Headache & Migraine

TOPLINE:

Migraine is associated with a significantly increased risk of developing inflammatory bowel disease (IBD), including both Crohn’s disease (CD) and ulcerative colitis (UC), a new nationwide, population-based cohort study showed.

METHODOLOGY:

• Investigators analyzed data from South Korea’s National Health Insurance Service (NHIS) database, which houses data for the nationwide obligatory health system for South Korean citizens.
• Individuals aged ≥ 20 years who had at least one national health screening in 2009 were enrolled in the study and followed until December 2019.
• Investigators searched the data for International Classification of Diseases (10th Revision) codes corresponding to migraine and IBD. IBD diagnoses were also based on clinical manifestation, endoscopic findings, and pathologic findings.

TAKEAWAY:

• More than 10 million people were enrolled in the study (55% male; mean age, 47 years), and of these, 2.8% were diagnosed with migraine during the study period.
• During a median follow-up of 10 years, the incidence of IBD was significantly higher in patients with migraine (adjusted hazard ratio [aHR], 1.31; P < .001), CD (aHR, 1.58; P < .001) and UC (aHR, 1.26; P < .001) than in those without migraine.
• in men vs women (aHR, 1.43 vs 1.12; P = .042).
• Investigators could only speculate about the mechanisms underlying the association between migraine and IBD but suggest pathological processes underlying both migraine and IBD, including proinflammatory cytokines and tumor necrosis factor alpha, may be involved.

IN PRACTICE:

“Clinicians should be aware of the potential risk of IBD in patients diagnosed with migraine especially in men for the development of UC and in migraineurs with a long disease duration for a further risk of CD,” the authors wrote.

SOURCE:

Hyunjung Lee, MD, of Seoul National University College of Medicine, Seoul, South Korea, led the study, which was published online on January 12, 2024, in Scientific Reports.

LIMITATIONS:

Disease severity of migraine and IBD was not available. In addition, certain medications taken to relieve migraine, such as nonsteroidal anti-inflammatory drugs like ibuprofen, could cause intestinal inflammation, but there was no medication information available.

DISCLOSURES:

There was no information about study funding nor disclosures from study authors.
 

A version of this article appeared on Medscape.com.

TOPLINE:

Migraine is associated with a significantly increased risk of developing inflammatory bowel disease (IBD), including both Crohn’s disease (CD) and ulcerative colitis (UC), a new nationwide, population-based cohort study showed.

METHODOLOGY:

• Investigators analyzed data from South Korea’s National Health Insurance Service (NHIS) database, which houses data for the nationwide obligatory health system for South Korean citizens.
• Individuals aged ≥ 20 years who had at least one national health screening in 2009 were enrolled in the study and followed until December 2019.
• Investigators searched the data for International Classification of Diseases (10th Revision) codes corresponding to migraine and IBD. IBD diagnoses were also based on clinical manifestation, endoscopic findings, and pathologic findings.

TAKEAWAY:

• More than 10 million people were enrolled in the study (55% male; mean age, 47 years), and of these, 2.8% were diagnosed with migraine during the study period.
• During a median follow-up of 10 years, the incidence of IBD was significantly higher in patients with migraine (adjusted hazard ratio [aHR], 1.31; P < .001), CD (aHR, 1.58; P < .001) and UC (aHR, 1.26; P < .001) than in those without migraine.
• in men vs women (aHR, 1.43 vs 1.12; P = .042).
• Investigators could only speculate about the mechanisms underlying the association between migraine and IBD but suggest pathological processes underlying both migraine and IBD, including proinflammatory cytokines and tumor necrosis factor alpha, may be involved.

IN PRACTICE:

“Clinicians should be aware of the potential risk of IBD in patients diagnosed with migraine especially in men for the development of UC and in migraineurs with a long disease duration for a further risk of CD,” the authors wrote.

SOURCE:

Hyunjung Lee, MD, of Seoul National University College of Medicine, Seoul, South Korea, led the study, which was published online on January 12, 2024, in Scientific Reports.

LIMITATIONS:

Disease severity of migraine and IBD was not available. In addition, certain medications taken to relieve migraine, such as nonsteroidal anti-inflammatory drugs like ibuprofen, could cause intestinal inflammation, but there was no medication information available.

DISCLOSURES:

There was no information about study funding nor disclosures from study authors.
 

A version of this article appeared on Medscape.com.

TOPLINE:

Migraine is associated with a significantly increased risk of developing inflammatory bowel disease (IBD), including both Crohn’s disease (CD) and ulcerative colitis (UC), a new nationwide, population-based cohort study showed.

