Clinical Edge Journal Scan

Key clinical point: The second proximal interphalangeal (PIP) joint of the right hand and the right knee joint were the most affected in patients with psoriatic arthritis (PsA), particularly in those with older age and an earlier onset of PsA.

Major finding: The second PIP joint of the right hand had the greatest prevalence of swelling (18.9%), and the right knee joint had the highest prevalence of tenderness (24.2%). Older age was a risk factor, whereas an earlier onset of PsA was a protective factor for both swelling of the second PIP joint of the right hand and tenderness of right knee joint (P < .05 for all).

Study details: This cross-sectional study included 264 patients with PsA.

Disclosures: This study was funded by the National Key Research and Development Program of China and the National Natural Science Foundation of China. The authors did not declare any conflicts of interest.

Source: Li J, Xiao J, Xie X, et al. Individual joints involvement pattern in psoriatic arthritis: A cross-sectional study in China. J Dermatol. 2024 (Jul 12). Doi: 10.1111/1346-8138.17369 Source

Key clinical point: The second proximal interphalangeal (PIP) joint of the right hand and the right knee joint were the most affected in patients with psoriatic arthritis (PsA), particularly in those with older age and an earlier onset of PsA.

Major finding: The second PIP joint of the right hand had the greatest prevalence of swelling (18.9%), and the right knee joint had the highest prevalence of tenderness (24.2%). Older age was a risk factor, whereas an earlier onset of PsA was a protective factor for both swelling of the second PIP joint of the right hand and tenderness of right knee joint (P < .05 for all).

Study details: This cross-sectional study included 264 patients with PsA.

Disclosures: This study was funded by the National Key Research and Development Program of China and the National Natural Science Foundation of China. The authors did not declare any conflicts of interest.

Source: Li J, Xiao J, Xie X, et al. Individual joints involvement pattern in psoriatic arthritis: A cross-sectional study in China. J Dermatol. 2024 (Jul 12). Doi: 10.1111/1346-8138.17369 Source

Key clinical point: The second proximal interphalangeal (PIP) joint of the right hand and the right knee joint were the most affected in patients with psoriatic arthritis (PsA), particularly in those with older age and an earlier onset of PsA.

Major finding: The second PIP joint of the right hand had the greatest prevalence of swelling (18.9%), and the right knee joint had the highest prevalence of tenderness (24.2%). Older age was a risk factor, whereas an earlier onset of PsA was a protective factor for both swelling of the second PIP joint of the right hand and tenderness of right knee joint (P < .05 for all).

Study details: This cross-sectional study included 264 patients with PsA.

Disclosures: This study was funded by the National Key Research and Development Program of China and the National Natural Science Foundation of China. The authors did not declare any conflicts of interest.

Source: Li J, Xiao J, Xie X, et al. Individual joints involvement pattern in psoriatic arthritis: A cross-sectional study in China. J Dermatol. 2024 (Jul 12). Doi: 10.1111/1346-8138.17369 Source

Key clinical point: A dose of 160 mg bimekizumab every 4 weeks demonstrated greater long-term efficacy than 45 or 90 mg ustekinumab every 12 weeks in patients with psoriatic arthritis (PsA) who were biologic-naïve or showed inadequate response to tumor necrosis factor inhibitors (TNFi-IR).

Major finding: At week 52, both biologic-naive (adjusted odds ratio [aOR] 3.33; P < .001) and TNFi-IR (aOR 9.85; P < .001) patients receiving bimekizumab vs 45 mg ustekinumab were more likely to achieve ≥70% improvement in the American College of Rheumatology response, with similar effect observed for bimekizumab vs 90 mg ustekinumab.

Study details: This was matching-adjusted indirect comparison of data from several phase 3 trials of bimekizumab (BE OPTIMAL, BE COMPLETE, and BE VITAL) and ustekinumab (PSUMMIT1 and PSUMMIT2). The trials involved patients with PsA who received bimekizumab (n = 698) or ustekinumab (45 mg: n = 265; 90 mg: n = 262).

Disclosures: This study was sponsored by UCB Pharma and supported by the NIHR Manchester Biomedical Research Centre, UK. Three authors declared being employees and shareholders of UCB Pharma. Several authors declared having ties with various sources, including UCB Pharma.

Source: Mease PJ, Warren RB, Nash P, et al. Comparative effectiveness of bimekizumab and ustekinumab in patients with psoriatic arthritis at 52 weeks assessed using a matching-adjusted indirect comparison. Rheumatol Ther. 2024 (Aug 9). Doi: 10.1007/s40744-024-00705-x Source

Key clinical point: A dose of 160 mg bimekizumab every 4 weeks demonstrated greater long-term efficacy than 45 or 90 mg ustekinumab every 12 weeks in patients with psoriatic arthritis (PsA) who were biologic-naïve or showed inadequate response to tumor necrosis factor inhibitors (TNFi-IR).

