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Identifying Predictors of Psoriatic Arthritis Progression in Patients with Arthralgia
Key clinical point: The significant predictors of developing psoriatic arthritis (PsA) in patients with arthralgia include a family history of psoriasis, synovitis, enthesopathy, and a low tender joint count.
Major finding: Among patients with arthralgia, 8.4% were at a risk of developing PsA, with 29% of these patients progressing to PsA within 1 year. Significant predictors of progression included a family history of psoriasis (odds ratio [OR], 32; 95% CI, 1.2-1026), synovitis detected by Power Doppler ultrasound (OR, 31; 95% CI, 1.1-967), enthesopathy findings on ultrasound (OR, 75; 95% CI, 13-710), and a low tender joint count (OR, 0.2; 95% CI, 0.05-0.6).
Study details: This prospective longitudinal study included 1419 patients with arthralgia who were older than 18 years of age.
Disclosures: This study did not receive any specific funding. The authors declared no conflicts of interest.
Source: Garcia-Salinas R, Magri S, Mareco J, et al. Arthralgia with risk of progression to psoriatic arthritis: Role of clinical assessments and ultrasound as prognostic factors. Rheumatology (Oxford). Published online October 15, 2024. Source
Key clinical point: The significant predictors of developing psoriatic arthritis (PsA) in patients with arthralgia include a family history of psoriasis, synovitis, enthesopathy, and a low tender joint count.
Major finding: Among patients with arthralgia, 8.4% were at a risk of developing PsA, with 29% of these patients progressing to PsA within 1 year. Significant predictors of progression included a family history of psoriasis (odds ratio [OR], 32; 95% CI, 1.2-1026), synovitis detected by Power Doppler ultrasound (OR, 31; 95% CI, 1.1-967), enthesopathy findings on ultrasound (OR, 75; 95% CI, 13-710), and a low tender joint count (OR, 0.2; 95% CI, 0.05-0.6).
Study details: This prospective longitudinal study included 1419 patients with arthralgia who were older than 18 years of age.
Disclosures: This study did not receive any specific funding. The authors declared no conflicts of interest.
Source: Garcia-Salinas R, Magri S, Mareco J, et al. Arthralgia with risk of progression to psoriatic arthritis: Role of clinical assessments and ultrasound as prognostic factors. Rheumatology (Oxford). Published online October 15, 2024. Source
Key clinical point: The significant predictors of developing psoriatic arthritis (PsA) in patients with arthralgia include a family history of psoriasis, synovitis, enthesopathy, and a low tender joint count.
Major finding: Among patients with arthralgia, 8.4% were at a risk of developing PsA, with 29% of these patients progressing to PsA within 1 year. Significant predictors of progression included a family history of psoriasis (odds ratio [OR], 32; 95% CI, 1.2-1026), synovitis detected by Power Doppler ultrasound (OR, 31; 95% CI, 1.1-967), enthesopathy findings on ultrasound (OR, 75; 95% CI, 13-710), and a low tender joint count (OR, 0.2; 95% CI, 0.05-0.6).
Study details: This prospective longitudinal study included 1419 patients with arthralgia who were older than 18 years of age.
Disclosures: This study did not receive any specific funding. The authors declared no conflicts of interest.
Source: Garcia-Salinas R, Magri S, Mareco J, et al. Arthralgia with risk of progression to psoriatic arthritis: Role of clinical assessments and ultrasound as prognostic factors. Rheumatology (Oxford). Published online October 15, 2024. Source
Risk Factors for Chronic Kidney Disease in PsA
Key clinical point: Diabetes, kidney stones, joint damage, high uric acid levels, and the daily use of nonsteroidal anti-inflammatory drugs (NSAIDs) were associated with the development of chronic kidney disease (CKD) in patients with psoriatic arthritis (PsA), whereas methotrexate use had a renoprotective effect.
Major finding: The development of CKD in patients with PsA was independently associated with diabetes mellitus (adjusted hazard ratio [aHR], 2.58; P < .001), kidney stones (aHR, 2.14; P = .01), radiographic damaged joint count (aHR, 1.02; P = .02), higher uric acid levels (aHR, 1.21; P < .001; per 50-unit increase), and the daily use of NSAIDs (aHR, 1.77; P = .02). Methotrexate use had a renoprotective effect (aHR, 0.51; P = .01).
Study details: This prospective observational cohort study included 1336 patients with PsA, of whom 123 (9.2%) had CKD.
Disclosures: The Gladman-Krembil Psoriatic Arthritis Research Program is supported by a grant from the Krembil Foundation. The authors did not declare any conflicts of interest.
