline [D] −4.3 and −4.6 vs. −2.3), headache days of at least moderate severity (D −3.9 and −4.2 vs. −2.1), and acute medication use (D −3.7 and −4.0 vs. −1.3) over 12 weeks (all P < .05). Adverse events were similar across groups.

Study details: Findings are pooled subgroup analysis of 3 phase 3 studies (HALO CM, HALO EM, and FOCUS) including 246 participants aged ≥60 years with chronic or episodic migraine with an inadequate response to 2-4 prior migraine preventives. They were randomly assigned to quarterly fremanezumab, monthly fremanezumab, or matched monthly placebo.

Disclosures: This study was funded by Teva Pharmaceuticals Ltd. Some investigators, including the lead author, reported participating in clinical trials and receiving honoraria, research support, and legal or personal fees from and being former or current employees of various sources, including Teva Pharmaceuticals.

Source: Nahas SJ et al. J Headache Pain. 2021;22:141 (Nov 24). Doi: 10.1186/s10194-021-01351-2.

Key clinical point: Fremanezumab was effective and well tolerated over 12 weeks in older patients with chronic or episodic migraine.

Major finding: Quarterly and monthly fremanezumab vs. placebo showed greater reduction in monthly average migraine days (least-squares mean change from baseline [D] −4.3 and −4.6 vs. −2.3), headache days of at least moderate severity (D −3.9 and −4.2 vs. −2.1), and acute medication use (D −3.7 and −4.0 vs. −1.3) over 12 weeks (all P < .05). Adverse events were similar across groups.

Study details: Findings are pooled subgroup analysis of 3 phase 3 studies (HALO CM, HALO EM, and FOCUS) including 246 participants aged ≥60 years with chronic or episodic migraine with an inadequate response to 2-4 prior migraine preventives. They were randomly assigned to quarterly fremanezumab, monthly fremanezumab, or matched monthly placebo.

Disclosures: This study was funded by Teva Pharmaceuticals Ltd. Some investigators, including the lead author, reported participating in clinical trials and receiving honoraria, research support, and legal or personal fees from and being former or current employees of various sources, including Teva Pharmaceuticals.

Source: Nahas SJ et al. J Headache Pain. 2021;22:141 (Nov 24). Doi: 10.1186/s10194-021-01351-2.

Key clinical point: Fremanezumab was effective and well tolerated over 12 weeks in older patients with chronic or episodic migraine.

Major finding: Quarterly and monthly fremanezumab vs. placebo showed greater reduction in monthly average migraine days (least-squares mean change from baseline [D] −4.3 and −4.6 vs. −2.3), headache days of at least moderate severity (D −3.9 and −4.2 vs. −2.1), and acute medication use (D −3.7 and −4.0 vs. −1.3) over 12 weeks (all P < .05). Adverse events were similar across groups.

Study details: Findings are pooled subgroup analysis of 3 phase 3 studies (HALO CM, HALO EM, and FOCUS) including 246 participants aged ≥60 years with chronic or episodic migraine with an inadequate response to 2-4 prior migraine preventives. They were randomly assigned to quarterly fremanezumab, monthly fremanezumab, or matched monthly placebo.

Disclosures: This study was funded by Teva Pharmaceuticals Ltd. Some investigators, including the lead author, reported participating in clinical trials and receiving honoraria, research support, and legal or personal fees from and being former or current employees of various sources, including Teva Pharmaceuticals.

Source: Nahas SJ et al. J Headache Pain. 2021;22:141 (Nov 24). Doi: 10.1186/s10194-021-01351-2.

Key clinical point: Patients with migraine are more likely to suffer from dry eye than patients without migraine.

Major finding: The prevalence of dry eye was significantly higher in patients with vs. without migraine (odds ratio, 1.55; P < .001).

Study details: Findings are from a meta-analysis of 7 case-control or cross-sectional studies including a total population of 1,033,288 individuals with or without migraine.

