Headache & Migraine

Key clinical point: The prevalence of migraine is higher in children and adolescents with attention deficit hyperactivity disorder (ADHD) vs those without.

Major finding: The risk of developing migraine was significantly higher in patients with ADHD than in matched controls (adjusted hazard ratio [aHR] 1.92; 95% CI 1.64-2.31) with the risk being prominent in children (aHR 2.01; 95% CI 1.63-2.49) and adolescents (aHR 1.94; 95% CI 1.35-2.79) but not in young adults with ADHD.

Study details: This was a nationwide longitudinal case-cohort study including 81,441 patients (including children, adolescents, and young adults aged 3-11, 12-17, and 18-29 years, respectively) with ADHD and 81,441 matched controls without ADHD.

Disclosures: The study was supported by grants from Taipei Veterans General Hospital; Kaohsiung Veterans General Hospital; Yen Tjing Ling Medical Foundation; and the Ministry of Science and Technology, Taiwan. The authors declared no conflicts of interest.

Source: Hsu T-W et al. Attention deficit hyperactivity disorder and risk of migraine: A nationwide longitudinal study. Headache. 2022 (May 6). Doi:  10.1111/head.14306

Key clinical point: The prevalence of migraine is higher in children and adolescents with attention deficit hyperactivity disorder (ADHD) vs those without.

Major finding: The risk of developing migraine was significantly higher in patients with ADHD than in matched controls (adjusted hazard ratio [aHR] 1.92; 95% CI 1.64-2.31) with the risk being prominent in children (aHR 2.01; 95% CI 1.63-2.49) and adolescents (aHR 1.94; 95% CI 1.35-2.79) but not in young adults with ADHD.

Study details: This was a nationwide longitudinal case-cohort study including 81,441 patients (including children, adolescents, and young adults aged 3-11, 12-17, and 18-29 years, respectively) with ADHD and 81,441 matched controls without ADHD.

Disclosures: The study was supported by grants from Taipei Veterans General Hospital; Kaohsiung Veterans General Hospital; Yen Tjing Ling Medical Foundation; and the Ministry of Science and Technology, Taiwan. The authors declared no conflicts of interest.

Source: Hsu T-W et al. Attention deficit hyperactivity disorder and risk of migraine: A nationwide longitudinal study. Headache. 2022 (May 6). Doi:  10.1111/head.14306

Key clinical point: The prevalence of migraine is higher in children and adolescents with attention deficit hyperactivity disorder (ADHD) vs those without.

Major finding: The risk of developing migraine was significantly higher in patients with ADHD than in matched controls (adjusted hazard ratio [aHR] 1.92; 95% CI 1.64-2.31) with the risk being prominent in children (aHR 2.01; 95% CI 1.63-2.49) and adolescents (aHR 1.94; 95% CI 1.35-2.79) but not in young adults with ADHD.

Study details: This was a nationwide longitudinal case-cohort study including 81,441 patients (including children, adolescents, and young adults aged 3-11, 12-17, and 18-29 years, respectively) with ADHD and 81,441 matched controls without ADHD.

Disclosures: The study was supported by grants from Taipei Veterans General Hospital; Kaohsiung Veterans General Hospital; Yen Tjing Ling Medical Foundation; and the Ministry of Science and Technology, Taiwan. The authors declared no conflicts of interest.

Source: Hsu T-W et al. Attention deficit hyperactivity disorder and risk of migraine: A nationwide longitudinal study. Headache. 2022 (May 6). Doi:  10.1111/head.14306

Key clinical point: Interictal levels of plasma glutamate are elevated in patients with episodic migraine (EM) and chronic migraine (CM), thus qualifying it as a potential marker for both EM and CM.

Major finding: Plasma glutamate levels were significantly higher in patients with EM (49.73 μmol/L [95% CI 40.82-66.12] ) and CM (58.70 μmol/L [95% CI 44.64-72.46]) vs control participants (38.79 μmol/L [95% CI 29.50-53.60]; P < .001).

Study details: This single-center study included 240 women aged 19-65 years, of which 98 had EM, 92 had CM, and 50 were nonmigraine control participants.

Disclosures: The study was supported by a National Research Foundation of Korea (NRF) grant from the Korean government. MK Chu declared serving as a site investigator for a multicenter trial and an advisory member for and receiving lecture honoraria and grants from various organizations, including NRF.

