Clinical Edge Journal Scan

Key clinical point: Passive smoking during pregnancy is associated with an increased risk for atopic dermatitis (AD) in offspring; however, the association between active smoking during pregnancy and AD in offspring remains unestablished.

Major finding: Passive smoking during pregnancy led to a higher risk for AD in offspring (odds ratio [OR] 1.52; 95% CI 1.36-1.70); however, active smoking during pregnancy did not increase the risk for AD in offspring (OR 0.96; 95% CI 0.86-1.07).

Study details: This meta-analysis of 15 observational studies included children or mother-child pairs who underwent either questionnaire-based or physician assessment for AD diagnosis and questionnaire-based assessment or cotinine level measurement for evaluating exposure to active or passive smoking.

Disclosures: This study was supported by the Key Scientific and Technological Research Projects of Henan Province and the Key Scientific Research Projects in Universities of Henan Province, China. The authors declared no conflicts of interest.

Source: Chao L, Liang W, Zhao X, et al. Maternal tobacco exposure during pregnancy and atopic dermatitis in offspring: A systematic review and meta-analysis. J Eur Acad Dermatol Venereol. 2024 (Ma 14). doi: 10.1111/jdv.19958 Source

Key clinical point: Passive smoking during pregnancy is associated with an increased risk for atopic dermatitis (AD) in offspring; however, the association between active smoking during pregnancy and AD in offspring remains unestablished.

Major finding: Passive smoking during pregnancy led to a higher risk for AD in offspring (odds ratio [OR] 1.52; 95% CI 1.36-1.70); however, active smoking during pregnancy did not increase the risk for AD in offspring (OR 0.96; 95% CI 0.86-1.07).

Study details: This meta-analysis of 15 observational studies included children or mother-child pairs who underwent either questionnaire-based or physician assessment for AD diagnosis and questionnaire-based assessment or cotinine level measurement for evaluating exposure to active or passive smoking.

Disclosures: This study was supported by the Key Scientific and Technological Research Projects of Henan Province and the Key Scientific Research Projects in Universities of Henan Province, China. The authors declared no conflicts of interest.

Source: Chao L, Liang W, Zhao X, et al. Maternal tobacco exposure during pregnancy and atopic dermatitis in offspring: A systematic review and meta-analysis. J Eur Acad Dermatol Venereol. 2024 (Ma 14). doi: 10.1111/jdv.19958 Source

Key clinical point: Passive smoking during pregnancy is associated with an increased risk for atopic dermatitis (AD) in offspring; however, the association between active smoking during pregnancy and AD in offspring remains unestablished.

Major finding: Passive smoking during pregnancy led to a higher risk for AD in offspring (odds ratio [OR] 1.52; 95% CI 1.36-1.70); however, active smoking during pregnancy did not increase the risk for AD in offspring (OR 0.96; 95% CI 0.86-1.07).

Study details: This meta-analysis of 15 observational studies included children or mother-child pairs who underwent either questionnaire-based or physician assessment for AD diagnosis and questionnaire-based assessment or cotinine level measurement for evaluating exposure to active or passive smoking.

Disclosures: This study was supported by the Key Scientific and Technological Research Projects of Henan Province and the Key Scientific Research Projects in Universities of Henan Province, China. The authors declared no conflicts of interest.

Source: Chao L, Liang W, Zhao X, et al. Maternal tobacco exposure during pregnancy and atopic dermatitis in offspring: A systematic review and meta-analysis. J Eur Acad Dermatol Venereol. 2024 (Ma 14). doi: 10.1111/jdv.19958 Source

Key clinical point: In children with atopic dermatitis (AD), weekly vitamin D3 (VD3) supplementation vs placebo for 6 weeks failed to decrease the clinical severity of AD or alter type 2 immunity biomarkers.

Major finding: At 6 weeks, the change in the Severity Scoring of AD (SCORAD) index was similar in the VD3 (−5.3 ± 11.6) and placebo (−5.5 ± 9.9; P = .91) groups. No significant between-group differences were observed for change in type 2 immunity blood biomarkers, such as eosinophil counts, total immunoglobulin E (IgE), and specific IgE against staphylococcal enterotoxin A and B (all P > .05).

Study details: This randomized controlled trial included 101 children with AD (age 2-17 years) who were randomly assigned to receive weekly oral VD3 (8000, 12,000, and 16,000 IU for ages 2-5.9, 6-11.9, and 12-17.9 years, respectively; n = 53) or placebo (n = 48) for 6 weeks.

Disclosures: This study was funded by Fondo de Desarrollo Científico y Tecnológico, Chile. The authors declared no conflicts of interest.