Major finding: At week 52, both biologic-naive (adjusted odds ratio [aOR] 3.33; P < .001) and TNFi-IR (aOR 9.85; P < .001) patients receiving bimekizumab vs 45 mg ustekinumab were more likely to achieve ≥70% improvement in the American College of Rheumatology response, with similar effect observed for bimekizumab vs 90 mg ustekinumab.

Study details: This was matching-adjusted indirect comparison of data from several phase 3 trials of bimekizumab (BE OPTIMAL, BE COMPLETE, and BE VITAL) and ustekinumab (PSUMMIT1 and PSUMMIT2). The trials involved patients with PsA who received bimekizumab (n = 698) or ustekinumab (45 mg: n = 265; 90 mg: n = 262).

Disclosures: This study was sponsored by UCB Pharma and supported by the NIHR Manchester Biomedical Research Centre, UK. Three authors declared being employees and shareholders of UCB Pharma. Several authors declared having ties with various sources, including UCB Pharma.

Source: Mease PJ, Warren RB, Nash P, et al. Comparative effectiveness of bimekizumab and ustekinumab in patients with psoriatic arthritis at 52 weeks assessed using a matching-adjusted indirect comparison. Rheumatol Ther. 2024 (Aug 9). Doi: 10.1007/s40744-024-00705-x Source

Key clinical point: A dose of 160 mg bimekizumab every 4 weeks demonstrated greater long-term efficacy than 45 or 90 mg ustekinumab every 12 weeks in patients with psoriatic arthritis (PsA) who were biologic-naïve or showed inadequate response to tumor necrosis factor inhibitors (TNFi-IR).

Major finding: At week 52, both biologic-naive (adjusted odds ratio [aOR] 3.33; P < .001) and TNFi-IR (aOR 9.85; P < .001) patients receiving bimekizumab vs 45 mg ustekinumab were more likely to achieve ≥70% improvement in the American College of Rheumatology response, with similar effect observed for bimekizumab vs 90 mg ustekinumab.

Study details: This was matching-adjusted indirect comparison of data from several phase 3 trials of bimekizumab (BE OPTIMAL, BE COMPLETE, and BE VITAL) and ustekinumab (PSUMMIT1 and PSUMMIT2). The trials involved patients with PsA who received bimekizumab (n = 698) or ustekinumab (45 mg: n = 265; 90 mg: n = 262).

Disclosures: This study was sponsored by UCB Pharma and supported by the NIHR Manchester Biomedical Research Centre, UK. Three authors declared being employees and shareholders of UCB Pharma. Several authors declared having ties with various sources, including UCB Pharma.

Source: Mease PJ, Warren RB, Nash P, et al. Comparative effectiveness of bimekizumab and ustekinumab in patients with psoriatic arthritis at 52 weeks assessed using a matching-adjusted indirect comparison. Rheumatol Ther. 2024 (Aug 9). Doi: 10.1007/s40744-024-00705-x Source

Key clinical point: First-line targeted therapy, particularly use of tumor necrosis factor inhibitors (TNFi), reduced the use of symptomatic treatments, methotrexate, mood disorder treatments, hospitalizations, and sick leave in patients with psoriatic arthritis (PsA).

Major finding: First-line targeted therapy significantly reduced the use of non-steroidal anti-inflammatory drugs (NSAID; −15%), prednisone (−9%), methotrexate (−15%), mood disorder treatments (−2%), and rate of hospitalizations (−12%) and sick leave (−4%; all P < 10^-4). TNFi showed greater reductions in NSAID (adjusted odds ratio [aOR] 1.04; 95% CI 1.01-1.07) and prednisone use (aOR 1.04; 95% CI 1.02-1.06) compared with interleukin 17 inhibitors (IL17i), with similar outcomes for IL12/23i.

Study details: This cohort study included 9793 patients with PsA age ≥18 years who had initiated targeted therapies for at least 9 months.

Disclosures: The authors did not declare any specific funding. Two authors declared receiving a subsidy to attend a congress or receiving consulting fees and serving as investigators for various sources.

Source: Pina Vegas L, Iggui S, Sbidian E, Claudepierre P. Impact of initiation of targeted therapy on the use of psoriatic arthritis-related treatments and healthcare consumption: A cohort study of 9793 patients from the French health insurance database (SNDS). RMD Open. 2024;10:e004631 (Aug 7). Doi: 10.1136/rmdopen-2024-004631 Source

Key clinical point: First-line targeted therapy, particularly use of tumor necrosis factor inhibitors (TNFi), reduced the use of symptomatic treatments, methotrexate, mood disorder treatments, hospitalizations, and sick leave in patients with psoriatic arthritis (PsA).