Source: Park CG, Chu MK. Interictal plasma glutamate levels are elevated in individuals with episodic and chronic migraine. Sci Rep. 2022;12:6921 (Apr 28). Doi: 10.1038/s41598-022-10883-9

Key clinical point: Interictal levels of plasma glutamate are elevated in patients with episodic migraine (EM) and chronic migraine (CM), thus qualifying it as a potential marker for both EM and CM.

Major finding: Plasma glutamate levels were significantly higher in patients with EM (49.73 μmol/L [95% CI 40.82-66.12] ) and CM (58.70 μmol/L [95% CI 44.64-72.46]) vs control participants (38.79 μmol/L [95% CI 29.50-53.60]; P < .001).

Study details: This single-center study included 240 women aged 19-65 years, of which 98 had EM, 92 had CM, and 50 were nonmigraine control participants.

Disclosures: The study was supported by a National Research Foundation of Korea (NRF) grant from the Korean government. MK Chu declared serving as a site investigator for a multicenter trial and an advisory member for and receiving lecture honoraria and grants from various organizations, including NRF.

Source: Park CG, Chu MK. Interictal plasma glutamate levels are elevated in individuals with episodic and chronic migraine. Sci Rep. 2022;12:6921 (Apr 28). Doi: 10.1038/s41598-022-10883-9

Key clinical point: Interictal levels of plasma glutamate are elevated in patients with episodic migraine (EM) and chronic migraine (CM), thus qualifying it as a potential marker for both EM and CM.

Major finding: Plasma glutamate levels were significantly higher in patients with EM (49.73 μmol/L [95% CI 40.82-66.12] ) and CM (58.70 μmol/L [95% CI 44.64-72.46]) vs control participants (38.79 μmol/L [95% CI 29.50-53.60]; P < .001).

Study details: This single-center study included 240 women aged 19-65 years, of which 98 had EM, 92 had CM, and 50 were nonmigraine control participants.

Disclosures: The study was supported by a National Research Foundation of Korea (NRF) grant from the Korean government. MK Chu declared serving as a site investigator for a multicenter trial and an advisory member for and receiving lecture honoraria and grants from various organizations, including NRF.

Source: Park CG, Chu MK. Interictal plasma glutamate levels are elevated in individuals with episodic and chronic migraine. Sci Rep. 2022;12:6921 (Apr 28). Doi: 10.1038/s41598-022-10883-9

Key clinical point: Adherence and persistence to fremanezumab was high among patients with migraine, especially for quarterly vs monthly dosing.

Major finding: After 6 months of fremanezumab initiation, the mean proportion of days covered (PDC) and medication possession ratio (MPR) were 86.1% and 88.7% respectively, with 74.8% and 79.0% of patients being classified as higher adherers by PDC (≥80%) and MPR (≥80%), respectively. Quarterly vs monthly fremanezumab was associated with significantly higher adherence (P ≤ .006) and mean persistence rates (P = .011).

Study details: This was a retrospective study including 987 adult patients with ≥1 migraine diagnosis during the study period who received fremanezumab on or after diagnosis.

Disclosures: The study was sponsored by Teva Pharmaceuticals. Some authors reported being current orformer employees of Teva.

Source: Krasenbaum LJ et al. A real-world study of acute and preventive medication use, adherence, and persistence in patients prescribed fremanezumab in the United States. J Headache Pain. 2022;23:54 (May 4). Doi: 10.1186/s10194-022-01413-z

Key clinical point: Adherence and persistence to fremanezumab was high among patients with migraine, especially for quarterly vs monthly dosing.

Major finding: After 6 months of fremanezumab initiation, the mean proportion of days covered (PDC) and medication possession ratio (MPR) were 86.1% and 88.7% respectively, with 74.8% and 79.0% of patients being classified as higher adherers by PDC (≥80%) and MPR (≥80%), respectively. Quarterly vs monthly fremanezumab was associated with significantly higher adherence (P ≤ .006) and mean persistence rates (P = .011).

Study details: This was a retrospective study including 987 adult patients with ≥1 migraine diagnosis during the study period who received fremanezumab on or after diagnosis.

Disclosures: The study was sponsored by Teva Pharmaceuticals. Some authors reported being current orformer employees of Teva.