Disclosures: This study was supported by the National Natural Science Foundation of China and Fundamental Research Funds of the State Key Laboratory of Ophthalmology. The authors declared no conflict of interests.

Source: Chen H et al. Cornea. 2021 (Nov 6). Doi: 10.1097/ICO.0000000000002851.

Key clinical point: Patients with migraine are more likely to suffer from dry eye than patients without migraine.

Major finding: The prevalence of dry eye was significantly higher in patients with vs. without migraine (odds ratio, 1.55; P < .001).

Study details: Findings are from a meta-analysis of 7 case-control or cross-sectional studies including a total population of 1,033,288 individuals with or without migraine.

Disclosures: This study was supported by the National Natural Science Foundation of China and Fundamental Research Funds of the State Key Laboratory of Ophthalmology. The authors declared no conflict of interests.

Source: Chen H et al. Cornea. 2021 (Nov 6). Doi: 10.1097/ICO.0000000000002851.

Key clinical point: Patients with migraine are more likely to suffer from dry eye than patients without migraine.

Major finding: The prevalence of dry eye was significantly higher in patients with vs. without migraine (odds ratio, 1.55; P < .001).

Study details: Findings are from a meta-analysis of 7 case-control or cross-sectional studies including a total population of 1,033,288 individuals with or without migraine.

Disclosures: This study was supported by the National Natural Science Foundation of China and Fundamental Research Funds of the State Key Laboratory of Ophthalmology. The authors declared no conflict of interests.

Source: Chen H et al. Cornea. 2021 (Nov 6). Doi: 10.1097/ICO.0000000000002851.

Key clinical point: Prevalence of migraine was higher in patients with celiac disease (CD) vs. healthy controls, with patients with CD and migraine showing worse gastrointestinal symptoms compared with those without migraine.

Major finding: The prevalence of migraine was higher in patients with vs. without CD (20.7% vs. 11.9%; P < .001). Patients with CD with vs. without migraine headache had a higher prevalence of abdominal pain (80.1% vs. 71.8%; P = .025), constipation (47.8% vs. 35.5%; P = .011), and diarrhea (60.8% vs. 45.9%; P = .002).

Study details: This case-control cross-sectional study included 1,000 adult patients with CD and 1,000 healthy controls.

Disclosures: No funding was received for this study. The authors declared no conflict of interests.

Source: Fanaeian MM et al. PLoS One. 2021;16(11):e0259502 (Nov 17). Doi:  10.1371/journal.pone.0259502.

Key clinical point: Prevalence of migraine was higher in patients with celiac disease (CD) vs. healthy controls, with patients with CD and migraine showing worse gastrointestinal symptoms compared with those without migraine.

Major finding: The prevalence of migraine was higher in patients with vs. without CD (20.7% vs. 11.9%; P < .001). Patients with CD with vs. without migraine headache had a higher prevalence of abdominal pain (80.1% vs. 71.8%; P = .025), constipation (47.8% vs. 35.5%; P = .011), and diarrhea (60.8% vs. 45.9%; P = .002).

Study details: This case-control cross-sectional study included 1,000 adult patients with CD and 1,000 healthy controls.

Disclosures: No funding was received for this study. The authors declared no conflict of interests.

Source: Fanaeian MM et al. PLoS One. 2021;16(11):e0259502 (Nov 17). Doi:  10.1371/journal.pone.0259502.

Key clinical point: Prevalence of migraine was higher in patients with celiac disease (CD) vs. healthy controls, with patients with CD and migraine showing worse gastrointestinal symptoms compared with those without migraine.

Major finding: The prevalence of migraine was higher in patients with vs. without CD (20.7% vs. 11.9%; P < .001). Patients with CD with vs. without migraine headache had a higher prevalence of abdominal pain (80.1% vs. 71.8%; P = .025), constipation (47.8% vs. 35.5%; P = .011), and diarrhea (60.8% vs. 45.9%; P = .002).

Study details: This case-control cross-sectional study included 1,000 adult patients with CD and 1,000 healthy controls.