Source: Borzutzky A, Iturriaga C, Pérez-Mateluna G, et al. Effect of weekly vitamin D supplementation on the severity of atopic dermatitis and type 2 immunity biomarkers in children: A randomized controlled trial. J Eur Acad Dermatol Venereol. 2024 (Mar 14). doi: 10.1111/jdv.19959 Source

Key clinical point: In children with atopic dermatitis (AD), weekly vitamin D3 (VD3) supplementation vs placebo for 6 weeks failed to decrease the clinical severity of AD or alter type 2 immunity biomarkers.

Major finding: At 6 weeks, the change in the Severity Scoring of AD (SCORAD) index was similar in the VD3 (−5.3 ± 11.6) and placebo (−5.5 ± 9.9; P = .91) groups. No significant between-group differences were observed for change in type 2 immunity blood biomarkers, such as eosinophil counts, total immunoglobulin E (IgE), and specific IgE against staphylococcal enterotoxin A and B (all P > .05).

Study details: This randomized controlled trial included 101 children with AD (age 2-17 years) who were randomly assigned to receive weekly oral VD3 (8000, 12,000, and 16,000 IU for ages 2-5.9, 6-11.9, and 12-17.9 years, respectively; n = 53) or placebo (n = 48) for 6 weeks.

Disclosures: This study was funded by Fondo de Desarrollo Científico y Tecnológico, Chile. The authors declared no conflicts of interest.

Source: Borzutzky A, Iturriaga C, Pérez-Mateluna G, et al. Effect of weekly vitamin D supplementation on the severity of atopic dermatitis and type 2 immunity biomarkers in children: A randomized controlled trial. J Eur Acad Dermatol Venereol. 2024 (Mar 14). doi: 10.1111/jdv.19959 Source

Key clinical point: In children with atopic dermatitis (AD), weekly vitamin D3 (VD3) supplementation vs placebo for 6 weeks failed to decrease the clinical severity of AD or alter type 2 immunity biomarkers.

Major finding: At 6 weeks, the change in the Severity Scoring of AD (SCORAD) index was similar in the VD3 (−5.3 ± 11.6) and placebo (−5.5 ± 9.9; P = .91) groups. No significant between-group differences were observed for change in type 2 immunity blood biomarkers, such as eosinophil counts, total immunoglobulin E (IgE), and specific IgE against staphylococcal enterotoxin A and B (all P > .05).

Study details: This randomized controlled trial included 101 children with AD (age 2-17 years) who were randomly assigned to receive weekly oral VD3 (8000, 12,000, and 16,000 IU for ages 2-5.9, 6-11.9, and 12-17.9 years, respectively; n = 53) or placebo (n = 48) for 6 weeks.

Disclosures: This study was funded by Fondo de Desarrollo Científico y Tecnológico, Chile. The authors declared no conflicts of interest.

Source: Borzutzky A, Iturriaga C, Pérez-Mateluna G, et al. Effect of weekly vitamin D supplementation on the severity of atopic dermatitis and type 2 immunity biomarkers in children: A randomized controlled trial. J Eur Acad Dermatol Venereol. 2024 (Mar 14). doi: 10.1111/jdv.19959 Source

Key clinical point: Tralokinumab-mediated inhibition of interleukin (IL)-13 improved epidermal pathology and reduced the expression of key atopic dermatitis (AD) biomarkers in the serum of patients with moderate to severe AD.

Major finding: At week 16, tralokinumab vs placebo led to a significantly greater decrease from baseline in serum levels of type 2 biomarkers (CCL17/TARC, periostin, immunoglobulin E, and IL-22; all P < .05), a greater mean percentage change in the Eczema Area Severity Index score (−55.6 vs −36.7), and improved expression of genes dysregulated in AD (46.6% vs 16.4%; P < .001).

Study details: This study involved the collection of blood samples from 802 patients with moderate to severe AD randomized in the ECZTRA 1 and ECZTEND trials, followed by the selection of a subset of 299 patients with relevant samples available who had received tralokinumab (n = 223) or placebo (n = 76).

Disclosures: LEO Pharma A/S funded both ECZTRA 1 and the ongoing ECZTEND trial. Six authors declared being employees or shareholders of LEO Pharma. Several authors declared receiving research grants from or having other ties with various sources, including LEO Pharma.

Source: Guttman-Yassky E, Kabashima K, Staumont-Salle D, et al. Targeting IL-13 with tralokinumab normalizes type 2 inflammation in atopic dermatitis both early and at 2 years. Allergy. 2024 (Apr 2). doi: 10.1111/all.16108 Source

Key clinical point: Tralokinumab-mediated inhibition of interleukin (IL)-13 improved epidermal pathology and reduced the expression of key atopic dermatitis (AD) biomarkers in the serum of patients with moderate to severe AD.