Major finding: First-line targeted therapy significantly reduced the use of non-steroidal anti-inflammatory drugs (NSAID; −15%), prednisone (−9%), methotrexate (−15%), mood disorder treatments (−2%), and rate of hospitalizations (−12%) and sick leave (−4%; all P < 10^-4). TNFi showed greater reductions in NSAID (adjusted odds ratio [aOR] 1.04; 95% CI 1.01-1.07) and prednisone use (aOR 1.04; 95% CI 1.02-1.06) compared with interleukin 17 inhibitors (IL17i), with similar outcomes for IL12/23i.

Study details: This cohort study included 9793 patients with PsA age ≥18 years who had initiated targeted therapies for at least 9 months.

Disclosures: The authors did not declare any specific funding. Two authors declared receiving a subsidy to attend a congress or receiving consulting fees and serving as investigators for various sources.

Source: Pina Vegas L, Iggui S, Sbidian E, Claudepierre P. Impact of initiation of targeted therapy on the use of psoriatic arthritis-related treatments and healthcare consumption: A cohort study of 9793 patients from the French health insurance database (SNDS). RMD Open. 2024;10:e004631 (Aug 7). Doi: 10.1136/rmdopen-2024-004631 Source

Key clinical point: First-line targeted therapy, particularly use of tumor necrosis factor inhibitors (TNFi), reduced the use of symptomatic treatments, methotrexate, mood disorder treatments, hospitalizations, and sick leave in patients with psoriatic arthritis (PsA).

Major finding: First-line targeted therapy significantly reduced the use of non-steroidal anti-inflammatory drugs (NSAID; −15%), prednisone (−9%), methotrexate (−15%), mood disorder treatments (−2%), and rate of hospitalizations (−12%) and sick leave (−4%; all P < 10^-4). TNFi showed greater reductions in NSAID (adjusted odds ratio [aOR] 1.04; 95% CI 1.01-1.07) and prednisone use (aOR 1.04; 95% CI 1.02-1.06) compared with interleukin 17 inhibitors (IL17i), with similar outcomes for IL12/23i.

Study details: This cohort study included 9793 patients with PsA age ≥18 years who had initiated targeted therapies for at least 9 months.

Disclosures: The authors did not declare any specific funding. Two authors declared receiving a subsidy to attend a congress or receiving consulting fees and serving as investigators for various sources.

Source: Pina Vegas L, Iggui S, Sbidian E, Claudepierre P. Impact of initiation of targeted therapy on the use of psoriatic arthritis-related treatments and healthcare consumption: A cohort study of 9793 patients from the French health insurance database (SNDS). RMD Open. 2024;10:e004631 (Aug 7). Doi: 10.1136/rmdopen-2024-004631 Source

Key clinical point: Patients with psoriatic arthritis (PsA) who achieved disease control despite having an inadequate response to conventional synthetic or biological disease-modifying antirheumatic drugs (cs/bDMARD) showed improved patient-reported outcomes (PRO).

Major finding: At week 104, patients who did vs did not achieve minimal disease activity had significant improvements in the Health Assessment Questionnaire–Disability Index (least squares mean change from baseline [Δ] −0.82 vs −0.17; P ≤ .0001), pain (Δ −4.75 vs −1.77; P ≤ .0001), and other investigated PRO.

Study details: This post hoc analysis of two phase 3 trials, SELECT-PsA 1 and SELECT-PsA 2, included 1069 and 317 patients with PsA and inadequate response to ≥1 csDMARD or bDMARD, respectively, who were randomly assigned to receive upadacitinib, placebo with crossover to upadacitinib, or adalimumab.

Disclosures: This study was funded by AbbVie, and AbbVie participated in the design of the trial and the publication of its results. Seven authors declared being employees of AbbVie and may own its stock or stock options. Several authors declared having ties with AbbVie and other sources.

Source: Kavanaugh A, Mease P, Gossec L, et al. Association between achievement of clinical disease control and improvement in patient-reported outcomes and quality of life in patients with psoriatic arthritis in the phase 3 SELECT-PsA 1 and 2 randomized controlled trials. ACR Open Rheumatol. 2024 (Aug 1). Doi: 10.1002/acr2.11714 Source

Key clinical point: Patients with psoriatic arthritis (PsA) who achieved disease control despite having an inadequate response to conventional synthetic or biological disease-modifying antirheumatic drugs (cs/bDMARD) showed improved patient-reported outcomes (PRO).

Major finding: At week 104, patients who did vs did not achieve minimal disease activity had significant improvements in the Health Assessment Questionnaire–Disability Index (least squares mean change from baseline [Δ] −0.82 vs −0.17; P ≤ .0001), pain (Δ −4.75 vs −1.77; P ≤ .0001), and other investigated PRO.

Study details: This post hoc analysis of two phase 3 trials, SELECT-PsA 1 and SELECT-PsA 2, included 1069 and 317 patients with PsA and inadequate response to ≥1 csDMARD or bDMARD, respectively, who were randomly assigned to receive upadacitinib, placebo with crossover to upadacitinib, or adalimumab.