Disclosures: No funding was received for this study. The authors declared no conflict of interests.

Source: Fanaeian MM et al. PLoS One. 2021;16(11):e0259502 (Nov 17). Doi:  10.1371/journal.pone.0259502.

Key clinical point: The frequency of occipital bending (OB) was 2-fold higher in patients with migraine with visual aura than those without visual aura.

Major finding: Overall, the prevalence of OB was 33.3% and was significantly higher in patients with migraine with vs. without visual aura (57.1% vs. 25.4%; odds ratio 3.9; P = .015).

Study details: Findings are from a retrospective analysis of 84 patients with migraine with (n = 21) or without visual aura (n = 63).

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

Source: Özkan E et al. Headache. 2021 (Nov 28). Doi: 10.1111/head.14240.

Key clinical point: The frequency of occipital bending (OB) was 2-fold higher in patients with migraine with visual aura than those without visual aura.

Major finding: Overall, the prevalence of OB was 33.3% and was significantly higher in patients with migraine with vs. without visual aura (57.1% vs. 25.4%; odds ratio 3.9; P = .015).

Study details: Findings are from a retrospective analysis of 84 patients with migraine with (n = 21) or without visual aura (n = 63).

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

Source: Özkan E et al. Headache. 2021 (Nov 28). Doi: 10.1111/head.14240.

Key clinical point: The frequency of occipital bending (OB) was 2-fold higher in patients with migraine with visual aura than those without visual aura.

Major finding: Overall, the prevalence of OB was 33.3% and was significantly higher in patients with migraine with vs. without visual aura (57.1% vs. 25.4%; odds ratio 3.9; P = .015).

Study details: Findings are from a retrospective analysis of 84 patients with migraine with (n = 21) or without visual aura (n = 63).

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

Source: Özkan E et al. Headache. 2021 (Nov 28). Doi: 10.1111/head.14240.

Key clinical point: Unilateral pain, fewer failed preventives, good response to triptans, and medication overuse at baseline were associated with a persistent positive response to galcanezumab during the first 3 months of therapy in patients with chronic migraine.

Major finding: Overall, 41.7% of patients had a persistent 3-month 50% responder rate in headache days of at least moderate intensity. Responders vs. nonresponders had lower number of failed preventives (odds ratio [OR] 0.733; P = .041), frequent unilateral pain (OR 3.686; P = .041), medication overuse at baseline (OR 4.575; P = .012), and good response to triptans (OR 3.248; P = .028).

Study details: This observational study included 156 adult patients with chronic migraine from the GARLIT study who had a galcanezumab prescription.

Disclosures: This study was funded by Campus Bio-Medico University. Some investigators including the lead author received grants, travel expenses, and honoraria for advisory boards, speaker panels, or clinical investigation studies from various pharmaceutical companies.

Source: Vernieri F et al. Eur J Neurol. 2021 (Nov 26). Doi: 10.1111/ene.15197.

Key clinical point: Unilateral pain, fewer failed preventives, good response to triptans, and medication overuse at baseline were associated with a persistent positive response to galcanezumab during the first 3 months of therapy in patients with chronic migraine.

Major finding: Overall, 41.7% of patients had a persistent 3-month 50% responder rate in headache days of at least moderate intensity. Responders vs. nonresponders had lower number of failed preventives (odds ratio [OR] 0.733; P = .041), frequent unilateral pain (OR 3.686; P = .041), medication overuse at baseline (OR 4.575; P = .012), and good response to triptans (OR 3.248; P = .028).

Study details: This observational study included 156 adult patients with chronic migraine from the GARLIT study who had a galcanezumab prescription.

Disclosures: This study was funded by Campus Bio-Medico University. Some investigators including the lead author received grants, travel expenses, and honoraria for advisory boards, speaker panels, or clinical investigation studies from various pharmaceutical companies.

Source: Vernieri F et al. Eur J Neurol. 2021 (Nov 26). Doi: 10.1111/ene.15197.