Source: Krasenbaum LJ et al. A real-world study of acute and preventive medication use, adherence, and persistence in patients prescribed fremanezumab in the United States. J Headache Pain. 2022;23:54 (May 4). Doi: 10.1186/s10194-022-01413-z

Key clinical point: Adherence and persistence to fremanezumab was high among patients with migraine, especially for quarterly vs monthly dosing.

Major finding: After 6 months of fremanezumab initiation, the mean proportion of days covered (PDC) and medication possession ratio (MPR) were 86.1% and 88.7% respectively, with 74.8% and 79.0% of patients being classified as higher adherers by PDC (≥80%) and MPR (≥80%), respectively. Quarterly vs monthly fremanezumab was associated with significantly higher adherence (P ≤ .006) and mean persistence rates (P = .011).

Study details: This was a retrospective study including 987 adult patients with ≥1 migraine diagnosis during the study period who received fremanezumab on or after diagnosis.

Disclosures: The study was sponsored by Teva Pharmaceuticals. Some authors reported being current orformer employees of Teva.

Source: Krasenbaum LJ et al. A real-world study of acute and preventive medication use, adherence, and persistence in patients prescribed fremanezumab in the United States. J Headache Pain. 2022;23:54 (May 4). Doi: 10.1186/s10194-022-01413-z

Key clinical point: With self-reported migraine being associated with 26% higher odds of adverse pregnancy outcomes (APO), it may be a significant risk factor for APO.

Major finding: After adjusting for confounding factors, women with migraine showed increased odds of any APO (adjusted odds ratio 1.26; 95% CI 1.12-1.41).

Study details: This was a multicenter prospective study, nuMoM2b, including 9450 nulliparous singleton pregnant women in early gestation, of which 1752 self-reported migraine at the first-trimester visit.

Disclosures: The nuMoM2b study was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Case Western Reserve University, and Columbia University, among others. EC Miller and NA Bello declared receiving financial support from various sources.

Source: Miller EC et al. Migraine and adverse pregnancy outcomes: the nuMoM2b study. Am J Obstet Gynecol. 2022 (May 2). Doi: 10.1016/j.ajog.2022.04.049

Key clinical point: With self-reported migraine being associated with 26% higher odds of adverse pregnancy outcomes (APO), it may be a significant risk factor for APO.

Major finding: After adjusting for confounding factors, women with migraine showed increased odds of any APO (adjusted odds ratio 1.26; 95% CI 1.12-1.41).

Study details: This was a multicenter prospective study, nuMoM2b, including 9450 nulliparous singleton pregnant women in early gestation, of which 1752 self-reported migraine at the first-trimester visit.

Disclosures: The nuMoM2b study was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Case Western Reserve University, and Columbia University, among others. EC Miller and NA Bello declared receiving financial support from various sources.

Source: Miller EC et al. Migraine and adverse pregnancy outcomes: the nuMoM2b study. Am J Obstet Gynecol. 2022 (May 2). Doi: 10.1016/j.ajog.2022.04.049

Key clinical point: With self-reported migraine being associated with 26% higher odds of adverse pregnancy outcomes (APO), it may be a significant risk factor for APO.

Major finding: After adjusting for confounding factors, women with migraine showed increased odds of any APO (adjusted odds ratio 1.26; 95% CI 1.12-1.41).

Study details: This was a multicenter prospective study, nuMoM2b, including 9450 nulliparous singleton pregnant women in early gestation, of which 1752 self-reported migraine at the first-trimester visit.

Disclosures: The nuMoM2b study was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Case Western Reserve University, and Columbia University, among others. EC Miller and NA Bello declared receiving financial support from various sources.

Source: Miller EC et al. Migraine and adverse pregnancy outcomes: the nuMoM2b study. Am J Obstet Gynecol. 2022 (May 2). Doi: 10.1016/j.ajog.2022.04.049

Key clinical point: Self-administered single-dose subcutaneous (SC) injection of diclofenac sodium (50 mg/mL) complexed with hydroxypropyl-β-cyclodextrin (HPβCD) is safe and effective for the treatment of acute migraine attacks in patients with moderate-to-severe migraine pain.

Major finding: After 2 hours of injection, 46.7% of patients were pain-free in the 50 mg diclofenac/HPβCD group, with the percentage being significantly higher than that in the placebo group (16.1%; P = .01). Most treatment-emergent adverse events were mild.