Source: Kharouf F, Gao S, Al-Matar S, Cook RJ, Chandran V, Gladman DD. Chronic kidney disease in patients with psoriatic arthritis: A cohort study. RMD Open. 2024;10:e004636. Source
Key clinical point: Diabetes, kidney stones, joint damage, high uric acid levels, and the daily use of nonsteroidal anti-inflammatory drugs (NSAIDs) were associated with the development of chronic kidney disease (CKD) in patients with psoriatic arthritis (PsA), whereas methotrexate use had a renoprotective effect.
Major finding: The development of CKD in patients with PsA was independently associated with diabetes mellitus (adjusted hazard ratio [aHR], 2.58; P < .001), kidney stones (aHR, 2.14; P = .01), radiographic damaged joint count (aHR, 1.02; P = .02), higher uric acid levels (aHR, 1.21; P < .001; per 50-unit increase), and the daily use of NSAIDs (aHR, 1.77; P = .02). Methotrexate use had a renoprotective effect (aHR, 0.51; P = .01).
Study details: This prospective observational cohort study included 1336 patients with PsA, of whom 123 (9.2%) had CKD.
Disclosures: The Gladman-Krembil Psoriatic Arthritis Research Program is supported by a grant from the Krembil Foundation. The authors did not declare any conflicts of interest.
Source: Kharouf F, Gao S, Al-Matar S, Cook RJ, Chandran V, Gladman DD. Chronic kidney disease in patients with psoriatic arthritis: A cohort study. RMD Open. 2024;10:e004636. Source
Key clinical point: Diabetes, kidney stones, joint damage, high uric acid levels, and the daily use of nonsteroidal anti-inflammatory drugs (NSAIDs) were associated with the development of chronic kidney disease (CKD) in patients with psoriatic arthritis (PsA), whereas methotrexate use had a renoprotective effect.
Major finding: The development of CKD in patients with PsA was independently associated with diabetes mellitus (adjusted hazard ratio [aHR], 2.58; P < .001), kidney stones (aHR, 2.14; P = .01), radiographic damaged joint count (aHR, 1.02; P = .02), higher uric acid levels (aHR, 1.21; P < .001; per 50-unit increase), and the daily use of NSAIDs (aHR, 1.77; P = .02). Methotrexate use had a renoprotective effect (aHR, 0.51; P = .01).
Study details: This prospective observational cohort study included 1336 patients with PsA, of whom 123 (9.2%) had CKD.
Disclosures: The Gladman-Krembil Psoriatic Arthritis Research Program is supported by a grant from the Krembil Foundation. The authors did not declare any conflicts of interest.
Source: Kharouf F, Gao S, Al-Matar S, Cook RJ, Chandran V, Gladman DD. Chronic kidney disease in patients with psoriatic arthritis: A cohort study. RMD Open. 2024;10:e004636. Source
Musculoskeletal Ultrasound Predicts Treatment Response in PsA
Key clinical point: In patients with psoriatic arthritis (PsA), elevated baseline ultrasound scores for synovitis, peritenonitis, and enthesitis were associated with increased reductions in the Disease Activity Index for PsA (DAPSA) score.
Major finding: At 3 to 6 months, an increased reduction in the DAPSA score was associated with elevated baseline sonographic scores for synovitis (adjusted β [βadj], −3.89; P = .02), peritenonitis (βadj, −3.93; P = .01), and structural enthesitis (βadj, −2.91; P = .045). An elevated baseline total inflammatory score independently predicted an increased reduction in the DAPSA score, regardless of the total damage score (βadj, −5.23; P = .007).
Study details: This prospective cohort study included 135 treatment periods involving 107 patients with PsA who were starting or switching to a new disease-modifying anti-rheumatic drug and had active peripheral manifestations.
Disclosures: Jessica Gutierrez declared receiving a fellowship grant from AbbVie. Lihi Eder declared being Canada Research Chair (Tier 2) in Inflammatory Rheumatic Diseases. Two authors declared having ties with various sources.
Source: Gutierrez J, Thib S, Koppikar S, Cook RJ, Eder L. Association between musculoskeletal sonographic features and response to treatment in patients with psoriatic arthritis. RMD Open. 2024;10:e003995. Source
Key clinical point: In patients with psoriatic arthritis (PsA), elevated baseline ultrasound scores for synovitis, peritenonitis, and enthesitis were associated with increased reductions in the Disease Activity Index for PsA (DAPSA) score.