Key clinical point: Unilateral pain, fewer failed preventives, good response to triptans, and medication overuse at baseline were associated with a persistent positive response to galcanezumab during the first 3 months of therapy in patients with chronic migraine.

Major finding: Overall, 41.7% of patients had a persistent 3-month 50% responder rate in headache days of at least moderate intensity. Responders vs. nonresponders had lower number of failed preventives (odds ratio [OR] 0.733; P = .041), frequent unilateral pain (OR 3.686; P = .041), medication overuse at baseline (OR 4.575; P = .012), and good response to triptans (OR 3.248; P = .028).

Study details: This observational study included 156 adult patients with chronic migraine from the GARLIT study who had a galcanezumab prescription.

Disclosures: This study was funded by Campus Bio-Medico University. Some investigators including the lead author received grants, travel expenses, and honoraria for advisory boards, speaker panels, or clinical investigation studies from various pharmaceutical companies.

Source: Vernieri F et al. Eur J Neurol. 2021 (Nov 26). Doi: 10.1111/ene.15197.

Key clinical point: Lasmiditan was associated with mild-to-moderate central nervous system (CNS)-related adverse events (AE), mostly transient in duration.

Major finding: Treatment-emergent serious AEs occurred in 0.4%, 0.2%, and 0.4% of patients treated with placebo, 100 mg lasmiditan, and 200 mg lasmiditan, respectively. The most common treatment-emergent AEs with lasmiditan were dizziness, nausea, paresthesia, fatigue, somnolence, and vertigo, with mostly mild-to-moderate severity. No deaths were reported.

Study details: Findings are from safety analysis of the phase 3 CENTURION trial that assessed 4,494 attacks across 1,471 patients with migraine with and without aura who were randomly assigned to either 200 mg lasmiditan or 100 mg lasmiditan for 4 attacks or placebo for 3 attacks and 50 mg lasmiditan for the third/fourth attack.

Disclosures: This study was sponsored by Eli Lilly and Company. Some investigators, including the lead author, reported receiving research grants, institutional payments, or fees for advisory boards and scientific lecturing; being an employee of; owning shares in; or consulting for various sources, including Eli Lilly and Company.

Source: Tassorelli C et al. J Headache Pain. 2021;22:132 (Nov 6). Doi: 10.1186/s10194-021-01343-2.

Key clinical point: Lasmiditan was associated with mild-to-moderate central nervous system (CNS)-related adverse events (AE), mostly transient in duration.

Major finding: Treatment-emergent serious AEs occurred in 0.4%, 0.2%, and 0.4% of patients treated with placebo, 100 mg lasmiditan, and 200 mg lasmiditan, respectively. The most common treatment-emergent AEs with lasmiditan were dizziness, nausea, paresthesia, fatigue, somnolence, and vertigo, with mostly mild-to-moderate severity. No deaths were reported.

Study details: Findings are from safety analysis of the phase 3 CENTURION trial that assessed 4,494 attacks across 1,471 patients with migraine with and without aura who were randomly assigned to either 200 mg lasmiditan or 100 mg lasmiditan for 4 attacks or placebo for 3 attacks and 50 mg lasmiditan for the third/fourth attack.

Disclosures: This study was sponsored by Eli Lilly and Company. Some investigators, including the lead author, reported receiving research grants, institutional payments, or fees for advisory boards and scientific lecturing; being an employee of; owning shares in; or consulting for various sources, including Eli Lilly and Company.

Source: Tassorelli C et al. J Headache Pain. 2021;22:132 (Nov 6). Doi: 10.1186/s10194-021-01343-2.

Key clinical point: Lasmiditan was associated with mild-to-moderate central nervous system (CNS)-related adverse events (AE), mostly transient in duration.