Major finding: At week 16, tralokinumab vs placebo led to a significantly greater decrease from baseline in serum levels of type 2 biomarkers (CCL17/TARC, periostin, immunoglobulin E, and IL-22; all P < .05), a greater mean percentage change in the Eczema Area Severity Index score (−55.6 vs −36.7), and improved expression of genes dysregulated in AD (46.6% vs 16.4%; P < .001).

Study details: This study involved the collection of blood samples from 802 patients with moderate to severe AD randomized in the ECZTRA 1 and ECZTEND trials, followed by the selection of a subset of 299 patients with relevant samples available who had received tralokinumab (n = 223) or placebo (n = 76).

Disclosures: LEO Pharma A/S funded both ECZTRA 1 and the ongoing ECZTEND trial. Six authors declared being employees or shareholders of LEO Pharma. Several authors declared receiving research grants from or having other ties with various sources, including LEO Pharma.

Source: Guttman-Yassky E, Kabashima K, Staumont-Salle D, et al. Targeting IL-13 with tralokinumab normalizes type 2 inflammation in atopic dermatitis both early and at 2 years. Allergy. 2024 (Apr 2). doi: 10.1111/all.16108 Source

Key clinical point: Tralokinumab-mediated inhibition of interleukin (IL)-13 improved epidermal pathology and reduced the expression of key atopic dermatitis (AD) biomarkers in the serum of patients with moderate to severe AD.

Major finding: At week 16, tralokinumab vs placebo led to a significantly greater decrease from baseline in serum levels of type 2 biomarkers (CCL17/TARC, periostin, immunoglobulin E, and IL-22; all P < .05), a greater mean percentage change in the Eczema Area Severity Index score (−55.6 vs −36.7), and improved expression of genes dysregulated in AD (46.6% vs 16.4%; P < .001).

Study details: This study involved the collection of blood samples from 802 patients with moderate to severe AD randomized in the ECZTRA 1 and ECZTEND trials, followed by the selection of a subset of 299 patients with relevant samples available who had received tralokinumab (n = 223) or placebo (n = 76).

Disclosures: LEO Pharma A/S funded both ECZTRA 1 and the ongoing ECZTEND trial. Six authors declared being employees or shareholders of LEO Pharma. Several authors declared receiving research grants from or having other ties with various sources, including LEO Pharma.

Source: Guttman-Yassky E, Kabashima K, Staumont-Salle D, et al. Targeting IL-13 with tralokinumab normalizes type 2 inflammation in atopic dermatitis both early and at 2 years. Allergy. 2024 (Apr 2). doi: 10.1111/all.16108 Source

Key clinical point: Children with atopic dermatitis (AD) at age 3 years showed an increased subsequent risk of developing inflammatory bowel disease (IBD), Crohn's disease (CD), and ulcerative colitis (UC); however, atopic manifestations were not associated with IBD.

Major finding: The presence of AD at age 3 years significantly increased the risk for IBD (pooled adjusted hazard ratio [aHR] 1.46; 95% CI 1.13-1.88), CD (pooled aHR 1.53; 95% CI 1.04-2.26), and UC (pooled aHR 1.78; 95% CI 1.15-2.75) later in life. Any atopic manifestation by age 3 years was not associated with IBD (pooled aHR 1.20; 95% CI 0.95-1.52).

Study details: This study included 83,311 children from the All Babies in Southeast Sweden (1997-1999) and the Norwegian Mother, Father, and Child (1999-2008) birth cohorts with questionnaire-based prospectively collected parent-reported information on asthma, AD, etc., developed by 3 years of age who were followed up from birth until 2021 or a diagnosis of IBD.

Disclosure: This study was supported by The Swedish Research Council and others. The authors declared no conflicts of interest.

Source: Lerchova T, Størdal K, Andersson B, Ludvigsson J, Mårild K. Atopic dermatitis in early childhood and risk of inflammatory bowel disease: A Scandinavian birth cohort study. J Pediatr. 2024;270:14027 (Mar21). doi: 10.1016/j.jpeds.2024.114027. Source

Key clinical point: Children with atopic dermatitis (AD) at age 3 years showed an increased subsequent risk of developing inflammatory bowel disease (IBD), Crohn's disease (CD), and ulcerative colitis (UC); however, atopic manifestations were not associated with IBD.

Major finding: The presence of AD at age 3 years significantly increased the risk for IBD (pooled adjusted hazard ratio [aHR] 1.46; 95% CI 1.13-1.88), CD (pooled aHR 1.53; 95% CI 1.04-2.26), and UC (pooled aHR 1.78; 95% CI 1.15-2.75) later in life. Any atopic manifestation by age 3 years was not associated with IBD (pooled aHR 1.20; 95% CI 0.95-1.52).