METHODOLOGY:

• Investigators analyzed data from South Korea’s National Health Insurance Service (NHIS) database, which houses data for the nationwide obligatory health system for South Korean citizens.
• Individuals aged ≥ 20 years who had at least one national health screening in 2009 were enrolled in the study and followed until December 2019.
• Investigators searched the data for International Classification of Diseases (10th Revision) codes corresponding to migraine and IBD. IBD diagnoses were also based on clinical manifestation, endoscopic findings, and pathologic findings.

TAKEAWAY:

• More than 10 million people were enrolled in the study (55% male; mean age, 47 years), and of these, 2.8% were diagnosed with migraine during the study period.
• During a median follow-up of 10 years, the incidence of IBD was significantly higher in patients with migraine (adjusted hazard ratio [aHR], 1.31; P < .001), CD (aHR, 1.58; P < .001) and UC (aHR, 1.26; P < .001) than in those without migraine.
• in men vs women (aHR, 1.43 vs 1.12; P = .042).
• Investigators could only speculate about the mechanisms underlying the association between migraine and IBD but suggest pathological processes underlying both migraine and IBD, including proinflammatory cytokines and tumor necrosis factor alpha, may be involved.

IN PRACTICE:

“Clinicians should be aware of the potential risk of IBD in patients diagnosed with migraine especially in men for the development of UC and in migraineurs with a long disease duration for a further risk of CD,” the authors wrote.

SOURCE:

Hyunjung Lee, MD, of Seoul National University College of Medicine, Seoul, South Korea, led the study, which was published online on January 12, 2024, in Scientific Reports.

LIMITATIONS:

Disease severity of migraine and IBD was not available. In addition, certain medications taken to relieve migraine, such as nonsteroidal anti-inflammatory drugs like ibuprofen, could cause intestinal inflammation, but there was no medication information available.

DISCLOSURES:

There was no information about study funding nor disclosures from study authors.
 

A version of this article appeared on Medscape.com.

Key clinical point: Patients with migraine initiating calcitonin gene-related peptide (CGRP) monoclonal antibody treatment with galcanezumab showed higher treatment persistence, lower treatment discontinuation, and similar adherence compared with those initiating fremanezumab or erenumab.

Major finding: Compared with fremanezumab, galcanezumab initiators showed higher rates of treatment persistence (P = .001) and lower treatment discontinuation (P = .005). Compared with erenumab, galcanezumab initiators had lower treatment discontinuation (P = .040). Patient adherence was similar among those who initiated galcanezumab vs fremanezumab or erenumab.

Study details: This retrospective real-world study included patients with migraine initiating galcanezumab treatment who were matched with those initiating fremanezumab (n = 2674) or erenumab (n = 3503) treatment using propensity score matching.

Disclosures: This study was funded by Eli Lilly and Company. The authors declared no conflicts of interest.

Source: Varnado OJ et al. Comparison of treatment patterns in patients with migraine initiating calcitonin gene-related peptide monoclonal antibodies: A Retrospective Real-World US Study. Patient Preference and Adherence. 2024;18:69-88 (Jan 9). doi: 10.2147/PPA.S437396

Key clinical point: Patients with migraine initiating calcitonin gene-related peptide (CGRP) monoclonal antibody treatment with galcanezumab showed higher treatment persistence, lower treatment discontinuation, and similar adherence compared with those initiating fremanezumab or erenumab.

Major finding: Compared with fremanezumab, galcanezumab initiators showed higher rates of treatment persistence (P = .001) and lower treatment discontinuation (P = .005). Compared with erenumab, galcanezumab initiators had lower treatment discontinuation (P = .040). Patient adherence was similar among those who initiated galcanezumab vs fremanezumab or erenumab.

Study details: This retrospective real-world study included patients with migraine initiating galcanezumab treatment who were matched with those initiating fremanezumab (n = 2674) or erenumab (n = 3503) treatment using propensity score matching.

Disclosures: This study was funded by Eli Lilly and Company. The authors declared no conflicts of interest.

Source: Varnado OJ et al. Comparison of treatment patterns in patients with migraine initiating calcitonin gene-related peptide monoclonal antibodies: A Retrospective Real-World US Study. Patient Preference and Adherence. 2024;18:69-88 (Jan 9). doi: 10.2147/PPA.S437396

Key clinical point: Patients with migraine initiating calcitonin gene-related peptide (CGRP) monoclonal antibody treatment with galcanezumab showed higher treatment persistence, lower treatment discontinuation, and similar adherence compared with those initiating fremanezumab or erenumab.