Study details: The findings are from a multicenter, phase 2, dose-finding pilot study including 122 adult patients experiencing 2-8 migraine attacks/month with moderate-to-severe pain who were randomly assigned to receive diclofenac/HPβCD (25, 50, or 75 mg) or placebo.

Disclosures: The study was sponsored by IBSA Institut Biochimique S.A. (Switzerland). Some authors declared serving as advisory board members, consultants, or speakers, or receiving honoraria for clinical investigation studies, travel and research grants, or personal fees from various sources.

Source: Geppetti P et al. Self-administered subcutaneous diclofenac sodium in acute migraine attack: A randomized, double-blind, placebo-controlled dose-finding pilot study. Cephalalgia. 2022 (Apr 26). Doi: 10.1177/03331024221093712

Key clinical point: Self-administered single-dose subcutaneous (SC) injection of diclofenac sodium (50 mg/mL) complexed with hydroxypropyl-β-cyclodextrin (HPβCD) is safe and effective for the treatment of acute migraine attacks in patients with moderate-to-severe migraine pain.

Major finding: After 2 hours of injection, 46.7% of patients were pain-free in the 50 mg diclofenac/HPβCD group, with the percentage being significantly higher than that in the placebo group (16.1%; P = .01). Most treatment-emergent adverse events were mild.

Study details: The findings are from a multicenter, phase 2, dose-finding pilot study including 122 adult patients experiencing 2-8 migraine attacks/month with moderate-to-severe pain who were randomly assigned to receive diclofenac/HPβCD (25, 50, or 75 mg) or placebo.

Disclosures: The study was sponsored by IBSA Institut Biochimique S.A. (Switzerland). Some authors declared serving as advisory board members, consultants, or speakers, or receiving honoraria for clinical investigation studies, travel and research grants, or personal fees from various sources.

Source: Geppetti P et al. Self-administered subcutaneous diclofenac sodium in acute migraine attack: A randomized, double-blind, placebo-controlled dose-finding pilot study. Cephalalgia. 2022 (Apr 26). Doi: 10.1177/03331024221093712

Key clinical point: Self-administered single-dose subcutaneous (SC) injection of diclofenac sodium (50 mg/mL) complexed with hydroxypropyl-β-cyclodextrin (HPβCD) is safe and effective for the treatment of acute migraine attacks in patients with moderate-to-severe migraine pain.

Major finding: After 2 hours of injection, 46.7% of patients were pain-free in the 50 mg diclofenac/HPβCD group, with the percentage being significantly higher than that in the placebo group (16.1%; P = .01). Most treatment-emergent adverse events were mild.

Study details: The findings are from a multicenter, phase 2, dose-finding pilot study including 122 adult patients experiencing 2-8 migraine attacks/month with moderate-to-severe pain who were randomly assigned to receive diclofenac/HPβCD (25, 50, or 75 mg) or placebo.

Disclosures: The study was sponsored by IBSA Institut Biochimique S.A. (Switzerland). Some authors declared serving as advisory board members, consultants, or speakers, or receiving honoraria for clinical investigation studies, travel and research grants, or personal fees from various sources.

Source: Geppetti P et al. Self-administered subcutaneous diclofenac sodium in acute migraine attack: A randomized, double-blind, placebo-controlled dose-finding pilot study. Cephalalgia. 2022 (Apr 26). Doi: 10.1177/03331024221093712

Key clinical point: Compared with placebo, ubrogepant therapy provides favorable 2-hour outcomes, as measured by functional disability, medication satisfaction, and impression of overall change in migraine, in patients with migraine who are triptan insufficient responders (TIR).

Major finding: At 2 hours after initial dose of ubrogepant vs placebo, significantly greater proportion of patients reported no disability (38% vs 29%; odds ratio [OR] 1.5; P = .048), treatment satisfaction (33% vs 21%; OR 1.8; P = .006), and improvement in migraine (30% vs 18%; OR 2.0; P = .006).

Study details: This post hoc analysis included 1799 patients with migraine with or without aura from the phase 3 ACHIEVE I and ACHIEVE II trials who were self-reported TIR and received 50 mg ubrogepant (n = 887) or placebo (n = 912).

Disclosures: The study was funded by Allergan (before acquisition by AbbVie). Some authors declared serving as consultants or advisory board members and receiving research support, honoraria, or royalties from various sources, including AbbVie/Allergan. The other authors are current or former employees and stockholders of AbbVie.