Major finding: At 3 to 6 months, an increased reduction in the DAPSA score was associated with elevated baseline sonographic scores for synovitis (adjusted β [βadj], −3.89; P = .02), peritenonitis (βadj, −3.93; P = .01), and structural enthesitis (βadj, −2.91; P = .045). An elevated baseline total inflammatory score independently predicted an increased reduction in the DAPSA score, regardless of the total damage score (βadj, −5.23; P = .007).
Study details: This prospective cohort study included 135 treatment periods involving 107 patients with PsA who were starting or switching to a new disease-modifying anti-rheumatic drug and had active peripheral manifestations.
Disclosures: Jessica Gutierrez declared receiving a fellowship grant from AbbVie. Lihi Eder declared being Canada Research Chair (Tier 2) in Inflammatory Rheumatic Diseases. Two authors declared having ties with various sources.
Source: Gutierrez J, Thib S, Koppikar S, Cook RJ, Eder L. Association between musculoskeletal sonographic features and response to treatment in patients with psoriatic arthritis. RMD Open. 2024;10:e003995. Source
Key clinical point: In patients with psoriatic arthritis (PsA), elevated baseline ultrasound scores for synovitis, peritenonitis, and enthesitis were associated with increased reductions in the Disease Activity Index for PsA (DAPSA) score.
Major finding: At 3 to 6 months, an increased reduction in the DAPSA score was associated with elevated baseline sonographic scores for synovitis (adjusted β [βadj], −3.89; P = .02), peritenonitis (βadj, −3.93; P = .01), and structural enthesitis (βadj, −2.91; P = .045). An elevated baseline total inflammatory score independently predicted an increased reduction in the DAPSA score, regardless of the total damage score (βadj, −5.23; P = .007).
Study details: This prospective cohort study included 135 treatment periods involving 107 patients with PsA who were starting or switching to a new disease-modifying anti-rheumatic drug and had active peripheral manifestations.
Disclosures: Jessica Gutierrez declared receiving a fellowship grant from AbbVie. Lihi Eder declared being Canada Research Chair (Tier 2) in Inflammatory Rheumatic Diseases. Two authors declared having ties with various sources.
Source: Gutierrez J, Thib S, Koppikar S, Cook RJ, Eder L. Association between musculoskeletal sonographic features and response to treatment in patients with psoriatic arthritis. RMD Open. 2024;10:e003995. Source
Deucravacitinib Yields Higher Minimal Disease Activity Response Than Placebo in PsA
Key clinical point: In patients with psoriatic arthritis (PsA), deucravacitinib (6 mg or 12 mg once daily) vs placebo for 16 weeks led to a higher minimal disease activity (MDA) response and a greater proportion of patients achieving MDA in each component.
Major finding: After 16 weeks, a significantly higher proportion of patients treated with deucravacitinib vs placebo achieved MDA (6 mg: 22.9% vs 7.6%; P = .01 and 12 mg: 23.9% vs 7.6%; P = .007) and individual components of MDA, including the tender joint count, pain, and the Health Assessment Questionnaire–Disability Index (all P < .05).
Study details: This post hoc analysis of a phase 2 trial included 203 adults with PsA who did not respond to or were intolerant to one or more prior therapies and were randomly assigned to receive 6 mg or 12 mg deucravacitinib or placebo.
Disclosures: This clinical trial was sponsored by Bristol Myers Squibb (BMS). Four authors declared being current or former employees or shareholders of BMS. Other authors declared having ties with various sources, including BMS.
Source: Kavanaugh A, Coates LC, Mease PJ, et al. Deucravacitinib, a selective, TYK2 inhibitor, in psoriatic arthritis: Achievement of minimal disease activity components in a phase 2 trial. Rheumatology (Oxford). Published online October 18, 2024. Source
Key clinical point: In patients with psoriatic arthritis (PsA), deucravacitinib (6 mg or 12 mg once daily) vs placebo for 16 weeks led to a higher minimal disease activity (MDA) response and a greater proportion of patients achieving MDA in each component.
Major finding: After 16 weeks, a significantly higher proportion of patients treated with deucravacitinib vs placebo achieved MDA (6 mg: 22.9% vs 7.6%; P = .01 and 12 mg: 23.9% vs 7.6%; P = .007) and individual components of MDA, including the tender joint count, pain, and the Health Assessment Questionnaire–Disability Index (all P < .05).
Study details: This post hoc analysis of a phase 2 trial included 203 adults with PsA who did not respond to or were intolerant to one or more prior therapies and were randomly assigned to receive 6 mg or 12 mg deucravacitinib or placebo.
Disclosures: This clinical trial was sponsored by Bristol Myers Squibb (BMS). Four authors declared being current or former employees or shareholders of BMS. Other authors declared having ties with various sources, including BMS.