Major finding: Compared with fremanezumab, galcanezumab initiators showed higher rates of treatment persistence (P = .001) and lower treatment discontinuation (P = .005). Compared with erenumab, galcanezumab initiators had lower treatment discontinuation (P = .040). Patient adherence was similar among those who initiated galcanezumab vs fremanezumab or erenumab.

Study details: This retrospective real-world study included patients with migraine initiating galcanezumab treatment who were matched with those initiating fremanezumab (n = 2674) or erenumab (n = 3503) treatment using propensity score matching.

Disclosures: This study was funded by Eli Lilly and Company. The authors declared no conflicts of interest.

Source: Varnado OJ et al. Comparison of treatment patterns in patients with migraine initiating calcitonin gene-related peptide monoclonal antibodies: A Retrospective Real-World US Study. Patient Preference and Adherence. 2024;18:69-88 (Jan 9). doi: 10.2147/PPA.S437396

Key clinical point: Patients with episodic migraine without aura (EMoA) presented a higher delayed discounting rate, which was positively associated with the migraine history.

Major finding: Patients with EMoA vs control individuals showed a significantly higher subjective discount rate (F = 4.74; P = .032), which was positively correlated with migraine history (r = 0.742; P < .001). The resting-state functional connectivity between the left ventral striatum and middle occipital gyrus was significantly associated with migraine history (r′ = 0.294; P = .036) and subjective discount rate (r′ = 0.380; P = .006).

Study details: This study included 51 patients with EMoA and 45 control individuals who underwent task-based and multi-model magnetic resonance imaging.

Disclosures: This study was supported by the National Natural Science Foundation of China, Foundation for the Cultivation of Doctoral Research Talents, and the 2021 Youth Foundation Training Program of the First Affiliated Hospital of Anhui Medical University. The authors declared no conflicts of interest.

Source: Wang L et al. Patients with episodic migraine without aura have an increased rate of delayed discounting. Brain Behav. 2024;14(1):e3367 (Jan 2). doi: 10.1002/brb3.3367

Key clinical point: Patients with episodic migraine without aura (EMoA) presented a higher delayed discounting rate, which was positively associated with the migraine history.

Major finding: Patients with EMoA vs control individuals showed a significantly higher subjective discount rate (F = 4.74; P = .032), which was positively correlated with migraine history (r = 0.742; P < .001). The resting-state functional connectivity between the left ventral striatum and middle occipital gyrus was significantly associated with migraine history (r′ = 0.294; P = .036) and subjective discount rate (r′ = 0.380; P = .006).

Study details: This study included 51 patients with EMoA and 45 control individuals who underwent task-based and multi-model magnetic resonance imaging.

Disclosures: This study was supported by the National Natural Science Foundation of China, Foundation for the Cultivation of Doctoral Research Talents, and the 2021 Youth Foundation Training Program of the First Affiliated Hospital of Anhui Medical University. The authors declared no conflicts of interest.

Source: Wang L et al. Patients with episodic migraine without aura have an increased rate of delayed discounting. Brain Behav. 2024;14(1):e3367 (Jan 2). doi: 10.1002/brb3.3367

Key clinical point: Patients with episodic migraine without aura (EMoA) presented a higher delayed discounting rate, which was positively associated with the migraine history.

Major finding: Patients with EMoA vs control individuals showed a significantly higher subjective discount rate (F = 4.74; P = .032), which was positively correlated with migraine history (r = 0.742; P < .001). The resting-state functional connectivity between the left ventral striatum and middle occipital gyrus was significantly associated with migraine history (r′ = 0.294; P = .036) and subjective discount rate (r′ = 0.380; P = .006).

Study details: This study included 51 patients with EMoA and 45 control individuals who underwent task-based and multi-model magnetic resonance imaging.

Disclosures: This study was supported by the National Natural Science Foundation of China, Foundation for the Cultivation of Doctoral Research Talents, and the 2021 Youth Foundation Training Program of the First Affiliated Hospital of Anhui Medical University. The authors declared no conflicts of interest.

Source: Wang L et al. Patients with episodic migraine without aura have an increased rate of delayed discounting. Brain Behav. 2024;14(1):e3367 (Jan 2). doi: 10.1002/brb3.3367

Key clinical point: Patients with migraine have increased risk for incident Parkinson's disease (PD), with younger age and underlying dyslipidemia aggravating the risk for PD among women and men with migraine, respectively.