Study details: This study included 83,311 children from the All Babies in Southeast Sweden (1997-1999) and the Norwegian Mother, Father, and Child (1999-2008) birth cohorts with questionnaire-based prospectively collected parent-reported information on asthma, AD, etc., developed by 3 years of age who were followed up from birth until 2021 or a diagnosis of IBD.

Disclosure: This study was supported by The Swedish Research Council and others. The authors declared no conflicts of interest.

Source: Lerchova T, Størdal K, Andersson B, Ludvigsson J, Mårild K. Atopic dermatitis in early childhood and risk of inflammatory bowel disease: A Scandinavian birth cohort study. J Pediatr. 2024;270:14027 (Mar21). doi: 10.1016/j.jpeds.2024.114027. Source

Key clinical point: Children with atopic dermatitis (AD) at age 3 years showed an increased subsequent risk of developing inflammatory bowel disease (IBD), Crohn's disease (CD), and ulcerative colitis (UC); however, atopic manifestations were not associated with IBD.

Major finding: The presence of AD at age 3 years significantly increased the risk for IBD (pooled adjusted hazard ratio [aHR] 1.46; 95% CI 1.13-1.88), CD (pooled aHR 1.53; 95% CI 1.04-2.26), and UC (pooled aHR 1.78; 95% CI 1.15-2.75) later in life. Any atopic manifestation by age 3 years was not associated with IBD (pooled aHR 1.20; 95% CI 0.95-1.52).

Study details: This study included 83,311 children from the All Babies in Southeast Sweden (1997-1999) and the Norwegian Mother, Father, and Child (1999-2008) birth cohorts with questionnaire-based prospectively collected parent-reported information on asthma, AD, etc., developed by 3 years of age who were followed up from birth until 2021 or a diagnosis of IBD.

Disclosure: This study was supported by The Swedish Research Council and others. The authors declared no conflicts of interest.

Source: Lerchova T, Størdal K, Andersson B, Ludvigsson J, Mårild K. Atopic dermatitis in early childhood and risk of inflammatory bowel disease: A Scandinavian birth cohort study. J Pediatr. 2024;270:14027 (Mar21). doi: 10.1016/j.jpeds.2024.114027. Source

Key clinical point: Anti-calcitonin gene-related peptide monoclonal antibodies (anti-CGRP mAb) showed superior efficacy to botulinum toxin A (BoNT-A) in reducing the migraine burden in patients with chronic migraine (CM).

Major finding: Anti-CGRP mAbs vs BoNT-A led to significant reductions in mean Headache Impact Test-6 and Allodynia Symptoms Checklist-12 scores at 6 months (mean change −11.1 vs −3.2 points, P < .0001; and −5.2 vs −0.5 points, P = .0056, respectively) and 12 months (mean change −11.4 vs −3.6 points, P = .0042; and −6.0 vs −0.9 points, P = .0011, respectively).

Study details: This exploratory analysis of the real-world effectiveness of anti-CGRP mAb vs BoNT-A included 126 patients with CM who were treated with anti-CGRP mAb (n = 36) or BoNT-A (n = 90).

Disclosures: The study was supported by the Italian Ministry of Health. Some authors declared receiving funding, travel grants, honoraria, or personal fees for participation in advisory boards, speaker panels, and clinical investigation studies from various sources.

Source: Montisano DA, Giossi R, Canella M, et al. Reducing the impact of headache and allodynia score in chronic migraine: An exploratory analysis from the Real-world Effectiveness of Anti-CGRP Monoclonal Antibodies Compared to Onabotulinum Toxin A (RAMO) Study. Toxins. 2024;16(4):178. doi: 10.3390/toxins16040178 Source

Key clinical point: Anti-calcitonin gene-related peptide monoclonal antibodies (anti-CGRP mAb) showed superior efficacy to botulinum toxin A (BoNT-A) in reducing the migraine burden in patients with chronic migraine (CM).

Major finding: Anti-CGRP mAbs vs BoNT-A led to significant reductions in mean Headache Impact Test-6 and Allodynia Symptoms Checklist-12 scores at 6 months (mean change −11.1 vs −3.2 points, P < .0001; and −5.2 vs −0.5 points, P = .0056, respectively) and 12 months (mean change −11.4 vs −3.6 points, P = .0042; and −6.0 vs −0.9 points, P = .0011, respectively).

Study details: This exploratory analysis of the real-world effectiveness of anti-CGRP mAb vs BoNT-A included 126 patients with CM who were treated with anti-CGRP mAb (n = 36) or BoNT-A (n = 90).