Source: Kavanaugh A, Coates LC, Mease PJ, et al. Deucravacitinib, a selective, TYK2 inhibitor, in psoriatic arthritis: Achievement of minimal disease activity components in a phase 2 trial. Rheumatology (Oxford). Published online October 18, 2024. Source
Key clinical point: In patients with psoriatic arthritis (PsA), deucravacitinib (6 mg or 12 mg once daily) vs placebo for 16 weeks led to a higher minimal disease activity (MDA) response and a greater proportion of patients achieving MDA in each component.
Major finding: After 16 weeks, a significantly higher proportion of patients treated with deucravacitinib vs placebo achieved MDA (6 mg: 22.9% vs 7.6%; P = .01 and 12 mg: 23.9% vs 7.6%; P = .007) and individual components of MDA, including the tender joint count, pain, and the Health Assessment Questionnaire–Disability Index (all P < .05).
Study details: This post hoc analysis of a phase 2 trial included 203 adults with PsA who did not respond to or were intolerant to one or more prior therapies and were randomly assigned to receive 6 mg or 12 mg deucravacitinib or placebo.
Disclosures: This clinical trial was sponsored by Bristol Myers Squibb (BMS). Four authors declared being current or former employees or shareholders of BMS. Other authors declared having ties with various sources, including BMS.
Source: Kavanaugh A, Coates LC, Mease PJ, et al. Deucravacitinib, a selective, TYK2 inhibitor, in psoriatic arthritis: Achievement of minimal disease activity components in a phase 2 trial. Rheumatology (Oxford). Published online October 18, 2024. Source
Apremilast Reduces MRI-Detected Inflammation in Joints and Entheses in PsA
Key clinical point: Apremilast reduced inflammation in the joints and entheses of patients with psoriatic arthritis (PsA), as assessed by magnetic resonance imaging.
Major finding: Apremilast improved the composite inflammation score of bone marrow edema, synovitis, and tenosynovitis in the hand, as assessed by the Psoriatic Arthritis Magnetic Resonance Imaging Scoring System at week 24 (least squares mean change [Δ], −2.32; 95% CI, −4.73 to 0.09) and week 48 (Δ, −2.91; 95% CI, −5.45 to −0.37). No new safety concerns were reported.
Study details: This phase 4 MOSAIC study included 122 adults with PsA treated with apremilast, each having at least three swollen and three tender joints involving the hands, along with at least 1 active enthesitis site.
Disclosures: This study was funded by Amgen. Six authors reported being employees of and owning stock in Amgen. Other authors declared having ties with various sources, including Amgen.
Source: Østergaard M, Boesen M, Maksymowych WP, et al. Effect of apremilast on hand and whole-body MRI assessments of inflammation in patients with psoriatic arthritis (MOSAIC): A phase 4, multicentre, single-arm, open-label study. Lancet Rheumatol. Published online October 30, 2024. Source
Key clinical point: Apremilast reduced inflammation in the joints and entheses of patients with psoriatic arthritis (PsA), as assessed by magnetic resonance imaging.
Major finding: Apremilast improved the composite inflammation score of bone marrow edema, synovitis, and tenosynovitis in the hand, as assessed by the Psoriatic Arthritis Magnetic Resonance Imaging Scoring System at week 24 (least squares mean change [Δ], −2.32; 95% CI, −4.73 to 0.09) and week 48 (Δ, −2.91; 95% CI, −5.45 to −0.37). No new safety concerns were reported.
Study details: This phase 4 MOSAIC study included 122 adults with PsA treated with apremilast, each having at least three swollen and three tender joints involving the hands, along with at least 1 active enthesitis site.
Disclosures: This study was funded by Amgen. Six authors reported being employees of and owning stock in Amgen. Other authors declared having ties with various sources, including Amgen.
Source: Østergaard M, Boesen M, Maksymowych WP, et al. Effect of apremilast on hand and whole-body MRI assessments of inflammation in patients with psoriatic arthritis (MOSAIC): A phase 4, multicentre, single-arm, open-label study. Lancet Rheumatol. Published online October 30, 2024. Source
Key clinical point: Apremilast reduced inflammation in the joints and entheses of patients with psoriatic arthritis (PsA), as assessed by magnetic resonance imaging.
Major finding: Apremilast improved the composite inflammation score of bone marrow edema, synovitis, and tenosynovitis in the hand, as assessed by the Psoriatic Arthritis Magnetic Resonance Imaging Scoring System at week 24 (least squares mean change [Δ], −2.32; 95% CI, −4.73 to 0.09) and week 48 (Δ, −2.91; 95% CI, −5.45 to −0.37). No new safety concerns were reported.