Disclosures: This study was funded by AbbVie, and AbbVie participated in the design of the trial and the publication of its results. Seven authors declared being employees of AbbVie and may own its stock or stock options. Several authors declared having ties with AbbVie and other sources.

Source: Kavanaugh A, Mease P, Gossec L, et al. Association between achievement of clinical disease control and improvement in patient-reported outcomes and quality of life in patients with psoriatic arthritis in the phase 3 SELECT-PsA 1 and 2 randomized controlled trials. ACR Open Rheumatol. 2024 (Aug 1). Doi: 10.1002/acr2.11714 Source

Key clinical point: Patients with psoriatic arthritis (PsA) who achieved disease control despite having an inadequate response to conventional synthetic or biological disease-modifying antirheumatic drugs (cs/bDMARD) showed improved patient-reported outcomes (PRO).

Major finding: At week 104, patients who did vs did not achieve minimal disease activity had significant improvements in the Health Assessment Questionnaire–Disability Index (least squares mean change from baseline [Δ] −0.82 vs −0.17; P ≤ .0001), pain (Δ −4.75 vs −1.77; P ≤ .0001), and other investigated PRO.

Study details: This post hoc analysis of two phase 3 trials, SELECT-PsA 1 and SELECT-PsA 2, included 1069 and 317 patients with PsA and inadequate response to ≥1 csDMARD or bDMARD, respectively, who were randomly assigned to receive upadacitinib, placebo with crossover to upadacitinib, or adalimumab.

Disclosures: This study was funded by AbbVie, and AbbVie participated in the design of the trial and the publication of its results. Seven authors declared being employees of AbbVie and may own its stock or stock options. Several authors declared having ties with AbbVie and other sources.

Source: Kavanaugh A, Mease P, Gossec L, et al. Association between achievement of clinical disease control and improvement in patient-reported outcomes and quality of life in patients with psoriatic arthritis in the phase 3 SELECT-PsA 1 and 2 randomized controlled trials. ACR Open Rheumatol. 2024 (Aug 1). Doi: 10.1002/acr2.11714 Source

Key clinical point: Patients who received interleukin-23 inhibitors (IL-23i) and interleukin-12/23 inhibitors (IL-12/23i) for the management of psoriasis had a comparable risk for incident psoriatic arthritis (PsA).

Major finding: Patients treated with IL-23i vs IL-12/23i demonstrated no significant difference in the risk for PsA (hazard ratio 0.96; P = .812) and cumulative incidence of PsA (P = .812).

Study details: This retrospective cohort study included the propensity score–matched data of patients with psoriasis age 18 years or older from the TriNetX database who were treated with either IL-23i (n = 2142) or IL-12/23i (n = 2142).

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

Source: Tsai SHL, Yang C-Y, Huo A-P, Wei JC-C. Interleukin 23 versus interleukin 12/23 inhibitors on preventing incidental psoriatic arthritis in patients with psoriasis? A real-world comparison from the TriNetX Global Collaborative Network. J Am Acad Dermatol. 2024 (Jul 27). Doi: 0.1016/j.jaad.2024.07.1473 Source

Key clinical point: Patients who received interleukin-23 inhibitors (IL-23i) and interleukin-12/23 inhibitors (IL-12/23i) for the management of psoriasis had a comparable risk for incident psoriatic arthritis (PsA).

Major finding: Patients treated with IL-23i vs IL-12/23i demonstrated no significant difference in the risk for PsA (hazard ratio 0.96; P = .812) and cumulative incidence of PsA (P = .812).

Study details: This retrospective cohort study included the propensity score–matched data of patients with psoriasis age 18 years or older from the TriNetX database who were treated with either IL-23i (n = 2142) or IL-12/23i (n = 2142).

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

Source: Tsai SHL, Yang C-Y, Huo A-P, Wei JC-C. Interleukin 23 versus interleukin 12/23 inhibitors on preventing incidental psoriatic arthritis in patients with psoriasis? A real-world comparison from the TriNetX Global Collaborative Network. J Am Acad Dermatol. 2024 (Jul 27). Doi: 0.1016/j.jaad.2024.07.1473 Source

Key clinical point: Patients who received interleukin-23 inhibitors (IL-23i) and interleukin-12/23 inhibitors (IL-12/23i) for the management of psoriasis had a comparable risk for incident psoriatic arthritis (PsA).

Major finding: Patients treated with IL-23i vs IL-12/23i demonstrated no significant difference in the risk for PsA (hazard ratio 0.96; P = .812) and cumulative incidence of PsA (P = .812).

Study details: This retrospective cohort study included the propensity score–matched data of patients with psoriasis age 18 years or older from the TriNetX database who were treated with either IL-23i (n = 2142) or IL-12/23i (n = 2142).