Disclosures: The study was supported by the Italian Ministry of Health. Some authors declared receiving funding, travel grants, honoraria, or personal fees for participation in advisory boards, speaker panels, and clinical investigation studies from various sources.

Source: Montisano DA, Giossi R, Canella M, et al. Reducing the impact of headache and allodynia score in chronic migraine: An exploratory analysis from the Real-world Effectiveness of Anti-CGRP Monoclonal Antibodies Compared to Onabotulinum Toxin A (RAMO) Study. Toxins. 2024;16(4):178. doi: 10.3390/toxins16040178 Source

Key clinical point: Anti-calcitonin gene-related peptide monoclonal antibodies (anti-CGRP mAb) showed superior efficacy to botulinum toxin A (BoNT-A) in reducing the migraine burden in patients with chronic migraine (CM).

Major finding: Anti-CGRP mAbs vs BoNT-A led to significant reductions in mean Headache Impact Test-6 and Allodynia Symptoms Checklist-12 scores at 6 months (mean change −11.1 vs −3.2 points, P < .0001; and −5.2 vs −0.5 points, P = .0056, respectively) and 12 months (mean change −11.4 vs −3.6 points, P = .0042; and −6.0 vs −0.9 points, P = .0011, respectively).

Study details: This exploratory analysis of the real-world effectiveness of anti-CGRP mAb vs BoNT-A included 126 patients with CM who were treated with anti-CGRP mAb (n = 36) or BoNT-A (n = 90).

Disclosures: The study was supported by the Italian Ministry of Health. Some authors declared receiving funding, travel grants, honoraria, or personal fees for participation in advisory boards, speaker panels, and clinical investigation studies from various sources.

Source: Montisano DA, Giossi R, Canella M, et al. Reducing the impact of headache and allodynia score in chronic migraine: An exploratory analysis from the Real-world Effectiveness of Anti-CGRP Monoclonal Antibodies Compared to Onabotulinum Toxin A (RAMO) Study. Toxins. 2024;16(4):178. doi: 10.3390/toxins16040178 Source

Key clinical point: Contrary to common beliefs, neither anxiety nor depressive symptoms were associated with migraine-related outcomes in children and adolescents.

Major finding: Headache frequency and migraine-related disability had no significant association with anxiety (headache frequency P = .639; migraine-related disability P = .470) and depressive symptoms (headache frequency P = .209; migraine-related disability P = .796) at baseline. Similarly, no significant association was observed between longitudinal changes in anxiety and depressive symptoms and migraine-related outcomes.

Study details: Findings are from a prospective clinical cohort study including 123 children and adolescents with migraine who responded to a headache questionnaire and were assessed for anxiety and depressive symptoms.

Disclosures: This study was supported by the Program of Undergraduate Research Experience, University of Calgary, Canada, and others. Serena Laura Orr declared receiving royalties and research funding from various sources and serving on the editorial boards of Headache, Neurology, and the American Migraine Foundation. The other authors declared no conflicts of interest.

Source: Rizvi BA, Kuziek J, Cho LY, et al. Anxiety and depressive symptoms and migraine-related outcomes in children and adolescents. Headache. 2024 (Apr 6). doi: 10.1111/head.14701 Source

Key clinical point: Contrary to common beliefs, neither anxiety nor depressive symptoms were associated with migraine-related outcomes in children and adolescents.

Major finding: Headache frequency and migraine-related disability had no significant association with anxiety (headache frequency P = .639; migraine-related disability P = .470) and depressive symptoms (headache frequency P = .209; migraine-related disability P = .796) at baseline. Similarly, no significant association was observed between longitudinal changes in anxiety and depressive symptoms and migraine-related outcomes.

Study details: Findings are from a prospective clinical cohort study including 123 children and adolescents with migraine who responded to a headache questionnaire and were assessed for anxiety and depressive symptoms.

Disclosures: This study was supported by the Program of Undergraduate Research Experience, University of Calgary, Canada, and others. Serena Laura Orr declared receiving royalties and research funding from various sources and serving on the editorial boards of Headache, Neurology, and the American Migraine Foundation. The other authors declared no conflicts of interest.

Source: Rizvi BA, Kuziek J, Cho LY, et al. Anxiety and depressive symptoms and migraine-related outcomes in children and adolescents. Headache. 2024 (Apr 6). doi: 10.1111/head.14701 Source

Key clinical point: Contrary to common beliefs, neither anxiety nor depressive symptoms were associated with migraine-related outcomes in children and adolescents.

Major finding: Headache frequency and migraine-related disability had no significant association with anxiety (headache frequency P = .639; migraine-related disability P = .470) and depressive symptoms (headache frequency P = .209; migraine-related disability P = .796) at baseline. Similarly, no significant association was observed between longitudinal changes in anxiety and depressive symptoms and migraine-related outcomes.