Major finding: Treatment-emergent serious AEs occurred in 0.4%, 0.2%, and 0.4% of patients treated with placebo, 100 mg lasmiditan, and 200 mg lasmiditan, respectively. The most common treatment-emergent AEs with lasmiditan were dizziness, nausea, paresthesia, fatigue, somnolence, and vertigo, with mostly mild-to-moderate severity. No deaths were reported.

Study details: Findings are from safety analysis of the phase 3 CENTURION trial that assessed 4,494 attacks across 1,471 patients with migraine with and without aura who were randomly assigned to either 200 mg lasmiditan or 100 mg lasmiditan for 4 attacks or placebo for 3 attacks and 50 mg lasmiditan for the third/fourth attack.

Disclosures: This study was sponsored by Eli Lilly and Company. Some investigators, including the lead author, reported receiving research grants, institutional payments, or fees for advisory boards and scientific lecturing; being an employee of; owning shares in; or consulting for various sources, including Eli Lilly and Company.

Source: Tassorelli C et al. J Headache Pain. 2021;22:132 (Nov 6). Doi: 10.1186/s10194-021-01343-2.

Key clinical point: Greater occipital nerve (GON) blockade with local anesthetics reduced the severity and duration of headaches in patients with episodic migraine without aura, with the headache frequency reducing significantly among patients receiving lidocaine alone or in combination with triamcinolone.

Major finding: GON block with triamcinolone, lidocaine, lidocaine+triamcinolone, or only normal saline significantly reduced the severity (P < .001) and duration (P = .001) of headaches, with no injection being superior to placebo. Headache frequency reduced in patients who received lidocaine (5.81 attacks per month; 95% CI of the difference −2.52 to −9.09) and lidocaine+triamcinolone (5.69 attacks per month; 95% CI of the difference −1.11 to −10.27).

Study details: This placebo-controlled clinical trial randomly assigned 55 adult patients with episodic migraine without aura to triamcinolone (n = 10), lidocaine (n = 16), lidocaine+triamcinolone (n = 13), or normal saline only (n = 16) groups.

Disclosures: This work was supported by the Iranian Center of Neurological Research in affiliation with Tehran University of Medical Sciences. The authors declared no conflict of interests.

Source: Malekian N et al. Cephalalgia. 2021 (Nov 17). Doi: 10.1177/03331024211058182.

Key clinical point: Greater occipital nerve (GON) blockade with local anesthetics reduced the severity and duration of headaches in patients with episodic migraine without aura, with the headache frequency reducing significantly among patients receiving lidocaine alone or in combination with triamcinolone.

Major finding: GON block with triamcinolone, lidocaine, lidocaine+triamcinolone, or only normal saline significantly reduced the severity (P < .001) and duration (P = .001) of headaches, with no injection being superior to placebo. Headache frequency reduced in patients who received lidocaine (5.81 attacks per month; 95% CI of the difference −2.52 to −9.09) and lidocaine+triamcinolone (5.69 attacks per month; 95% CI of the difference −1.11 to −10.27).

Study details: This placebo-controlled clinical trial randomly assigned 55 adult patients with episodic migraine without aura to triamcinolone (n = 10), lidocaine (n = 16), lidocaine+triamcinolone (n = 13), or normal saline only (n = 16) groups.

Disclosures: This work was supported by the Iranian Center of Neurological Research in affiliation with Tehran University of Medical Sciences. The authors declared no conflict of interests.

Source: Malekian N et al. Cephalalgia. 2021 (Nov 17). Doi: 10.1177/03331024211058182.

Key clinical point: Greater occipital nerve (GON) blockade with local anesthetics reduced the severity and duration of headaches in patients with episodic migraine without aura, with the headache frequency reducing significantly among patients receiving lidocaine alone or in combination with triamcinolone.

Major finding: GON block with triamcinolone, lidocaine, lidocaine+triamcinolone, or only normal saline significantly reduced the severity (P < .001) and duration (P = .001) of headaches, with no injection being superior to placebo. Headache frequency reduced in patients who received lidocaine (5.81 attacks per month; 95% CI of the difference −2.52 to −9.09) and lidocaine+triamcinolone (5.69 attacks per month; 95% CI of the difference −1.11 to −10.27).