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

Source: Tsai SHL, Yang C-Y, Huo A-P, Wei JC-C. Interleukin 23 versus interleukin 12/23 inhibitors on preventing incidental psoriatic arthritis in patients with psoriasis? A real-world comparison from the TriNetX Global Collaborative Network. J Am Acad Dermatol. 2024 (Jul 27). Doi: 0.1016/j.jaad.2024.07.1473 Source

Key clinical point: Bimekizumab demonstrated sustained efficacy and was well tolerated for 52 weeks, regardless of concomitant methotrexate use, in patients with psoriatic arthritis (PsA) who were biologic-naive or intolerant to tumor necrosis factor inhibitors (TNFi-IR).

Major finding: Through week 52, nearly half of the patients receiving bimekizumab with or without methotrexate achieved a ≥50% improvement in American College of Rheumatology response (biologic-naive ~55%; TNFi-IR ~48-56%) and minimal disease activity (biologic-naive ~55%; TNFi-IR ~47%). The rates of experiencing at least one treatment emergent adverse event were similar across the subgroups.

Study details: This post hoc analysis of phase 3 trials (BE OPTIMAL, BE COMPLETE, and BE VITAL) included biologic-naive (n = 852) or TNFi-IR (n = 400) patients with PsA who received bimekizumab, placebo with crossover to bimekizumab at week 16, or adalimumab, with or without methotrexate.

Disclosures: This study was funded by UCB Pharma and supported by the NIHR Manchester Biomedical Research Centre, UK. Two authors declared being employees of or holding stocks in UCB. Several authors declared having other ties with UCB and other sources.

Source: McInnes IB, Mease PJ, Tanaka Y, et al. Efficacy and safety of bimekizumab in patients with psoriatic arthritis with or without methotrexate: 52-week results from two phase 3 studies. ACR Open Rheumatol. 2024 (Jul 30). Doi: 10.1002/acr2.11727 Source

Key clinical point: Bimekizumab demonstrated sustained efficacy and was well tolerated for 52 weeks, regardless of concomitant methotrexate use, in patients with psoriatic arthritis (PsA) who were biologic-naive or intolerant to tumor necrosis factor inhibitors (TNFi-IR).

Major finding: Through week 52, nearly half of the patients receiving bimekizumab with or without methotrexate achieved a ≥50% improvement in American College of Rheumatology response (biologic-naive ~55%; TNFi-IR ~48-56%) and minimal disease activity (biologic-naive ~55%; TNFi-IR ~47%). The rates of experiencing at least one treatment emergent adverse event were similar across the subgroups.

Study details: This post hoc analysis of phase 3 trials (BE OPTIMAL, BE COMPLETE, and BE VITAL) included biologic-naive (n = 852) or TNFi-IR (n = 400) patients with PsA who received bimekizumab, placebo with crossover to bimekizumab at week 16, or adalimumab, with or without methotrexate.

Disclosures: This study was funded by UCB Pharma and supported by the NIHR Manchester Biomedical Research Centre, UK. Two authors declared being employees of or holding stocks in UCB. Several authors declared having other ties with UCB and other sources.

Source: McInnes IB, Mease PJ, Tanaka Y, et al. Efficacy and safety of bimekizumab in patients with psoriatic arthritis with or without methotrexate: 52-week results from two phase 3 studies. ACR Open Rheumatol. 2024 (Jul 30). Doi: 10.1002/acr2.11727 Source

Key clinical point: Bimekizumab demonstrated sustained efficacy and was well tolerated for 52 weeks, regardless of concomitant methotrexate use, in patients with psoriatic arthritis (PsA) who were biologic-naive or intolerant to tumor necrosis factor inhibitors (TNFi-IR).

Major finding: Through week 52, nearly half of the patients receiving bimekizumab with or without methotrexate achieved a ≥50% improvement in American College of Rheumatology response (biologic-naive ~55%; TNFi-IR ~48-56%) and minimal disease activity (biologic-naive ~55%; TNFi-IR ~47%). The rates of experiencing at least one treatment emergent adverse event were similar across the subgroups.

Study details: This post hoc analysis of phase 3 trials (BE OPTIMAL, BE COMPLETE, and BE VITAL) included biologic-naive (n = 852) or TNFi-IR (n = 400) patients with PsA who received bimekizumab, placebo with crossover to bimekizumab at week 16, or adalimumab, with or without methotrexate.

Disclosures: This study was funded by UCB Pharma and supported by the NIHR Manchester Biomedical Research Centre, UK. Two authors declared being employees of or holding stocks in UCB. Several authors declared having other ties with UCB and other sources.

Source: McInnes IB, Mease PJ, Tanaka Y, et al. Efficacy and safety of bimekizumab in patients with psoriatic arthritis with or without methotrexate: 52-week results from two phase 3 studies. ACR Open Rheumatol. 2024 (Jul 30). Doi: 10.1002/acr2.11727 Source

Key clinical point: Rimegepant was more effective than placebo in reducing pain and most bothersome symptoms in patients with moderate to severe migraine, while also showing favorable safety and tolerability.