Study details: Findings are from a prospective clinical cohort study including 123 children and adolescents with migraine who responded to a headache questionnaire and were assessed for anxiety and depressive symptoms.

Disclosures: This study was supported by the Program of Undergraduate Research Experience, University of Calgary, Canada, and others. Serena Laura Orr declared receiving royalties and research funding from various sources and serving on the editorial boards of Headache, Neurology, and the American Migraine Foundation. The other authors declared no conflicts of interest.

Source: Rizvi BA, Kuziek J, Cho LY, et al. Anxiety and depressive symptoms and migraine-related outcomes in children and adolescents. Headache. 2024 (Apr 6). doi: 10.1111/head.14701 Source

Key clinical point: Treatment with a combination of anti-calcitonin gene-related peptide (anti-CGRP) monoclonal antibodies (mAb) and onabotulinumtoxinA (onabot) was more effective than monotherapy with either anti-CGRP alone or onabot in reducing monthly migraine days (MMD) in patients with chronic migraine.

Major finding: Initiating therapy with either anti-CGRP mAbs or onabot significantly reduced the median MMD from 30 to 15 days, which further decreased to 8 days after initiating dual therapy with anti-CGRP mAb and onabot (both P < .0001). Overall, 68% of patients receiving dual therapy achieved 50% or greater reduction in MMD.

Study details: This real-world retrospective chart review included 423 patients with chronic migraine (age ≥ 18 years) who received monotherapy with either anti-CGRP mAb or onabot (n = 229) followed by dual therapy (concurrent treatment with anti-CGRP mAb and onabot; n = 194) for at least three consecutive months.

Disclosures: This study was funded by a Cleveland Clinic institutional grant. The authors declared no conflicts of interest.

Source: Salim A, Hennessy E, Sonneborn C, et al. Synergism of anti-CGRP monoclonal antibodies and onabotulinumtoxinA in the treatment of chronic migraine: A real-world retrospective chart review. CNS Drugs. 2024 (Apr 7). doi: 10.1007/s40263-024-01086-z  Source

Key clinical point: Treatment with a combination of anti-calcitonin gene-related peptide (anti-CGRP) monoclonal antibodies (mAb) and onabotulinumtoxinA (onabot) was more effective than monotherapy with either anti-CGRP alone or onabot in reducing monthly migraine days (MMD) in patients with chronic migraine.

Major finding: Initiating therapy with either anti-CGRP mAbs or onabot significantly reduced the median MMD from 30 to 15 days, which further decreased to 8 days after initiating dual therapy with anti-CGRP mAb and onabot (both P < .0001). Overall, 68% of patients receiving dual therapy achieved 50% or greater reduction in MMD.

Study details: This real-world retrospective chart review included 423 patients with chronic migraine (age ≥ 18 years) who received monotherapy with either anti-CGRP mAb or onabot (n = 229) followed by dual therapy (concurrent treatment with anti-CGRP mAb and onabot; n = 194) for at least three consecutive months.

Disclosures: This study was funded by a Cleveland Clinic institutional grant. The authors declared no conflicts of interest.

Source: Salim A, Hennessy E, Sonneborn C, et al. Synergism of anti-CGRP monoclonal antibodies and onabotulinumtoxinA in the treatment of chronic migraine: A real-world retrospective chart review. CNS Drugs. 2024 (Apr 7). doi: 10.1007/s40263-024-01086-z  Source

Key clinical point: Treatment with a combination of anti-calcitonin gene-related peptide (anti-CGRP) monoclonal antibodies (mAb) and onabotulinumtoxinA (onabot) was more effective than monotherapy with either anti-CGRP alone or onabot in reducing monthly migraine days (MMD) in patients with chronic migraine.

Major finding: Initiating therapy with either anti-CGRP mAbs or onabot significantly reduced the median MMD from 30 to 15 days, which further decreased to 8 days after initiating dual therapy with anti-CGRP mAb and onabot (both P < .0001). Overall, 68% of patients receiving dual therapy achieved 50% or greater reduction in MMD.

Study details: This real-world retrospective chart review included 423 patients with chronic migraine (age ≥ 18 years) who received monotherapy with either anti-CGRP mAb or onabot (n = 229) followed by dual therapy (concurrent treatment with anti-CGRP mAb and onabot; n = 194) for at least three consecutive months.

Disclosures: This study was funded by a Cleveland Clinic institutional grant. The authors declared no conflicts of interest.

Source: Salim A, Hennessy E, Sonneborn C, et al. Synergism of anti-CGRP monoclonal antibodies and onabotulinumtoxinA in the treatment of chronic migraine: A real-world retrospective chart review. CNS Drugs. 2024 (Apr 7). doi: 10.1007/s40263-024-01086-z  Source

Key clinical point: Higher body mass index (BMI) was positively associated with an increased risk for medication-overuse headache (MOH) in patients with migraine.