Source: Lipton RB et al. Functionality, satisfaction, and global impression of change with ubrogepant for the acute treatment of migraine in triptan insufficient responders: A post hoc analysis of the ACHIEVE I and ACHIEVE II randomized trials. J Headache Pain. 2022;23:50 (Apr 25). Doi: 10.1186/s10194-022-01419-7

Key clinical point: Compared with placebo, ubrogepant therapy provides favorable 2-hour outcomes, as measured by functional disability, medication satisfaction, and impression of overall change in migraine, in patients with migraine who are triptan insufficient responders (TIR).

Major finding: At 2 hours after initial dose of ubrogepant vs placebo, significantly greater proportion of patients reported no disability (38% vs 29%; odds ratio [OR] 1.5; P = .048), treatment satisfaction (33% vs 21%; OR 1.8; P = .006), and improvement in migraine (30% vs 18%; OR 2.0; P = .006).

Study details: This post hoc analysis included 1799 patients with migraine with or without aura from the phase 3 ACHIEVE I and ACHIEVE II trials who were self-reported TIR and received 50 mg ubrogepant (n = 887) or placebo (n = 912).

Disclosures: The study was funded by Allergan (before acquisition by AbbVie). Some authors declared serving as consultants or advisory board members and receiving research support, honoraria, or royalties from various sources, including AbbVie/Allergan. The other authors are current or former employees and stockholders of AbbVie.

Source: Lipton RB et al. Functionality, satisfaction, and global impression of change with ubrogepant for the acute treatment of migraine in triptan insufficient responders: A post hoc analysis of the ACHIEVE I and ACHIEVE II randomized trials. J Headache Pain. 2022;23:50 (Apr 25). Doi: 10.1186/s10194-022-01419-7

Key clinical point: Compared with placebo, ubrogepant therapy provides favorable 2-hour outcomes, as measured by functional disability, medication satisfaction, and impression of overall change in migraine, in patients with migraine who are triptan insufficient responders (TIR).

Major finding: At 2 hours after initial dose of ubrogepant vs placebo, significantly greater proportion of patients reported no disability (38% vs 29%; odds ratio [OR] 1.5; P = .048), treatment satisfaction (33% vs 21%; OR 1.8; P = .006), and improvement in migraine (30% vs 18%; OR 2.0; P = .006).

Study details: This post hoc analysis included 1799 patients with migraine with or without aura from the phase 3 ACHIEVE I and ACHIEVE II trials who were self-reported TIR and received 50 mg ubrogepant (n = 887) or placebo (n = 912).

Disclosures: The study was funded by Allergan (before acquisition by AbbVie). Some authors declared serving as consultants or advisory board members and receiving research support, honoraria, or royalties from various sources, including AbbVie/Allergan. The other authors are current or former employees and stockholders of AbbVie.

Source: Lipton RB et al. Functionality, satisfaction, and global impression of change with ubrogepant for the acute treatment of migraine in triptan insufficient responders: A post hoc analysis of the ACHIEVE I and ACHIEVE II randomized trials. J Headache Pain. 2022;23:50 (Apr 25). Doi: 10.1186/s10194-022-01419-7

Key clinical point: In treatment-resistant episodic or chronic migraine, galcanezumab therapy can help achieve a clinically meaningful reduction in monthly acute headache medication use.

Major finding: Galcanezumab vs. placebo led to a significantly greater least-squares mean reduction in monthly acute headache medication use from 1 to 3 months (4.2 vs 0.8 days; P < .0001). At 6 months, the monthly acute headache medication use was similar between the groups.

Study details: The data come from the phase 3 CONQUER study including 462 patients with treatment-resistant episodic or chronic migraine who were randomly assigned to receive galcanezumab (n = 232) or placebo (n = 230) in the double-blind phase (months 1-3), followed by galcanezumab in the open-label phase (months 4-6).

Disclosures: The study was sponsored by Eli Lilly and Company. Some authors declared being on the advisory board or speakers’ bureau for and receiving consulting fees, speaker fees, honoraria, or travel support from various sources, including Eli Lilly. The other authors are employees or stockholders of Eli Lilly or one of its subsidiaries.