Major findings: At 2 hours post dose, rimegepant was more effective than placebo in providing freedom from pain (risk difference 4.9; P = .0298) and the most bothersome symptoms (risk difference 8.9; P = .0016). Similar proportions of participants in the rimegepant vs placebo group experienced at least one adverse event (12.6% vs 10.7%), with nausea (0.9% vs 1.1%) and dizziness (0.7% vs 0.4%) being the most common adverse events.

Study details: This randomized, double-blind, placebo-controlled trial (Safety and Efficacy Study in Adult Subjects With Acute Migraines, NCT03235479)  included 1084 patients with migraine with or without aura who were randomly assigned to receive 75 mg rimegepant (n = 543) or placebo (n = 541).

Disclosures: This study was supported by Biohaven Pharmaceuticals (acquired by Pfizer, Inc.). Four authors declared being employees or stockholders of Biohaven Pharmaceuticals, Pfizer, or having other ties with various sources.

Source: Lipton RB, Thiry A, Morris BA, Croop R. Efficacy and safety of rimegepant 75 mg oral tablet, a CGRP receptor antagonist, for the acute treatment of migraine: A randomized, double-blind, placebo-controlled trial. J Pain Res. 2024;17:2431-2441 (Jul 22). Doi: 10.2147/JPR.S453806 Source

Key clinical point: Rimegepant was more effective than placebo in reducing pain and most bothersome symptoms in patients with moderate to severe migraine, while also showing favorable safety and tolerability.

Major findings: At 2 hours post dose, rimegepant was more effective than placebo in providing freedom from pain (risk difference 4.9; P = .0298) and the most bothersome symptoms (risk difference 8.9; P = .0016). Similar proportions of participants in the rimegepant vs placebo group experienced at least one adverse event (12.6% vs 10.7%), with nausea (0.9% vs 1.1%) and dizziness (0.7% vs 0.4%) being the most common adverse events.

Study details: This randomized, double-blind, placebo-controlled trial (Safety and Efficacy Study in Adult Subjects With Acute Migraines, NCT03235479)  included 1084 patients with migraine with or without aura who were randomly assigned to receive 75 mg rimegepant (n = 543) or placebo (n = 541).

Disclosures: This study was supported by Biohaven Pharmaceuticals (acquired by Pfizer, Inc.). Four authors declared being employees or stockholders of Biohaven Pharmaceuticals, Pfizer, or having other ties with various sources.

Source: Lipton RB, Thiry A, Morris BA, Croop R. Efficacy and safety of rimegepant 75 mg oral tablet, a CGRP receptor antagonist, for the acute treatment of migraine: A randomized, double-blind, placebo-controlled trial. J Pain Res. 2024;17:2431-2441 (Jul 22). Doi: 10.2147/JPR.S453806 Source

Key clinical point: Rimegepant was more effective than placebo in reducing pain and most bothersome symptoms in patients with moderate to severe migraine, while also showing favorable safety and tolerability.

Major findings: At 2 hours post dose, rimegepant was more effective than placebo in providing freedom from pain (risk difference 4.9; P = .0298) and the most bothersome symptoms (risk difference 8.9; P = .0016). Similar proportions of participants in the rimegepant vs placebo group experienced at least one adverse event (12.6% vs 10.7%), with nausea (0.9% vs 1.1%) and dizziness (0.7% vs 0.4%) being the most common adverse events.

Study details: This randomized, double-blind, placebo-controlled trial (Safety and Efficacy Study in Adult Subjects With Acute Migraines, NCT03235479)  included 1084 patients with migraine with or without aura who were randomly assigned to receive 75 mg rimegepant (n = 543) or placebo (n = 541).

Disclosures: This study was supported by Biohaven Pharmaceuticals (acquired by Pfizer, Inc.). Four authors declared being employees or stockholders of Biohaven Pharmaceuticals, Pfizer, or having other ties with various sources.

Source: Lipton RB, Thiry A, Morris BA, Croop R. Efficacy and safety of rimegepant 75 mg oral tablet, a CGRP receptor antagonist, for the acute treatment of migraine: A randomized, double-blind, placebo-controlled trial. J Pain Res. 2024;17:2431-2441 (Jul 22). Doi: 10.2147/JPR.S453806 Source

Key clinical point: This Mendelian randomization study showed that leisure screen time (LST) worsens migraine, whereas moderate to vigorous physical activity (MVPA) alleviates it, with hypertension and diastolic blood pressure (DBP) being responsible for the effects of MVPA or LST on migraine.