Major finding: Higher BMI was positively associated with a higher risk for MOH (adjusted odds ratio [aOR] 1.05; 95% CI 1.01-1.11; P = .031), with the risk being significantly higher in patients with migraine who had a BMI ≥ 28.0 kg/m² vs those with BMI of 18.5-23.9 kg/m² (aOR 1.81; 95% CI 1.04-3.17; P = .037).

Study details: This secondary analysis of the Survey of Fibromyalgia Comorbidity with Headache study included 2251 patients with migraine, of whom 195 (8.7%) had concomitant MOH.

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

Source: Liu H, Zhao H, Liu K, et al. Association between body mass index and medication-overuse headache among individuals with migraine: A cross-sectional study. Obes Facts. 2024 (Apr 3). doi: 10.1159/000538528 Source

Key clinical point: Higher body mass index (BMI) was positively associated with an increased risk for medication-overuse headache (MOH) in patients with migraine.

Major finding: Higher BMI was positively associated with a higher risk for MOH (adjusted odds ratio [aOR] 1.05; 95% CI 1.01-1.11; P = .031), with the risk being significantly higher in patients with migraine who had a BMI ≥ 28.0 kg/m² vs those with BMI of 18.5-23.9 kg/m² (aOR 1.81; 95% CI 1.04-3.17; P = .037).

Study details: This secondary analysis of the Survey of Fibromyalgia Comorbidity with Headache study included 2251 patients with migraine, of whom 195 (8.7%) had concomitant MOH.

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

Source: Liu H, Zhao H, Liu K, et al. Association between body mass index and medication-overuse headache among individuals with migraine: A cross-sectional study. Obes Facts. 2024 (Apr 3). doi: 10.1159/000538528 Source

Key clinical point: Higher body mass index (BMI) was positively associated with an increased risk for medication-overuse headache (MOH) in patients with migraine.

Major finding: Higher BMI was positively associated with a higher risk for MOH (adjusted odds ratio [aOR] 1.05; 95% CI 1.01-1.11; P = .031), with the risk being significantly higher in patients with migraine who had a BMI ≥ 28.0 kg/m² vs those with BMI of 18.5-23.9 kg/m² (aOR 1.81; 95% CI 1.04-3.17; P = .037).

Study details: This secondary analysis of the Survey of Fibromyalgia Comorbidity with Headache study included 2251 patients with migraine, of whom 195 (8.7%) had concomitant MOH.

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

Source: Liu H, Zhao H, Liu K, et al. Association between body mass index and medication-overuse headache among individuals with migraine: A cross-sectional study. Obes Facts. 2024 (Apr 3). doi: 10.1159/000538528 Source

Key clinical point: A higher dietary phytochemical index (DPI) score is associated with lower migraine frequency and improved migraine-related disability in patients with migraine.

Major finding: Patients with migraine in the third vs first tertile of the DPI showed a significant reduction in migraine frequency (incidence rate ratio 0.84; P_trend= .009) and an improvement in migraine-related disability (β −2.48; P_trend = .046). However, no significant association was seen between DPI and headache duration (P_trend = .439), headache severity (P_trend = .239), depression (P_trend = .480), anxiety (P_trend = .655), and stress (P_trend = .876).

Study details: This cross-sectional study evaluated the association between DPI and the clinical and psychological characteristics of migraine headaches in 262 patients with migraine (age 20-50 years).

Disclosures: This study was supported by the Isfahan University of Medical Sciences, Isfahan, Iran. The authors declared no conflicts of interest.

Source: Amani Tirani S, Balali A, Kazemi M, et al. The predictive role of the dietary phytochemical index in relation to the clinical and psychological traits of migraine headaches. Sci Rep. 2024;14:6886 (Mar 22). doi: 10.1038/s41598-024-57536-7 Source

Key clinical point: A higher dietary phytochemical index (DPI) score is associated with lower migraine frequency and improved migraine-related disability in patients with migraine.

Major finding: Patients with migraine in the third vs first tertile of the DPI showed a significant reduction in migraine frequency (incidence rate ratio 0.84; P_trend= .009) and an improvement in migraine-related disability (β −2.48; P_trend = .046). However, no significant association was seen between DPI and headache duration (P_trend = .439), headache severity (P_trend = .239), depression (P_trend = .480), anxiety (P_trend = .655), and stress (P_trend = .876).

Study details: This cross-sectional study evaluated the association between DPI and the clinical and psychological characteristics of migraine headaches in 262 patients with migraine (age 20-50 years).