Source: Ambrosini A et al. Changes in acute headache medication use and health care resource utilization: Results from a randomized, double-blind, placebo-controlled clinical trial evaluating galcanezumab in adults with treatment-resistant migraine (CONQUER). J Manag Care Spec Pharm. 2022 (Apr 22). Doi: 10.18553/jmcp.2022.21375

Key clinical point: In treatment-resistant episodic or chronic migraine, galcanezumab therapy can help achieve a clinically meaningful reduction in monthly acute headache medication use.

Major finding: Galcanezumab vs. placebo led to a significantly greater least-squares mean reduction in monthly acute headache medication use from 1 to 3 months (4.2 vs 0.8 days; P < .0001). At 6 months, the monthly acute headache medication use was similar between the groups.

Study details: The data come from the phase 3 CONQUER study including 462 patients with treatment-resistant episodic or chronic migraine who were randomly assigned to receive galcanezumab (n = 232) or placebo (n = 230) in the double-blind phase (months 1-3), followed by galcanezumab in the open-label phase (months 4-6).

Disclosures: The study was sponsored by Eli Lilly and Company. Some authors declared being on the advisory board or speakers’ bureau for and receiving consulting fees, speaker fees, honoraria, or travel support from various sources, including Eli Lilly. The other authors are employees or stockholders of Eli Lilly or one of its subsidiaries.

Source: Ambrosini A et al. Changes in acute headache medication use and health care resource utilization: Results from a randomized, double-blind, placebo-controlled clinical trial evaluating galcanezumab in adults with treatment-resistant migraine (CONQUER). J Manag Care Spec Pharm. 2022 (Apr 22). Doi: 10.18553/jmcp.2022.21375

Key clinical point: In treatment-resistant episodic or chronic migraine, galcanezumab therapy can help achieve a clinically meaningful reduction in monthly acute headache medication use.

Major finding: Galcanezumab vs. placebo led to a significantly greater least-squares mean reduction in monthly acute headache medication use from 1 to 3 months (4.2 vs 0.8 days; P < .0001). At 6 months, the monthly acute headache medication use was similar between the groups.

Study details: The data come from the phase 3 CONQUER study including 462 patients with treatment-resistant episodic or chronic migraine who were randomly assigned to receive galcanezumab (n = 232) or placebo (n = 230) in the double-blind phase (months 1-3), followed by galcanezumab in the open-label phase (months 4-6).

Disclosures: The study was sponsored by Eli Lilly and Company. Some authors declared being on the advisory board or speakers’ bureau for and receiving consulting fees, speaker fees, honoraria, or travel support from various sources, including Eli Lilly. The other authors are employees or stockholders of Eli Lilly or one of its subsidiaries.

Source: Ambrosini A et al. Changes in acute headache medication use and health care resource utilization: Results from a randomized, double-blind, placebo-controlled clinical trial evaluating galcanezumab in adults with treatment-resistant migraine (CONQUER). J Manag Care Spec Pharm. 2022 (Apr 22). Doi: 10.18553/jmcp.2022.21375

Key clinical point: A second dose of eptinezumab may be beneficial in patients with migraine who exhibit a suboptimal first-dose response.

Major finding: Percent change in monthly migraine days (MMD) over weeks 1-12 (PROMISE-1: odds ratio [OR] 0.97; P = .0001; PROMISE-2: OR 0.94; P < .0001) and change in 6-item Headache Impact Test total score (only PROMISE-2: OR 0.92; P = .027) were observed to be significant first-dose predictors of second-dose response.

Study details: This post hoc analysis included patients with migraine (episodic [n = 416; PROMISE-1] and chronic [n = 479; PROMISE-2]), suboptimal response (<50% reduction from baseline in MMD across weeks 1-12), and patient-reported outcome data at weeks 12 and 24.

Disclosures: The study was sponsored by Lundbeck LLC, USA. Some authors declared serving as consultants, advisory board members, or speakers for and receiving speaker honoraria from various sources, including Lundbeck. The other authors are current orformer employees of H. Lundbeck A/S or its subsidiary/contracted service provider.

Source: Schim JD et al. Likelihood of response with subsequent dosing for patients with migraine and initial suboptimal response with eptinezumab: A post hoc analysis of two placebo-controlled randomized clinical trials. Headache. 2022 (May 6). Doi: 10.1111/head.14302

Key clinical point: A second dose of eptinezumab may be beneficial in patients with migraine who exhibit a suboptimal first-dose response.