Study details: This phase 4 MOSAIC study included 122 adults with PsA treated with apremilast, each having at least three swollen and three tender joints involving the hands, along with at least 1 active enthesitis site.
Disclosures: This study was funded by Amgen. Six authors reported being employees of and owning stock in Amgen. Other authors declared having ties with various sources, including Amgen.
Source: Østergaard M, Boesen M, Maksymowych WP, et al. Effect of apremilast on hand and whole-body MRI assessments of inflammation in patients with psoriatic arthritis (MOSAIC): A phase 4, multicentre, single-arm, open-label study. Lancet Rheumatol. Published online October 30, 2024. Source
Guselkumab Improves Disease Activity Across Multiple Domains in TNFi-IR PsA
Key clinical point: Guselkumab led to sustained minimal or low disease activity (MDA/LDA) and remission across multiple disease domains over 1 year in patients with psoriatic arthritis (PsA) who had an inadequate response or intolerance to tumor necrosis factor inhibitors (TNFi-IR).
Major finding: At week 24, a greater proportion of patients receiving guselkumab vs placebo achieved MDA/LDA (14.8%-52.4% vs 3.1%-28.1%) and remission (3.7%-5.3% vs 0.0%-2.1%), according to composite indices. Most of the patients who achieved LDA/MDA or remission at week 24 (≥70%) maintained the response at week 48.
Study details: This post hoc analysis of the phase 3b COSMOS trial included 285 patients with PsA who had TNFi-IR and were randomly assigned to receive 100 mg guselkumab (n = 189) or placebo (n = 96) with 51 patients switching to guselkumab at week 24.
Disclosures: This study was supported by Johnson & Johnson Innovative Medicine. Several authors declared having ties with various sources, including being employees and having stock options or bond ownership in Johnson & Johnson or its subsidiaries.
Source: Gossec L, Baraliakos X, Aletaha D, et al. Multi-domain effectiveness of guselkumab evaluated via composite indices through 1 year in patients with PsA and inadequate response to TNFi: Post hoc analysis of COSMOS. Rheumatology (Oxford). Published online October 22, 2024. Source
Key clinical point: Guselkumab led to sustained minimal or low disease activity (MDA/LDA) and remission across multiple disease domains over 1 year in patients with psoriatic arthritis (PsA) who had an inadequate response or intolerance to tumor necrosis factor inhibitors (TNFi-IR).
Major finding: At week 24, a greater proportion of patients receiving guselkumab vs placebo achieved MDA/LDA (14.8%-52.4% vs 3.1%-28.1%) and remission (3.7%-5.3% vs 0.0%-2.1%), according to composite indices. Most of the patients who achieved LDA/MDA or remission at week 24 (≥70%) maintained the response at week 48.
Study details: This post hoc analysis of the phase 3b COSMOS trial included 285 patients with PsA who had TNFi-IR and were randomly assigned to receive 100 mg guselkumab (n = 189) or placebo (n = 96) with 51 patients switching to guselkumab at week 24.
Disclosures: This study was supported by Johnson & Johnson Innovative Medicine. Several authors declared having ties with various sources, including being employees and having stock options or bond ownership in Johnson & Johnson or its subsidiaries.
Source: Gossec L, Baraliakos X, Aletaha D, et al. Multi-domain effectiveness of guselkumab evaluated via composite indices through 1 year in patients with PsA and inadequate response to TNFi: Post hoc analysis of COSMOS. Rheumatology (Oxford). Published online October 22, 2024. Source
Key clinical point: Guselkumab led to sustained minimal or low disease activity (MDA/LDA) and remission across multiple disease domains over 1 year in patients with psoriatic arthritis (PsA) who had an inadequate response or intolerance to tumor necrosis factor inhibitors (TNFi-IR).
Major finding: At week 24, a greater proportion of patients receiving guselkumab vs placebo achieved MDA/LDA (14.8%-52.4% vs 3.1%-28.1%) and remission (3.7%-5.3% vs 0.0%-2.1%), according to composite indices. Most of the patients who achieved LDA/MDA or remission at week 24 (≥70%) maintained the response at week 48.
Study details: This post hoc analysis of the phase 3b COSMOS trial included 285 patients with PsA who had TNFi-IR and were randomly assigned to receive 100 mg guselkumab (n = 189) or placebo (n = 96) with 51 patients switching to guselkumab at week 24.
Disclosures: This study was supported by Johnson & Johnson Innovative Medicine. Several authors declared having ties with various sources, including being employees and having stock options or bond ownership in Johnson & Johnson or its subsidiaries.