Study details: This placebo-controlled clinical trial randomly assigned 55 adult patients with episodic migraine without aura to triamcinolone (n = 10), lidocaine (n = 16), lidocaine+triamcinolone (n = 13), or normal saline only (n = 16) groups.

Disclosures: This work was supported by the Iranian Center of Neurological Research in affiliation with Tehran University of Medical Sciences. The authors declared no conflict of interests.

Source: Malekian N et al. Cephalalgia. 2021 (Nov 17). Doi: 10.1177/03331024211058182.

Key clinical point: Intranasal ketorolac was not inferior to intravenous ketorolac in reducing pain intensity 60 min postmedication in children with migraine headaches of moderate-to-severe pain intensity.

Major finding: The difference in mean pain reduction at 60 min between intranasal and intravenous ketorolac groups was 0.2 (95% CI −0.9 to 1.3), with intranasal ketorolac being noninferior to intravenous ketorolac (P < .001). No serious adverse events were reported.

Study details: Findings are from a phase 3 clinical trial including 59 children (age 8-17 years) with migraine headache of moderate-to-severe pain intensity requiring any intravenous analgesic. They were randomly assigned to receive either intranasal ketorolac (1 mg/kg) or intravenous ketorolac (0.5 mg/kg).

Disclosures: This study was funded by the Columbia University’s CTSA grant from NCATS/NIH and Migraine Research Foundation. The authors declared no conflict of interests.

Source: Tsze DS et al. Acad Emerg Med. 2021 (Nov 25). Doi: 10.1111/acem.14422.

Key clinical point: Intranasal ketorolac was not inferior to intravenous ketorolac in reducing pain intensity 60 min postmedication in children with migraine headaches of moderate-to-severe pain intensity.

Major finding: The difference in mean pain reduction at 60 min between intranasal and intravenous ketorolac groups was 0.2 (95% CI −0.9 to 1.3), with intranasal ketorolac being noninferior to intravenous ketorolac (P < .001). No serious adverse events were reported.

Study details: Findings are from a phase 3 clinical trial including 59 children (age 8-17 years) with migraine headache of moderate-to-severe pain intensity requiring any intravenous analgesic. They were randomly assigned to receive either intranasal ketorolac (1 mg/kg) or intravenous ketorolac (0.5 mg/kg).

Disclosures: This study was funded by the Columbia University’s CTSA grant from NCATS/NIH and Migraine Research Foundation. The authors declared no conflict of interests.

Source: Tsze DS et al. Acad Emerg Med. 2021 (Nov 25). Doi: 10.1111/acem.14422.

Key clinical point: Intranasal ketorolac was not inferior to intravenous ketorolac in reducing pain intensity 60 min postmedication in children with migraine headaches of moderate-to-severe pain intensity.

Major finding: The difference in mean pain reduction at 60 min between intranasal and intravenous ketorolac groups was 0.2 (95% CI −0.9 to 1.3), with intranasal ketorolac being noninferior to intravenous ketorolac (P < .001). No serious adverse events were reported.

Study details: Findings are from a phase 3 clinical trial including 59 children (age 8-17 years) with migraine headache of moderate-to-severe pain intensity requiring any intravenous analgesic. They were randomly assigned to receive either intranasal ketorolac (1 mg/kg) or intravenous ketorolac (0.5 mg/kg).

Disclosures: This study was funded by the Columbia University’s CTSA grant from NCATS/NIH and Migraine Research Foundation. The authors declared no conflict of interests.

Source: Tsze DS et al. Acad Emerg Med. 2021 (Nov 25). Doi: 10.1111/acem.14422.

Key clinical point: A 140 mg dose of erenumab monthly was well tolerated and showed sustained efficacy over 2 years in patients with episodic migraine who failed 2-4 prior migraine preventive treatments.