Major finding: Percent change in monthly migraine days (MMD) over weeks 1-12 (PROMISE-1: odds ratio [OR] 0.97; P = .0001; PROMISE-2: OR 0.94; P < .0001) and change in 6-item Headache Impact Test total score (only PROMISE-2: OR 0.92; P = .027) were observed to be significant first-dose predictors of second-dose response.

Study details: This post hoc analysis included patients with migraine (episodic [n = 416; PROMISE-1] and chronic [n = 479; PROMISE-2]), suboptimal response (<50% reduction from baseline in MMD across weeks 1-12), and patient-reported outcome data at weeks 12 and 24.

Disclosures: The study was sponsored by Lundbeck LLC, USA. Some authors declared serving as consultants, advisory board members, or speakers for and receiving speaker honoraria from various sources, including Lundbeck. The other authors are current orformer employees of H. Lundbeck A/S or its subsidiary/contracted service provider.

Source: Schim JD et al. Likelihood of response with subsequent dosing for patients with migraine and initial suboptimal response with eptinezumab: A post hoc analysis of two placebo-controlled randomized clinical trials. Headache. 2022 (May 6). Doi: 10.1111/head.14302

Key clinical point: A second dose of eptinezumab may be beneficial in patients with migraine who exhibit a suboptimal first-dose response.

Major finding: Percent change in monthly migraine days (MMD) over weeks 1-12 (PROMISE-1: odds ratio [OR] 0.97; P = .0001; PROMISE-2: OR 0.94; P < .0001) and change in 6-item Headache Impact Test total score (only PROMISE-2: OR 0.92; P = .027) were observed to be significant first-dose predictors of second-dose response.

Study details: This post hoc analysis included patients with migraine (episodic [n = 416; PROMISE-1] and chronic [n = 479; PROMISE-2]), suboptimal response (<50% reduction from baseline in MMD across weeks 1-12), and patient-reported outcome data at weeks 12 and 24.

Disclosures: The study was sponsored by Lundbeck LLC, USA. Some authors declared serving as consultants, advisory board members, or speakers for and receiving speaker honoraria from various sources, including Lundbeck. The other authors are current orformer employees of H. Lundbeck A/S or its subsidiary/contracted service provider.

Source: Schim JD et al. Likelihood of response with subsequent dosing for patients with migraine and initial suboptimal response with eptinezumab: A post hoc analysis of two placebo-controlled randomized clinical trials. Headache. 2022 (May 6). Doi: 10.1111/head.14302

Key clinical point: Erenumab is effective in managing patients with treatment-resistant chronic migraine in a tertiary care setting without causing any serious adverse effects.

Major finding: At 3 and 6 months, erenumab significantly reduced the median monthly migraine days (MMD; −4 and −9 days, respectively; P < .001), with the MMD 50% responder rate at 3 months being 36%. No serious adverse events were observed.

Study details: This was a prospective study including 92 patients aged >18 years with chronic migraine and ≥3 prior migraine preventive treatment failures who received monthly 70 mg erenumab for 3 months.

Disclosures: The authors did not report any source of funding or conflict of interests.

Source: Khalil M et al. Erenumab in chronic migraine: Experience from a UK tertiary centre and comparison with other real-world evidence. Eur J Neurol. 2022 (Apr 21). Doi: 10.1111/ene.15364

Key clinical point: Erenumab is effective in managing patients with treatment-resistant chronic migraine in a tertiary care setting without causing any serious adverse effects.

Major finding: At 3 and 6 months, erenumab significantly reduced the median monthly migraine days (MMD; −4 and −9 days, respectively; P < .001), with the MMD 50% responder rate at 3 months being 36%. No serious adverse events were observed.

Study details: This was a prospective study including 92 patients aged >18 years with chronic migraine and ≥3 prior migraine preventive treatment failures who received monthly 70 mg erenumab for 3 months.

Disclosures: The authors did not report any source of funding or conflict of interests.

Source: Khalil M et al. Erenumab in chronic migraine: Experience from a UK tertiary centre and comparison with other real-world evidence. Eur J Neurol. 2022 (Apr 21). Doi: 10.1111/ene.15364

Key clinical point: Erenumab is effective in managing patients with treatment-resistant chronic migraine in a tertiary care setting without causing any serious adverse effects.