Disclosures: This study was supported by the Isfahan University of Medical Sciences, Isfahan, Iran. The authors declared no conflicts of interest.

Source: Amani Tirani S, Balali A, Kazemi M, et al. The predictive role of the dietary phytochemical index in relation to the clinical and psychological traits of migraine headaches. Sci Rep. 2024;14:6886 (Mar 22). doi: 10.1038/s41598-024-57536-7 Source

Key clinical point: A higher dietary phytochemical index (DPI) score is associated with lower migraine frequency and improved migraine-related disability in patients with migraine.

Major finding: Patients with migraine in the third vs first tertile of the DPI showed a significant reduction in migraine frequency (incidence rate ratio 0.84; P_trend= .009) and an improvement in migraine-related disability (β −2.48; P_trend = .046). However, no significant association was seen between DPI and headache duration (P_trend = .439), headache severity (P_trend = .239), depression (P_trend = .480), anxiety (P_trend = .655), and stress (P_trend = .876).

Study details: This cross-sectional study evaluated the association between DPI and the clinical and psychological characteristics of migraine headaches in 262 patients with migraine (age 20-50 years).

Disclosures: This study was supported by the Isfahan University of Medical Sciences, Isfahan, Iran. The authors declared no conflicts of interest.

Source: Amani Tirani S, Balali A, Kazemi M, et al. The predictive role of the dietary phytochemical index in relation to the clinical and psychological traits of migraine headaches. Sci Rep. 2024;14:6886 (Mar 22). doi: 10.1038/s41598-024-57536-7 Source

Key clinical point: Atopic dermatitis (AD) is significantly associated with a higher risk for headache disorders or migraine.

Major finding: Patients with AD had a significantly higher risk for headache disorder (odds ratio [OR] 1.46; 95% CI 1.36-1.56) or migraine (OR 1.32; 95% CI 1.18-1.47; both P < .001). This finding was consistent across the different subgroup analyses.

Study details: The data come from a meta-analysis of 10 observational studies that evaluated the risk for headache disorders in 12,717,747 patients with AD, of which six studies evaluated migraine risk in 11,090,412 patients with AD.

Disclosures: This study was supported by the project of training talent for Zhejiang province young and middle-aged clinical traditional Chinese medicine experts and Hangzhou Municipal Health and Family Planning Commission Science and Technology Project, China. The authors declared no conflicts of interest.

Source: Yang W, Dai H, Xu X-F, et al. Association of atopic dermatitis and headache disorder: A systematic review and meta-analyses. Front Neurol. 2024;15:1383832. doi: 10.3389/fneur.2024.1383832 Source

Key clinical point: Atopic dermatitis (AD) is significantly associated with a higher risk for headache disorders or migraine.

Major finding: Patients with AD had a significantly higher risk for headache disorder (odds ratio [OR] 1.46; 95% CI 1.36-1.56) or migraine (OR 1.32; 95% CI 1.18-1.47; both P < .001). This finding was consistent across the different subgroup analyses.

Study details: The data come from a meta-analysis of 10 observational studies that evaluated the risk for headache disorders in 12,717,747 patients with AD, of which six studies evaluated migraine risk in 11,090,412 patients with AD.

Disclosures: This study was supported by the project of training talent for Zhejiang province young and middle-aged clinical traditional Chinese medicine experts and Hangzhou Municipal Health and Family Planning Commission Science and Technology Project, China. The authors declared no conflicts of interest.

Source: Yang W, Dai H, Xu X-F, et al. Association of atopic dermatitis and headache disorder: A systematic review and meta-analyses. Front Neurol. 2024;15:1383832. doi: 10.3389/fneur.2024.1383832 Source

Key clinical point: Atopic dermatitis (AD) is significantly associated with a higher risk for headache disorders or migraine.

Major finding: Patients with AD had a significantly higher risk for headache disorder (odds ratio [OR] 1.46; 95% CI 1.36-1.56) or migraine (OR 1.32; 95% CI 1.18-1.47; both P < .001). This finding was consistent across the different subgroup analyses.

Study details: The data come from a meta-analysis of 10 observational studies that evaluated the risk for headache disorders in 12,717,747 patients with AD, of which six studies evaluated migraine risk in 11,090,412 patients with AD.

Disclosures: This study was supported by the project of training talent for Zhejiang province young and middle-aged clinical traditional Chinese medicine experts and Hangzhou Municipal Health and Family Planning Commission Science and Technology Project, China. The authors declared no conflicts of interest.

Source: Yang W, Dai H, Xu X-F, et al. Association of atopic dermatitis and headache disorder: A systematic review and meta-analyses. Front Neurol. 2024;15:1383832. doi: 10.3389/fneur.2024.1383832 Source