Source: Gossec L, Baraliakos X, Aletaha D, et al. Multi-domain effectiveness of guselkumab evaluated via composite indices through 1 year in patients with PsA and inadequate response to TNFi: Post hoc analysis of COSMOS. Rheumatology (Oxford). Published online October 22, 2024. Source
Erenumab Outperforms Topiramate in Chronic Migraine Prevention
Key clinical point: Both erenumab and topiramate reduced migraine-induced disability; however, erenumab had a better safety profile for the prevention of chronic migraine.
Major findings: Migraine Disability Assessment (MIDAS) scores reduced after 3 months of treatment with both erenumab (15.17 at baseline to 5.79 at 3 months post-treatment) and topiramate (9.13 at baseline to 6.20 at 3 months post-treatment). A 50% reduction in the MIDAS score was achieved in patients receiving erenumab vs topiramate (≈79% vs 16%), with fewer discontinuations due to adverse events in patients receiving erenumab vs topiramate (3.8% vs 14.2%).
Study details: This retrospective cohort study included adults with a 12-month history of episodic or chronic migraine who received erenumab once monthly (dose, 70 mg/month; n = 52) or topiramate twice daily (dose, 50-100 mg/day; n = 56).
Disclosure: The study was funded by the Dubai Medical College for Girls. The authors declared no conflicts of interest.
Source: Nebrisi EE, Ruwayya ZSA, Alzayori DI, Alzayori RI, Chandran SB, Elshafei M. Efficacy and tolerability of erenumab and topiramate for prevention of chronic migraine: A retrospective cohort study. Medicina. Published online October 14, 2024. Source
Key clinical point: Both erenumab and topiramate reduced migraine-induced disability; however, erenumab had a better safety profile for the prevention of chronic migraine.
Major findings: Migraine Disability Assessment (MIDAS) scores reduced after 3 months of treatment with both erenumab (15.17 at baseline to 5.79 at 3 months post-treatment) and topiramate (9.13 at baseline to 6.20 at 3 months post-treatment). A 50% reduction in the MIDAS score was achieved in patients receiving erenumab vs topiramate (≈79% vs 16%), with fewer discontinuations due to adverse events in patients receiving erenumab vs topiramate (3.8% vs 14.2%).
Study details: This retrospective cohort study included adults with a 12-month history of episodic or chronic migraine who received erenumab once monthly (dose, 70 mg/month; n = 52) or topiramate twice daily (dose, 50-100 mg/day; n = 56).
Disclosure: The study was funded by the Dubai Medical College for Girls. The authors declared no conflicts of interest.
Source: Nebrisi EE, Ruwayya ZSA, Alzayori DI, Alzayori RI, Chandran SB, Elshafei M. Efficacy and tolerability of erenumab and topiramate for prevention of chronic migraine: A retrospective cohort study. Medicina. Published online October 14, 2024. Source
Key clinical point: Both erenumab and topiramate reduced migraine-induced disability; however, erenumab had a better safety profile for the prevention of chronic migraine.
Major findings: Migraine Disability Assessment (MIDAS) scores reduced after 3 months of treatment with both erenumab (15.17 at baseline to 5.79 at 3 months post-treatment) and topiramate (9.13 at baseline to 6.20 at 3 months post-treatment). A 50% reduction in the MIDAS score was achieved in patients receiving erenumab vs topiramate (≈79% vs 16%), with fewer discontinuations due to adverse events in patients receiving erenumab vs topiramate (3.8% vs 14.2%).
Study details: This retrospective cohort study included adults with a 12-month history of episodic or chronic migraine who received erenumab once monthly (dose, 70 mg/month; n = 52) or topiramate twice daily (dose, 50-100 mg/day; n = 56).
Disclosure: The study was funded by the Dubai Medical College for Girls. The authors declared no conflicts of interest.
Source: Nebrisi EE, Ruwayya ZSA, Alzayori DI, Alzayori RI, Chandran SB, Elshafei M. Efficacy and tolerability of erenumab and topiramate for prevention of chronic migraine: A retrospective cohort study. Medicina. Published online October 14, 2024. Source
Genetic Risk Linked to Earlier Migraine Onset but Not Chronification
Key clinical point: A higher polygenic risk score (PRS) was associated with an earlier migraine onset in both women and men; however, it was not associated with migraine chronification.
Major findings: A higher PRS was strongly associated with an earlier onset of migraine in both women (hazard ratios [HRs], 2.1 in DodoNA and 1.8 in GHI; P < .001 for both) and men (HRs, 2.5 in DodoNA; P < .001 and 1.6 in GHI; P = .027). However, PRS was not associated with migraine chronification (HR, 1.2; P = .424).