Major finding: At 3 and 6 months, erenumab significantly reduced the median monthly migraine days (MMD; −4 and −9 days, respectively; P < .001), with the MMD 50% responder rate at 3 months being 36%. No serious adverse events were observed.

Study details: This was a prospective study including 92 patients aged >18 years with chronic migraine and ≥3 prior migraine preventive treatment failures who received monthly 70 mg erenumab for 3 months.

Disclosures: The authors did not report any source of funding or conflict of interests.

Source: Khalil M et al. Erenumab in chronic migraine: Experience from a UK tertiary centre and comparison with other real-world evidence. Eur J Neurol. 2022 (Apr 21). Doi: 10.1111/ene.15364

Key clinical point: Fremanezumab treatment leads to clinically meaningful improvement in patients with migraine for up to 6 months, regardless of the dosing regimen or number of prior migraine preventive treatment failures.

Major finding: At 6 months, mean percentage reductions from baseline in monthly migraine days, monthly headache days, Migraine Disability Assessment score, and 6-item Headache Impact Test score were 72.4% (−9.2 days), 70.0% (−9.8 days), 63.1% (−18.1 days), and 27.0% (−16.2 days), respectively. Subgroups formed according to the dosing schedule and number of prior migraine preventive treatment failures showed similar improvements.

Study details: This was a retrospective, online physician chart review study that included data from 421 clinicians and 1003 patients with migraine who had initiated fremanezumab treatment at ≥18 years of age and received ≥1 fremanezumab dose.

Disclosures: The study was sponsored by Teva Pharmaceuticals. Some authors declared being current or former employees of Teva. The other authors are employees of an organization funded by Teva.

Source: Driessen MT et al. Real-world effectiveness of fremanezumab in migraine patients initiating treatment in the United States: results from a retrospective chart study. J Headache Pain. 2022;23:47 (Apr 11). Doi: 10.1186/s10194-022-01411-1

Key clinical point: Fremanezumab treatment leads to clinically meaningful improvement in patients with migraine for up to 6 months, regardless of the dosing regimen or number of prior migraine preventive treatment failures.

Major finding: At 6 months, mean percentage reductions from baseline in monthly migraine days, monthly headache days, Migraine Disability Assessment score, and 6-item Headache Impact Test score were 72.4% (−9.2 days), 70.0% (−9.8 days), 63.1% (−18.1 days), and 27.0% (−16.2 days), respectively. Subgroups formed according to the dosing schedule and number of prior migraine preventive treatment failures showed similar improvements.

Study details: This was a retrospective, online physician chart review study that included data from 421 clinicians and 1003 patients with migraine who had initiated fremanezumab treatment at ≥18 years of age and received ≥1 fremanezumab dose.

Disclosures: The study was sponsored by Teva Pharmaceuticals. Some authors declared being current or former employees of Teva. The other authors are employees of an organization funded by Teva.

Source: Driessen MT et al. Real-world effectiveness of fremanezumab in migraine patients initiating treatment in the United States: results from a retrospective chart study. J Headache Pain. 2022;23:47 (Apr 11). Doi: 10.1186/s10194-022-01411-1

Key clinical point: Fremanezumab treatment leads to clinically meaningful improvement in patients with migraine for up to 6 months, regardless of the dosing regimen or number of prior migraine preventive treatment failures.

Major finding: At 6 months, mean percentage reductions from baseline in monthly migraine days, monthly headache days, Migraine Disability Assessment score, and 6-item Headache Impact Test score were 72.4% (−9.2 days), 70.0% (−9.8 days), 63.1% (−18.1 days), and 27.0% (−16.2 days), respectively. Subgroups formed according to the dosing schedule and number of prior migraine preventive treatment failures showed similar improvements.

Study details: This was a retrospective, online physician chart review study that included data from 421 clinicians and 1003 patients with migraine who had initiated fremanezumab treatment at ≥18 years of age and received ≥1 fremanezumab dose.

Disclosures: The study was sponsored by Teva Pharmaceuticals. Some authors declared being current or former employees of Teva. The other authors are employees of an organization funded by Teva.

Source: Driessen MT et al. Real-world effectiveness of fremanezumab in migraine patients initiating treatment in the United States: results from a retrospective chart study. J Headache Pain. 2022;23:47 (Apr 11). Doi: 10.1186/s10194-022-01411-1