Major finding: At week 112, the proportion of patients achieving ³50%, ³75%, and 100% reduction in monthly migraine days from baseline was 57.2%, 30.6%, and 16.2%, respectively. Overall, 86.3% of patients experienced treatment-emergent adverse events, the most common being nasopharyngitis, influenza, and back pain. No deaths or new safety signals were reported.

Study details: Findings are 2-year follow-up results of the phase 3b LIBERTY study including 240 patients with episodic migraine who failed 2-4 prior prophylactic treatments, completed placebo-controlled double-blind treatment phase, and were enrolled in the 3-year open-label extension phase with 140 mg erenumab monthly.

Disclosures: This study was supported by Novartis Pharma, Switzerland. Some investigators reported receiving grants and fees from, owning stocks in, or being an employee of various pharmaceutical companies, including Novartis.

Source: Ferrari MD et al. J Neurol Neurosurg Psychiatry. 2021 (Nov 29). Doi: 10.1136/jnnp-2021-327480.

Key clinical point: A 140 mg dose of erenumab monthly was well tolerated and showed sustained efficacy over 2 years in patients with episodic migraine who failed 2-4 prior migraine preventive treatments.

Major finding: At week 112, the proportion of patients achieving ³50%, ³75%, and 100% reduction in monthly migraine days from baseline was 57.2%, 30.6%, and 16.2%, respectively. Overall, 86.3% of patients experienced treatment-emergent adverse events, the most common being nasopharyngitis, influenza, and back pain. No deaths or new safety signals were reported.

Study details: Findings are 2-year follow-up results of the phase 3b LIBERTY study including 240 patients with episodic migraine who failed 2-4 prior prophylactic treatments, completed placebo-controlled double-blind treatment phase, and were enrolled in the 3-year open-label extension phase with 140 mg erenumab monthly.

Disclosures: This study was supported by Novartis Pharma, Switzerland. Some investigators reported receiving grants and fees from, owning stocks in, or being an employee of various pharmaceutical companies, including Novartis.

Source: Ferrari MD et al. J Neurol Neurosurg Psychiatry. 2021 (Nov 29). Doi: 10.1136/jnnp-2021-327480.

Key clinical point: A 140 mg dose of erenumab monthly was well tolerated and showed sustained efficacy over 2 years in patients with episodic migraine who failed 2-4 prior migraine preventive treatments.

Major finding: At week 112, the proportion of patients achieving ³50%, ³75%, and 100% reduction in monthly migraine days from baseline was 57.2%, 30.6%, and 16.2%, respectively. Overall, 86.3% of patients experienced treatment-emergent adverse events, the most common being nasopharyngitis, influenza, and back pain. No deaths or new safety signals were reported.

Study details: Findings are 2-year follow-up results of the phase 3b LIBERTY study including 240 patients with episodic migraine who failed 2-4 prior prophylactic treatments, completed placebo-controlled double-blind treatment phase, and were enrolled in the 3-year open-label extension phase with 140 mg erenumab monthly.

Disclosures: This study was supported by Novartis Pharma, Switzerland. Some investigators reported receiving grants and fees from, owning stocks in, or being an employee of various pharmaceutical companies, including Novartis.

Source: Ferrari MD et al. J Neurol Neurosurg Psychiatry. 2021 (Nov 29). Doi: 10.1136/jnnp-2021-327480.

During my usual 2 weeks off over the holidays I did my usual stuff – taxes, read journals, do CME, review legal cases that have come in, hang out with my family, nap with my dogs.

Somewhere in that stretch of time off. I run out of things to do, and that’s when I have to confront an odd truth: I’ve forgotten how to relax.

In medical school and residency I certainly could enjoy the rare weekend time off. I’d watch sports, go running, do things with friends.

But now it’s a different world. My friends, while still people I enjoy, are on the other end of a computer, far away. My interest in sports and movies waned years ago, and I avoid televisions as part of my aversion to the news. Even the books I used to enjoy, such as the late Clive Cussler’s, don’t hold my attention anymore. If I’m going to read anything it’s going to be humor, because the medical field is serious enough as it is.