Major finding: The risk of incident PD was 1.35-fold (adjusted hazard ratio 1.35; 95% CI 1.29-1.41) higher in patients with vs without migraine, with the risk of PD being significantly higher among younger vs older women (age < 65 years vs ≥ 65 years; P = .038) and men with vs without dyslipidemia (P = .012).

Study details: This retrospective, nationwide, population-based cohort study included 214,193 individuals with migraine and 5,879,711 individuals without migraine, of whom 1973 (0.92%) and 30,664 (0.52%) individuals with and without migraine, respectively, were diagnosed with PD.

Disclosures: This research was supported by a grant from the National Research Foundation, Technology Development Program, and Technology Innovation Program. Korea. The authors declared no conflicts of interest.

Source: Ha WS et al. The association between migraine and Parkinson's disease: A nationwide cohort study. Epidemiol Health. 2023 (Dec 18). doi: 10.4178/epih.e2024010

Key clinical point: Patients with migraine have increased risk for incident Parkinson's disease (PD), with younger age and underlying dyslipidemia aggravating the risk for PD among women and men with migraine, respectively.

Major finding: The risk of incident PD was 1.35-fold (adjusted hazard ratio 1.35; 95% CI 1.29-1.41) higher in patients with vs without migraine, with the risk of PD being significantly higher among younger vs older women (age < 65 years vs ≥ 65 years; P = .038) and men with vs without dyslipidemia (P = .012).

Study details: This retrospective, nationwide, population-based cohort study included 214,193 individuals with migraine and 5,879,711 individuals without migraine, of whom 1973 (0.92%) and 30,664 (0.52%) individuals with and without migraine, respectively, were diagnosed with PD.

Disclosures: This research was supported by a grant from the National Research Foundation, Technology Development Program, and Technology Innovation Program. Korea. The authors declared no conflicts of interest.

Source: Ha WS et al. The association between migraine and Parkinson's disease: A nationwide cohort study. Epidemiol Health. 2023 (Dec 18). doi: 10.4178/epih.e2024010

Key clinical point: Patients with migraine have increased risk for incident Parkinson's disease (PD), with younger age and underlying dyslipidemia aggravating the risk for PD among women and men with migraine, respectively.

Major finding: The risk of incident PD was 1.35-fold (adjusted hazard ratio 1.35; 95% CI 1.29-1.41) higher in patients with vs without migraine, with the risk of PD being significantly higher among younger vs older women (age < 65 years vs ≥ 65 years; P = .038) and men with vs without dyslipidemia (P = .012).

Study details: This retrospective, nationwide, population-based cohort study included 214,193 individuals with migraine and 5,879,711 individuals without migraine, of whom 1973 (0.92%) and 30,664 (0.52%) individuals with and without migraine, respectively, were diagnosed with PD.

Disclosures: This research was supported by a grant from the National Research Foundation, Technology Development Program, and Technology Innovation Program. Korea. The authors declared no conflicts of interest.

Source: Ha WS et al. The association between migraine and Parkinson's disease: A nationwide cohort study. Epidemiol Health. 2023 (Dec 18). doi: 10.4178/epih.e2024010

Key clinical point: In this meta-analysis, migraine was more frequent among patients with vs without epilepsy and epilepsy was more frequent among patients with vs without migraine, highlighting a co-morbid association between migraine and epilepsy.

Major finding: The lifetime prevalence of migraine was 80% higher in patients with epilepsy compared with those without epilepsy (odds ratio [OR]/relative risk [RR] 1.80; P < .001). Similarly, the lifetime prevalence of epilepsy was 80% higher in patients with migraine compared with those without migraine (OR/RR 1.80; P < .001).

Study details: The data come from a meta-analysis of 13 studies that evaluated the association between migraine and epilepsy.

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

Source: Wu X and Zhuang J. Association between migraine and epilepsy: A meta-analysis. Front Neurol. 2024;14:1276663 (Jan 5). doi: 10.3389/fneur.2023.1276663

Key clinical point: In this meta-analysis, migraine was more frequent among patients with vs without epilepsy and epilepsy was more frequent among patients with vs without migraine, highlighting a co-morbid association between migraine and epilepsy.

Major finding: The lifetime prevalence of migraine was 80% higher in patients with epilepsy compared with those without epilepsy (odds ratio [OR]/relative risk [RR] 1.80; P < .001). Similarly, the lifetime prevalence of epilepsy was 80% higher in patients with migraine compared with those without migraine (OR/RR 1.80; P < .001).