Study details: This retrospective clinical/genetic case-control study analyzed data from the DodoNA cohort (1653 individuals with migraine and 3460 control individuals without migraine) and the GHI cohort (2443 individuals with migraine and 8576 control individuals without migraine).
Disclosure: The study was funded by the Agency for Healthcare Research and Quality. Two authors declared having ties with various sources.
Source: Chase BA, Frigerio R, Rubin S, et al. An integrative migraine polygenic risk score is associated with age at onset but not with chronification. Published online October 29, 2024. Source
Key clinical point: A higher polygenic risk score (PRS) was associated with an earlier migraine onset in both women and men; however, it was not associated with migraine chronification.
Major findings: A higher PRS was strongly associated with an earlier onset of migraine in both women (hazard ratios [HRs], 2.1 in DodoNA and 1.8 in GHI; P < .001 for both) and men (HRs, 2.5 in DodoNA; P < .001 and 1.6 in GHI; P = .027). However, PRS was not associated with migraine chronification (HR, 1.2; P = .424).
Study details: This retrospective clinical/genetic case-control study analyzed data from the DodoNA cohort (1653 individuals with migraine and 3460 control individuals without migraine) and the GHI cohort (2443 individuals with migraine and 8576 control individuals without migraine).
Disclosure: The study was funded by the Agency for Healthcare Research and Quality. Two authors declared having ties with various sources.
Source: Chase BA, Frigerio R, Rubin S, et al. An integrative migraine polygenic risk score is associated with age at onset but not with chronification. Published online October 29, 2024. Source
Key clinical point: A higher polygenic risk score (PRS) was associated with an earlier migraine onset in both women and men; however, it was not associated with migraine chronification.
Major findings: A higher PRS was strongly associated with an earlier onset of migraine in both women (hazard ratios [HRs], 2.1 in DodoNA and 1.8 in GHI; P < .001 for both) and men (HRs, 2.5 in DodoNA; P < .001 and 1.6 in GHI; P = .027). However, PRS was not associated with migraine chronification (HR, 1.2; P = .424).
Study details: This retrospective clinical/genetic case-control study analyzed data from the DodoNA cohort (1653 individuals with migraine and 3460 control individuals without migraine) and the GHI cohort (2443 individuals with migraine and 8576 control individuals without migraine).
Disclosure: The study was funded by the Agency for Healthcare Research and Quality. Two authors declared having ties with various sources.
Source: Chase BA, Frigerio R, Rubin S, et al. An integrative migraine polygenic risk score is associated with age at onset but not with chronification. Published online October 29, 2024. Source
Atogepant Is Effective and Safe for Episodic Migraine Prevention
Key clinical point: Atogepant was an effective and safe treatment option for the prevention of episodic migraine.
Major findings: Atogepant (10 mg, 30 mg, and 60 mg) vs placebo led to a significant reduction in monthly migraine days (MMDs; P < .001, P < .001, and P = .0009, respectively), monthly headache days (all P < .001), acute medication use (all P < .001), as well as increase in the proportion of patients achieving a ≥50% reduction in MMDs (P = .007, P = .02, and P = .003, respectively). No significant difference was observed in serious adverse events between the atogepant and placebo groups.
Study details: This meta-analysis of six randomized controlled trials included 4569 patients with episodic migraine who were randomly assigned to receive atogepant (10 mg, 30 mg, or 60 mg) or placebo.
Disclosure: The study did not receive funding from any sources. The authors declared no conflicts of interest.
Source: Alrasheed AS, Almaqboul TM, Alshamrani RA, AlMohish NM, Alabdali MM. Safety and efficacy of atogepant for the preventive treatment of migraines in adults: A systematic review and meta-analysis. J Clin Med. Published online November 08, 2024. Source
Key clinical point: Atogepant was an effective and safe treatment option for the prevention of episodic migraine.
Major findings: Atogepant (10 mg, 30 mg, and 60 mg) vs placebo led to a significant reduction in monthly migraine days (MMDs; P < .001, P < .001, and P = .0009, respectively), monthly headache days (all P < .001), acute medication use (all P < .001), as well as increase in the proportion of patients achieving a ≥50% reduction in MMDs (P = .007, P = .02, and P = .003, respectively). No significant difference was observed in serious adverse events between the atogepant and placebo groups.
Study details: This meta-analysis of six randomized controlled trials included 4569 patients with episodic migraine who were randomly assigned to receive atogepant (10 mg, 30 mg, or 60 mg) or placebo.