The bottom line is that it’s hard for me to relax and “do nothing” anymore. I don’t know if that’s just me, or if it’s part of the personality of being a doctor, or both.

If I’m not at my desk working, I feel like I’m not doing anything. Do other doctors feel that way? Have I become a workaholic in my middle age?

Is this a bad thing?

It probably is, and I should look to the beginning of a new year to make some changes. Maybe I should go back to running (or, at this point in my life, walking) or finding some humor books I enjoy and reading them. The old standby of going on a vacation is kind of limited right now.

I’ve been an attending physician for 24 years now, which is still hard to believe. My retirement isn’t (hopefully) anytime soon, but is coming up faster than it seems. If I don’t relearn to relax by then, when will I?
 

Dr. Block has a solo neurology practice in Scottsdale, Ariz.

During my usual 2 weeks off over the holidays I did my usual stuff – taxes, read journals, do CME, review legal cases that have come in, hang out with my family, nap with my dogs.

Somewhere in that stretch of time off. I run out of things to do, and that’s when I have to confront an odd truth: I’ve forgotten how to relax.

In medical school and residency I certainly could enjoy the rare weekend time off. I’d watch sports, go running, do things with friends.

But now it’s a different world. My friends, while still people I enjoy, are on the other end of a computer, far away. My interest in sports and movies waned years ago, and I avoid televisions as part of my aversion to the news. Even the books I used to enjoy, such as the late Clive Cussler’s, don’t hold my attention anymore. If I’m going to read anything it’s going to be humor, because the medical field is serious enough as it is.

The bottom line is that it’s hard for me to relax and “do nothing” anymore. I don’t know if that’s just me, or if it’s part of the personality of being a doctor, or both.

If I’m not at my desk working, I feel like I’m not doing anything. Do other doctors feel that way? Have I become a workaholic in my middle age?

Is this a bad thing?

It probably is, and I should look to the beginning of a new year to make some changes. Maybe I should go back to running (or, at this point in my life, walking) or finding some humor books I enjoy and reading them. The old standby of going on a vacation is kind of limited right now.

I’ve been an attending physician for 24 years now, which is still hard to believe. My retirement isn’t (hopefully) anytime soon, but is coming up faster than it seems. If I don’t relearn to relax by then, when will I?
 

Dr. Block has a solo neurology practice in Scottsdale, Ariz.

During my usual 2 weeks off over the holidays I did my usual stuff – taxes, read journals, do CME, review legal cases that have come in, hang out with my family, nap with my dogs.

Somewhere in that stretch of time off. I run out of things to do, and that’s when I have to confront an odd truth: I’ve forgotten how to relax.

In medical school and residency I certainly could enjoy the rare weekend time off. I’d watch sports, go running, do things with friends.

But now it’s a different world. My friends, while still people I enjoy, are on the other end of a computer, far away. My interest in sports and movies waned years ago, and I avoid televisions as part of my aversion to the news. Even the books I used to enjoy, such as the late Clive Cussler’s, don’t hold my attention anymore. If I’m going to read anything it’s going to be humor, because the medical field is serious enough as it is.

The bottom line is that it’s hard for me to relax and “do nothing” anymore. I don’t know if that’s just me, or if it’s part of the personality of being a doctor, or both.

If I’m not at my desk working, I feel like I’m not doing anything. Do other doctors feel that way? Have I become a workaholic in my middle age?

Is this a bad thing?

It probably is, and I should look to the beginning of a new year to make some changes. Maybe I should go back to running (or, at this point in my life, walking) or finding some humor books I enjoy and reading them. The old standby of going on a vacation is kind of limited right now.

I’ve been an attending physician for 24 years now, which is still hard to believe. My retirement isn’t (hopefully) anytime soon, but is coming up faster than it seems. If I don’t relearn to relax by then, when will I?
 

Dr. Block has a solo neurology practice in Scottsdale, Ariz.