Study details: The data come from a meta-analysis of 13 studies that evaluated the association between migraine and epilepsy.

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

Source: Wu X and Zhuang J. Association between migraine and epilepsy: A meta-analysis. Front Neurol. 2024;14:1276663 (Jan 5). doi: 10.3389/fneur.2023.1276663

Key clinical point: In this meta-analysis, migraine was more frequent among patients with vs without epilepsy and epilepsy was more frequent among patients with vs without migraine, highlighting a co-morbid association between migraine and epilepsy.

Major finding: The lifetime prevalence of migraine was 80% higher in patients with epilepsy compared with those without epilepsy (odds ratio [OR]/relative risk [RR] 1.80; P < .001). Similarly, the lifetime prevalence of epilepsy was 80% higher in patients with migraine compared with those without migraine (OR/RR 1.80; P < .001).

Study details: The data come from a meta-analysis of 13 studies that evaluated the association between migraine and epilepsy.

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

Source: Wu X and Zhuang J. Association between migraine and epilepsy: A meta-analysis. Front Neurol. 2024;14:1276663 (Jan 5). doi: 10.3389/fneur.2023.1276663

Key clinical point: Erenumab demonstrated a more favorable efficacy profile than rimegepant for the prevention of episodic and chronic migraine.

Major finding: Compared with 75 mg rimegepant, 70 mg erenumab significantly reduced monthly migraine days (MMD) by 0.90 days at 3 months (P = .042) and 140 mg erenumab significantly reduced MMD by 0.94 (P = .014) and 1.28 (P = .005) days at 1 month and 3 months, respectively. Erenumab showed advantages over rimegepant in improving Migraine-Specific Quality-of-life role function-restrictive domain and Migraine Disability Assessment scores (MIDAS) at 3 months.

Study details: This study performed anchored matching-adjusted indirect comparison of the relative efficacy of two erenumab regimens (70 mg and 140 mg) with rimegepant (75 mg) for migraine prevention using data from two phase 2/3 trials for erenumab (295 and STRIVE) and a phase 2/3 trial for rimegepant.

Disclosures: This study was funded by Novartis Healthcare Pvt. Ltd. Several authors declared being employees of and holding stocks or stock options in Novartis.

Source: Mahon R et al. Comparative effectiveness of erenumab versus rimegepant for migraine prevention using matching-adjusted indirect comparison. J Comp Eff Res. 2024 (Jan 4). doi: 10.57264/cer-2023-0122

Key clinical point: Erenumab demonstrated a more favorable efficacy profile than rimegepant for the prevention of episodic and chronic migraine.

Major finding: Compared with 75 mg rimegepant, 70 mg erenumab significantly reduced monthly migraine days (MMD) by 0.90 days at 3 months (P = .042) and 140 mg erenumab significantly reduced MMD by 0.94 (P = .014) and 1.28 (P = .005) days at 1 month and 3 months, respectively. Erenumab showed advantages over rimegepant in improving Migraine-Specific Quality-of-life role function-restrictive domain and Migraine Disability Assessment scores (MIDAS) at 3 months.

Study details: This study performed anchored matching-adjusted indirect comparison of the relative efficacy of two erenumab regimens (70 mg and 140 mg) with rimegepant (75 mg) for migraine prevention using data from two phase 2/3 trials for erenumab (295 and STRIVE) and a phase 2/3 trial for rimegepant.

Disclosures: This study was funded by Novartis Healthcare Pvt. Ltd. Several authors declared being employees of and holding stocks or stock options in Novartis.

Source: Mahon R et al. Comparative effectiveness of erenumab versus rimegepant for migraine prevention using matching-adjusted indirect comparison. J Comp Eff Res. 2024 (Jan 4). doi: 10.57264/cer-2023-0122

Key clinical point: Erenumab demonstrated a more favorable efficacy profile than rimegepant for the prevention of episodic and chronic migraine.

Major finding: Compared with 75 mg rimegepant, 70 mg erenumab significantly reduced monthly migraine days (MMD) by 0.90 days at 3 months (P = .042) and 140 mg erenumab significantly reduced MMD by 0.94 (P = .014) and 1.28 (P = .005) days at 1 month and 3 months, respectively. Erenumab showed advantages over rimegepant in improving Migraine-Specific Quality-of-life role function-restrictive domain and Migraine Disability Assessment scores (MIDAS) at 3 months.