Major findings: Genetically predicted LST was associated with a significantly increased risk for migraine (odds ratio [OR] 1.28; P < .001), whereas MVPA was linked to a significantly reduced risk (OR 0.73; P = .000006). Hypertension mediated 4.86% and 24.81% of the effects of MVPA and LST on migraine risk, respectively, and DBP accounted for 4.66% of the effects of MVPA on migraine risk.

Study details: This study included 18,477 patients with migraine and 287,837 control individuals without migraine from the FinnGen consortium and 26,052 patients with migraine and 487,214 control individuals without migraine from the large-scale genome-wide association studies.

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

Source: Gan Q, Song E, Zhang L, et al. The role of hypertension in the relationship between leisure screen time, physical activity and migraine: A 2-sample Mendelian randomization study. J Headache Pain. 2024;25:122 (Jul 24). Doi: 10.1186/s10194-024-01820-4 Source

Key clinical point: This Mendelian randomization study showed that leisure screen time (LST) worsens migraine, whereas moderate to vigorous physical activity (MVPA) alleviates it, with hypertension and diastolic blood pressure (DBP) being responsible for the effects of MVPA or LST on migraine.

Major findings: Genetically predicted LST was associated with a significantly increased risk for migraine (odds ratio [OR] 1.28; P < .001), whereas MVPA was linked to a significantly reduced risk (OR 0.73; P = .000006). Hypertension mediated 4.86% and 24.81% of the effects of MVPA and LST on migraine risk, respectively, and DBP accounted for 4.66% of the effects of MVPA on migraine risk.

Study details: This study included 18,477 patients with migraine and 287,837 control individuals without migraine from the FinnGen consortium and 26,052 patients with migraine and 487,214 control individuals without migraine from the large-scale genome-wide association studies.

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

Source: Gan Q, Song E, Zhang L, et al. The role of hypertension in the relationship between leisure screen time, physical activity and migraine: A 2-sample Mendelian randomization study. J Headache Pain. 2024;25:122 (Jul 24). Doi: 10.1186/s10194-024-01820-4 Source

Key clinical point: This Mendelian randomization study showed that leisure screen time (LST) worsens migraine, whereas moderate to vigorous physical activity (MVPA) alleviates it, with hypertension and diastolic blood pressure (DBP) being responsible for the effects of MVPA or LST on migraine.

Major findings: Genetically predicted LST was associated with a significantly increased risk for migraine (odds ratio [OR] 1.28; P < .001), whereas MVPA was linked to a significantly reduced risk (OR 0.73; P = .000006). Hypertension mediated 4.86% and 24.81% of the effects of MVPA and LST on migraine risk, respectively, and DBP accounted for 4.66% of the effects of MVPA on migraine risk.

Study details: This study included 18,477 patients with migraine and 287,837 control individuals without migraine from the FinnGen consortium and 26,052 patients with migraine and 487,214 control individuals without migraine from the large-scale genome-wide association studies.

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

Source: Gan Q, Song E, Zhang L, et al. The role of hypertension in the relationship between leisure screen time, physical activity and migraine: A 2-sample Mendelian randomization study. J Headache Pain. 2024;25:122 (Jul 24). Doi: 10.1186/s10194-024-01820-4 Source

Key clinical point: The meta-analysis showed that atogepant was effective and well tolerated in patients with migraine in a non–dose-dependent manner, with rare incidences of serious treatment-emergent adverse events (TEAE) reported.

Major findings: Atogepant vs placebo led to a significant reduction in monthly migraine days (standardized mean difference [SMD] −0.40; P = .00001) and headache days (SMD −0.39; P = .00001), with consistent results observed across all dosage groups. The risk for TEAE (relative risk [RR] 1.11; P = .02) was significantly higher in the atogepant vs placebo group, with constipation (RR 2.55; P < .00001), nausea (RR 2.19; P < .00001), and urinary tract infection (RR 1.49; P = .03) being the most common.

Study details: This meta-analysis of four randomized controlled trials included 2813 patients with migraine who were treated with atogepant (10 mg, 30 mg, or 60 mg).

Disclosures: This study was supported by the Chongqing Clinical Pharmacy Key Specialties Construction Project, China. The authors declared no conflicts of interest.

Source: Hou M, Luo X, He S, et al. Efficacy and safety of atogepant, a small molecule CGRP receptor antagonist, for the preventive treatment of migraine: A systematic review and meta-analysis. J Headache Pain. 2024;25:116 (Jul 19). Doi: 10.1186/s10194-024-01822-2 Source

Key clinical point: The meta-analysis showed that atogepant was effective and well tolerated in patients with migraine in a non–dose-dependent manner, with rare incidences of serious treatment-emergent adverse events (TEAE) reported.

Major findings: Atogepant vs placebo led to a significant reduction in monthly migraine days (standardized mean difference [SMD] −0.40; P = .00001) and headache days (SMD −0.39; P = .00001), with consistent results observed across all dosage groups. The risk for TEAE (relative risk [RR] 1.11; P = .02) was significantly higher in the atogepant vs placebo group, with constipation (RR 2.55; P < .00001), nausea (RR 2.19; P < .00001), and urinary tract infection (RR 1.49; P = .03) being the most common.