Disclosure: The study did not receive funding from any sources. The authors declared no conflicts of interest.
Source: Alrasheed AS, Almaqboul TM, Alshamrani RA, AlMohish NM, Alabdali MM. Safety and efficacy of atogepant for the preventive treatment of migraines in adults: A systematic review and meta-analysis. J Clin Med. Published online November 08, 2024. Source
Key clinical point: Atogepant was an effective and safe treatment option for the prevention of episodic migraine.
Major findings: Atogepant (10 mg, 30 mg, and 60 mg) vs placebo led to a significant reduction in monthly migraine days (MMDs; P < .001, P < .001, and P = .0009, respectively), monthly headache days (all P < .001), acute medication use (all P < .001), as well as increase in the proportion of patients achieving a ≥50% reduction in MMDs (P = .007, P = .02, and P = .003, respectively). No significant difference was observed in serious adverse events between the atogepant and placebo groups.
Study details: This meta-analysis of six randomized controlled trials included 4569 patients with episodic migraine who were randomly assigned to receive atogepant (10 mg, 30 mg, or 60 mg) or placebo.
Disclosure: The study did not receive funding from any sources. The authors declared no conflicts of interest.
Source: Alrasheed AS, Almaqboul TM, Alshamrani RA, AlMohish NM, Alabdali MM. Safety and efficacy of atogepant for the preventive treatment of migraines in adults: A systematic review and meta-analysis. J Clin Med. Published online November 08, 2024. Source
Migraine With Aura Increases Stroke Risk in Pregnancy
Key clinical point: Pregnant women with migraine with aura had a significantly increased risk for both acute ischemic stroke and hemorrhagic stroke.
Major findings: Pregnant women with vs without migraine had a higher incidence of acute ischemic stroke (0.1% vs 0.0%) and hemorrhagic stroke (0.3% vs 0.1%). The risk for acute ischemic stroke was highest in those with aura (odds ratio [OR], 23.26; 95% CI, 18.46-29.31), followed by those without aura (OR, 8.15; 95% CI, 4.79-13.88) and those with unspecified migraine (OR, 5.43; 95% CI, 4.72-6.25).
Study details: This population-based study utilized the Healthcare Cost and Utilization Project's National Inpatient Sample database and involved 19,825,525 pregnant women, of whom 1.1% had migraine.
Disclosure: The study did not receive any funding. The authors declared no conflicts of interest.
Source: Reddy M, Vazquez S, Nolan B, et al. Migraine and its association with stroke in pregnancy: A national examination. J Womens Health. 2024;33:1476-1481. Source
Key clinical point: Pregnant women with migraine with aura had a significantly increased risk for both acute ischemic stroke and hemorrhagic stroke.
Major findings: Pregnant women with vs without migraine had a higher incidence of acute ischemic stroke (0.1% vs 0.0%) and hemorrhagic stroke (0.3% vs 0.1%). The risk for acute ischemic stroke was highest in those with aura (odds ratio [OR], 23.26; 95% CI, 18.46-29.31), followed by those without aura (OR, 8.15; 95% CI, 4.79-13.88) and those with unspecified migraine (OR, 5.43; 95% CI, 4.72-6.25).
Study details: This population-based study utilized the Healthcare Cost and Utilization Project's National Inpatient Sample database and involved 19,825,525 pregnant women, of whom 1.1% had migraine.
Disclosure: The study did not receive any funding. The authors declared no conflicts of interest.
Source: Reddy M, Vazquez S, Nolan B, et al. Migraine and its association with stroke in pregnancy: A national examination. J Womens Health. 2024;33:1476-1481. Source
Key clinical point: Pregnant women with migraine with aura had a significantly increased risk for both acute ischemic stroke and hemorrhagic stroke.
Major findings: Pregnant women with vs without migraine had a higher incidence of acute ischemic stroke (0.1% vs 0.0%) and hemorrhagic stroke (0.3% vs 0.1%). The risk for acute ischemic stroke was highest in those with aura (odds ratio [OR], 23.26; 95% CI, 18.46-29.31), followed by those without aura (OR, 8.15; 95% CI, 4.79-13.88) and those with unspecified migraine (OR, 5.43; 95% CI, 4.72-6.25).
Study details: This population-based study utilized the Healthcare Cost and Utilization Project's National Inpatient Sample database and involved 19,825,525 pregnant women, of whom 1.1% had migraine.
Disclosure: The study did not receive any funding. The authors declared no conflicts of interest.
Source: Reddy M, Vazquez S, Nolan B, et al. Migraine and its association with stroke in pregnancy: A national examination. J Womens Health. 2024;33:1476-1481. Source