Study details: This study performed anchored matching-adjusted indirect comparison of the relative efficacy of two erenumab regimens (70 mg and 140 mg) with rimegepant (75 mg) for migraine prevention using data from two phase 2/3 trials for erenumab (295 and STRIVE) and a phase 2/3 trial for rimegepant.

Disclosures: This study was funded by Novartis Healthcare Pvt. Ltd. Several authors declared being employees of and holding stocks or stock options in Novartis.

Source: Mahon R et al. Comparative effectiveness of erenumab versus rimegepant for migraine prevention using matching-adjusted indirect comparison. J Comp Eff Res. 2024 (Jan 4). doi: 10.57264/cer-2023-0122

Key clinical point: Monoclonal antibodies targeting the anti-calcitonin gene-related peptide (CGRP) showed persistent and comparable outcomes within a real-world cohort of patients with migraine leading to a reduction in migraine days per month (MDM) among responders with large effect sizes; however, the response was influenced by genetic factors.

Major finding: Patients responding to anti-CGRP monoclonal antibodies demonstrated persistent reduction in MDM (usually ≥50% reduction from baseline) at first (η² = 0.26) and second (η² = 0.22) follow-up, with all treatments showing similar effects and large effect sizes. Non-responders vs responders had a lower mean genetic risk score (P = .041) without any difference in polygenic risk score.

Study details: This retrospective clinical and genetic study included 481 patients with migraine who were prescribed preventive erenumab (n = 166), galcanezumab (n = 164), or fremanezumab (n = 151).

Disclosures: This study was funded by the US Agency for Healthcare Research and Quality. S Meyers declared serving on the speakers’ bureau for Biohaven Pharmaceuticals and Allergan.

Source: Chase BA et al. Characteristics associated with response to subcutaneously administered anti-CGRP monoclonal antibody medications in a real-world community cohort of persons living with migraine: A retrospective clinical and genetic study. Headache. 2023 (Dec 10). doi:

Key clinical point: Monoclonal antibodies targeting the anti-calcitonin gene-related peptide (CGRP) showed persistent and comparable outcomes within a real-world cohort of patients with migraine leading to a reduction in migraine days per month (MDM) among responders with large effect sizes; however, the response was influenced by genetic factors.

Major finding: Patients responding to anti-CGRP monoclonal antibodies demonstrated persistent reduction in MDM (usually ≥50% reduction from baseline) at first (η² = 0.26) and second (η² = 0.22) follow-up, with all treatments showing similar effects and large effect sizes. Non-responders vs responders had a lower mean genetic risk score (P = .041) without any difference in polygenic risk score.

Study details: This retrospective clinical and genetic study included 481 patients with migraine who were prescribed preventive erenumab (n = 166), galcanezumab (n = 164), or fremanezumab (n = 151).

Disclosures: This study was funded by the US Agency for Healthcare Research and Quality. S Meyers declared serving on the speakers’ bureau for Biohaven Pharmaceuticals and Allergan.

Source: Chase BA et al. Characteristics associated with response to subcutaneously administered anti-CGRP monoclonal antibody medications in a real-world community cohort of persons living with migraine: A retrospective clinical and genetic study. Headache. 2023 (Dec 10). doi:

Key clinical point: Monoclonal antibodies targeting the anti-calcitonin gene-related peptide (CGRP) showed persistent and comparable outcomes within a real-world cohort of patients with migraine leading to a reduction in migraine days per month (MDM) among responders with large effect sizes; however, the response was influenced by genetic factors.

Major finding: Patients responding to anti-CGRP monoclonal antibodies demonstrated persistent reduction in MDM (usually ≥50% reduction from baseline) at first (η² = 0.26) and second (η² = 0.22) follow-up, with all treatments showing similar effects and large effect sizes. Non-responders vs responders had a lower mean genetic risk score (P = .041) without any difference in polygenic risk score.

Study details: This retrospective clinical and genetic study included 481 patients with migraine who were prescribed preventive erenumab (n = 166), galcanezumab (n = 164), or fremanezumab (n = 151).

Disclosures: This study was funded by the US Agency for Healthcare Research and Quality. S Meyers declared serving on the speakers’ bureau for Biohaven Pharmaceuticals and Allergan.

Source: Chase BA et al. Characteristics associated with response to subcutaneously administered anti-CGRP monoclonal antibody medications in a real-world community cohort of persons living with migraine: A retrospective clinical and genetic study. Headache. 2023 (Dec 10). doi:

Key clinical point: Agomelatine appeared to be an effective preventive treatment for episodic migraine without aura.