Study details: This meta-analysis of four randomized controlled trials included 2813 patients with migraine who were treated with atogepant (10 mg, 30 mg, or 60 mg).

Disclosures: This study was supported by the Chongqing Clinical Pharmacy Key Specialties Construction Project, China. The authors declared no conflicts of interest.

Source: Hou M, Luo X, He S, et al. Efficacy and safety of atogepant, a small molecule CGRP receptor antagonist, for the preventive treatment of migraine: A systematic review and meta-analysis. J Headache Pain. 2024;25:116 (Jul 19). Doi: 10.1186/s10194-024-01822-2 Source

Key clinical point: The meta-analysis showed that atogepant was effective and well tolerated in patients with migraine in a non–dose-dependent manner, with rare incidences of serious treatment-emergent adverse events (TEAE) reported.

Major findings: Atogepant vs placebo led to a significant reduction in monthly migraine days (standardized mean difference [SMD] −0.40; P = .00001) and headache days (SMD −0.39; P = .00001), with consistent results observed across all dosage groups. The risk for TEAE (relative risk [RR] 1.11; P = .02) was significantly higher in the atogepant vs placebo group, with constipation (RR 2.55; P < .00001), nausea (RR 2.19; P < .00001), and urinary tract infection (RR 1.49; P = .03) being the most common.

Study details: This meta-analysis of four randomized controlled trials included 2813 patients with migraine who were treated with atogepant (10 mg, 30 mg, or 60 mg).

Disclosures: This study was supported by the Chongqing Clinical Pharmacy Key Specialties Construction Project, China. The authors declared no conflicts of interest.

Source: Hou M, Luo X, He S, et al. Efficacy and safety of atogepant, a small molecule CGRP receptor antagonist, for the preventive treatment of migraine: A systematic review and meta-analysis. J Headache Pain. 2024;25:116 (Jul 19). Doi: 10.1186/s10194-024-01822-2 Source

Key clinical point: The presence of migraine aura exacerbated migraine-related disability, mainly due to concurrent non-pain symptoms of migraine rather than the aura itself.

Major findings: The presence of aura on the first day of the migraine episode was significantly associated with increased odds of disability across all migraine days (odds ratio [OR] 1.40; P < .001); and non-pain symptoms, such as allodynia, photophobia, phonophobia, and nausea or vomiting (P < .001 for all). No association was observed between aura and headache-related migraine symptoms.

Study details: This observational prospective cohort study included 554 adults with episodic migraine, with complete data on migraine symptoms and psychological variables collected daily for 90 days using the N-1 Headache™ digital app (N = 11,156 total migraine days).

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

Source: Denney DE, Lee AA, Landy SH, Smitherman TA. Headache-related disability as a function of migraine aura: A daily diary study. Headache. 2024 (Aug 1). Doi: 10.1111/head.14796 Source

Key clinical point: The presence of migraine aura exacerbated migraine-related disability, mainly due to concurrent non-pain symptoms of migraine rather than the aura itself.

Major findings: The presence of aura on the first day of the migraine episode was significantly associated with increased odds of disability across all migraine days (odds ratio [OR] 1.40; P < .001); and non-pain symptoms, such as allodynia, photophobia, phonophobia, and nausea or vomiting (P < .001 for all). No association was observed between aura and headache-related migraine symptoms.

Study details: This observational prospective cohort study included 554 adults with episodic migraine, with complete data on migraine symptoms and psychological variables collected daily for 90 days using the N-1 Headache™ digital app (N = 11,156 total migraine days).

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

Source: Denney DE, Lee AA, Landy SH, Smitherman TA. Headache-related disability as a function of migraine aura: A daily diary study. Headache. 2024 (Aug 1). Doi: 10.1111/head.14796 Source

Key clinical point: The presence of migraine aura exacerbated migraine-related disability, mainly due to concurrent non-pain symptoms of migraine rather than the aura itself.

Major findings: The presence of aura on the first day of the migraine episode was significantly associated with increased odds of disability across all migraine days (odds ratio [OR] 1.40; P < .001); and non-pain symptoms, such as allodynia, photophobia, phonophobia, and nausea or vomiting (P < .001 for all). No association was observed between aura and headache-related migraine symptoms.

Study details: This observational prospective cohort study included 554 adults with episodic migraine, with complete data on migraine symptoms and psychological variables collected daily for 90 days using the N-1 Headache™ digital app (N = 11,156 total migraine days).

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

Source: Denney DE, Lee AA, Landy SH, Smitherman TA. Headache-related disability as a function of migraine aura: A daily diary study. Headache. 2024 (Aug 1). Doi: 10.1111/head.14796 Source