Major finding: After 3 months of treatment, patients receiving agomelatine vs placebo had significant reduction in headache frequency (4.8 vs 5.82; P = .009) and severity (─4.1 vs ─0.71; P < .001), mean monthly migraine days (8.86 vs 10.63; P = .025), and Migraine Disability Assessment Score (MIDAS; ─1.06 vs ─0.36; P < .001).

Study details: Findings are from a parallel randomized controlled trial that included 99 patients with episodic migraine without aura who were randomly assigned to receive either agomelatine (n = 49) or placebo (vitamin B₁ tablets; n = 50).

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

Source: Farzin K et al. The effectiveness of agomelatine on headache severity and frequency in episodic migraine without aura; a parallel randomized controlled trial study. BMC Neurol. 2024;24:2 (Jan 2). doi: 10.1186/s12883-023-03516-9

Key clinical point: Agomelatine appeared to be an effective preventive treatment for episodic migraine without aura.

Major finding: After 3 months of treatment, patients receiving agomelatine vs placebo had significant reduction in headache frequency (4.8 vs 5.82; P = .009) and severity (─4.1 vs ─0.71; P < .001), mean monthly migraine days (8.86 vs 10.63; P = .025), and Migraine Disability Assessment Score (MIDAS; ─1.06 vs ─0.36; P < .001).

Study details: Findings are from a parallel randomized controlled trial that included 99 patients with episodic migraine without aura who were randomly assigned to receive either agomelatine (n = 49) or placebo (vitamin B₁ tablets; n = 50).

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

Source: Farzin K et al. The effectiveness of agomelatine on headache severity and frequency in episodic migraine without aura; a parallel randomized controlled trial study. BMC Neurol. 2024;24:2 (Jan 2). doi: 10.1186/s12883-023-03516-9

Key clinical point: Agomelatine appeared to be an effective preventive treatment for episodic migraine without aura.

Major finding: After 3 months of treatment, patients receiving agomelatine vs placebo had significant reduction in headache frequency (4.8 vs 5.82; P = .009) and severity (─4.1 vs ─0.71; P < .001), mean monthly migraine days (8.86 vs 10.63; P = .025), and Migraine Disability Assessment Score (MIDAS; ─1.06 vs ─0.36; P < .001).

Study details: Findings are from a parallel randomized controlled trial that included 99 patients with episodic migraine without aura who were randomly assigned to receive either agomelatine (n = 49) or placebo (vitamin B₁ tablets; n = 50).

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

Source: Farzin K et al. The effectiveness of agomelatine on headache severity and frequency in episodic migraine without aura; a parallel randomized controlled trial study. BMC Neurol. 2024;24:2 (Jan 2). doi: 10.1186/s12883-023-03516-9

Key clinical point: Gut microbiota may have a potential casual association with migraine symptoms, with evidence indicating a connection between gut microbiota and increased or decreased risk for migraine.

Major finding: A higher abundance of genus Lactobacillus (inverse variance weighted [IVW] odds ratio [OR] 1.10; P = .004) and family Prevotellaceae (IVW OR 0.89; P = .02) were causally associated with a higher and lower risk for migraine, respectively.

Study details: This study used a two-sample Mendelian randomization framework to assess the causal effects of gut microbiota on migraine risk using 2651 single nucleotide polymorphisms as instrumental variables. Large-scale genome-wide association studies consisting of 18,340 participants from 24 cohorts provided the summary-level statistics for gut microbiota.

Disclosures: This study was funded by the National Key Research and Development Program. The authors declared no conflicts of interest.

Source: Meng X et al. Exploring the role of gut microbiota in migraine risk: A two-sample Mendelian randomization study. Scand J Gastroenterol. 2023 (Dec 27). doi: 10.1080/00365521.2023.2298370

Key clinical point: Gut microbiota may have a potential casual association with migraine symptoms, with evidence indicating a connection between gut microbiota and increased or decreased risk for migraine.

Major finding: A higher abundance of genus Lactobacillus (inverse variance weighted [IVW] odds ratio [OR] 1.10; P = .004) and family Prevotellaceae (IVW OR 0.89; P = .02) were causally associated with a higher and lower risk for migraine, respectively.

Study details: This study used a two-sample Mendelian randomization framework to assess the causal effects of gut microbiota on migraine risk using 2651 single nucleotide polymorphisms as instrumental variables. Large-scale genome-wide association studies consisting of 18,340 participants from 24 cohorts provided the summary-level statistics for gut microbiota.

Disclosures: This study was funded by the National Key Research and Development Program. The authors declared no conflicts of interest.

Source: Meng X et al. Exploring the role of gut microbiota in migraine risk: A two-sample Mendelian randomization study. Scand J Gastroenterol. 2023 (Dec 27). doi: 10.1080/00365521.2023.2298370

Key clinical point: Gut microbiota may have a potential casual association with migraine symptoms, with evidence indicating a connection between gut microbiota and increased or decreased risk for migraine.

Major finding: A higher abundance of genus Lactobacillus (inverse variance weighted [IVW] odds ratio [OR] 1.10; P = .004) and family Prevotellaceae (IVW OR 0.89; P = .02) were causally associated with a higher and lower risk for migraine, respectively.

Study details: This study used a two-sample Mendelian randomization framework to assess the causal effects of gut microbiota on migraine risk using 2651 single nucleotide polymorphisms as instrumental variables. Large-scale genome-wide association studies consisting of 18,340 participants from 24 cohorts provided the summary-level statistics for gut microbiota.

Disclosures: This study was funded by the National Key Research and Development Program. The authors declared no conflicts of interest.

Source: Meng X et al. Exploring the role of gut microbiota in migraine risk: A two-sample Mendelian randomization study. Scand J Gastroenterol. 2023 (Dec 27). doi: 10.1080/00365521.2023.2298370

Key clinical point: High-dose eicosapentaenoic acid (EPA)/docosahexaenoic acid (DHA) supplementation demonstrated highest efficacy and acceptability among all studied treatments, emphasizing its potential as a first-choice treatment for migraine prophylaxis.

Major finding: Among all prophylactic treatments, high-dose EPA/DHA supplementation showed the highest decrease in migraine frequency (standardized mean difference [SMD] ─1.36; 95% CI ─2.32 to ─0.39) and severity (SMD ─2.23; 95% CI ─3.17 to ─1.30) and the most favorable acceptability rate (odds ratio 1.00; 95% CI 0.06 to 17.41) compared with placebo.

Study details: The data come from a network meta-analysis of 40 randomized controlled trials that included 6616 patients with either episodic or chronic migraine.

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

Source: Tseng PT et al. Efficacy of high dosage anti-inflammatory eicosapentaenoic acid/docosahexaenoic acid for migraine prophylaxis: A network meta-analysis. Adv Nutr. 2023;15(2):100163 (Dec 16). doi: 10.1016/j.advnut.2023.100163

Key clinical point: High-dose eicosapentaenoic acid (EPA)/docosahexaenoic acid (DHA) supplementation demonstrated highest efficacy and acceptability among all studied treatments, emphasizing its potential as a first-choice treatment for migraine prophylaxis.

Major finding: Among all prophylactic treatments, high-dose EPA/DHA supplementation showed the highest decrease in migraine frequency (standardized mean difference [SMD] ─1.36; 95% CI ─2.32 to ─0.39) and severity (SMD ─2.23; 95% CI ─3.17 to ─1.30) and the most favorable acceptability rate (odds ratio 1.00; 95% CI 0.06 to 17.41) compared with placebo.

Study details: The data come from a network meta-analysis of 40 randomized controlled trials that included 6616 patients with either episodic or chronic migraine.

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

Source: Tseng PT et al. Efficacy of high dosage anti-inflammatory eicosapentaenoic acid/docosahexaenoic acid for migraine prophylaxis: A network meta-analysis. Adv Nutr. 2023;15(2):100163 (Dec 16). doi: 10.1016/j.advnut.2023.100163

Key clinical point: High-dose eicosapentaenoic acid (EPA)/docosahexaenoic acid (DHA) supplementation demonstrated highest efficacy and acceptability among all studied treatments, emphasizing its potential as a first-choice treatment for migraine prophylaxis.

Major finding: Among all prophylactic treatments, high-dose EPA/DHA supplementation showed the highest decrease in migraine frequency (standardized mean difference [SMD] ─1.36; 95% CI ─2.32 to ─0.39) and severity (SMD ─2.23; 95% CI ─3.17 to ─1.30) and the most favorable acceptability rate (odds ratio 1.00; 95% CI 0.06 to 17.41) compared with placebo.

Study details: The data come from a network meta-analysis of 40 randomized controlled trials that included 6616 patients with either episodic or chronic migraine.

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

Source: Tseng PT et al. Efficacy of high dosage anti-inflammatory eicosapentaenoic acid/docosahexaenoic acid for migraine prophylaxis: A network meta-analysis. Adv Nutr. 2023;15(2):100163 (Dec 16). doi: 10.1016/j.advnut.2023.100163