Migraine ICYMI

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

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

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

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

Key clinical point: Increased cardiovascular (CV) risk, as assessed by the Systematic Coronary Risk Evaluation 2 system, was associated with a lower risk for prevalent and incident migraine, notably in women.

Major findings: Compared with individuals with the lowest CV risk scores (< 1%), those with CV risk scores of 1% to < 2.5% had a higher risk for prevalent migraine (odds ratio [OR], 0.93; 95% CI, 0.90-0.96) and incident migraine (OR, 0.63; 95% CI, 0.57-0.69), whereas individuals with CV risk scores ≥ 10% had a lower risk for prevalent migraine (OR, 0.43; 95% CI, 0.39-0.48) and incident migraine (OR, 0.17; 95% CI, 0.10-0.27). The association between migraine and CV risk was stronger in women than in men within the same CV risk categories.

Study details: This ~13-year prospective population-based study involved 140,915 adults (58.5% women), with 25,915 having prevalent migraine and 2224 having incident migraine.

Disclosure: The study was supported by the Dutch Research Council and others. Two authors reported receiving research grants, advisory board fees, or speaking fees from various sources.

Source: Al-Hassany L, MaassenVanDenBrink A, Kurth T. Cardiovascular risk scores and migraine status. JAMA Netw Open. Published online October 22, 2024. Source

Key clinical point: Increased cardiovascular (CV) risk, as assessed by the Systematic Coronary Risk Evaluation 2 system, was associated with a lower risk for prevalent and incident migraine, notably in women.

Major findings: Compared with individuals with the lowest CV risk scores (< 1%), those with CV risk scores of 1% to < 2.5% had a higher risk for prevalent migraine (odds ratio [OR], 0.93; 95% CI, 0.90-0.96) and incident migraine (OR, 0.63; 95% CI, 0.57-0.69), whereas individuals with CV risk scores ≥ 10% had a lower risk for prevalent migraine (OR, 0.43; 95% CI, 0.39-0.48) and incident migraine (OR, 0.17; 95% CI, 0.10-0.27). The association between migraine and CV risk was stronger in women than in men within the same CV risk categories.

Study details: This ~13-year prospective population-based study involved 140,915 adults (58.5% women), with 25,915 having prevalent migraine and 2224 having incident migraine.

Disclosure: The study was supported by the Dutch Research Council and others. Two authors reported receiving research grants, advisory board fees, or speaking fees from various sources.

Source: Al-Hassany L, MaassenVanDenBrink A, Kurth T. Cardiovascular risk scores and migraine status. JAMA Netw Open. Published online October 22, 2024. Source

Key clinical point: Increased cardiovascular (CV) risk, as assessed by the Systematic Coronary Risk Evaluation 2 system, was associated with a lower risk for prevalent and incident migraine, notably in women.

Major findings: Compared with individuals with the lowest CV risk scores (< 1%), those with CV risk scores of 1% to < 2.5% had a higher risk for prevalent migraine (odds ratio [OR], 0.93; 95% CI, 0.90-0.96) and incident migraine (OR, 0.63; 95% CI, 0.57-0.69), whereas individuals with CV risk scores ≥ 10% had a lower risk for prevalent migraine (OR, 0.43; 95% CI, 0.39-0.48) and incident migraine (OR, 0.17; 95% CI, 0.10-0.27). The association between migraine and CV risk was stronger in women than in men within the same CV risk categories.

Study details: This ~13-year prospective population-based study involved 140,915 adults (58.5% women), with 25,915 having prevalent migraine and 2224 having incident migraine.

Disclosure: The study was supported by the Dutch Research Council and others. Two authors reported receiving research grants, advisory board fees, or speaking fees from various sources.

Source: Al-Hassany L, MaassenVanDenBrink A, Kurth T. Cardiovascular risk scores and migraine status. JAMA Netw Open. Published online October 22, 2024. Source

Key clinical point: In patients with migraine and those with prior treatment failure and medication overuse (MO), eptinezumab significantly reduced acute headache medication (AHM), with sustained reductions for up to 18 months.

Major findings: Eptinezumab significantly reduced AHM compared with placebo in patients with migraine and those with MO (P < .001 for all). These reductions in AHM were sustained through the 18-month treatment period, with continued reductions in the extension period. 

Study details: This DELIVER trial post-hoc analysis of 890 patients, 49.2% had MO who failed 2-4 preventive treatments, among these 865 patients continued in the 48-week extension period. 

Disclosure: This study was funded by H. Lundbeck A/S. Two authors reported receiving speaking fees from various sources. Five authors declared being full-time employees of H. Lundbeck A/S. Other authors declared multiple ties with various sources.

Source: Gryglas-Dworak A, Schim J, Ettrup A, et al. Long-term reductions in acute headache medication use after eptinezumab treatment in patients with migraine and prior preventive treatment failures: Post hoc analysis of the DELIVER randomized trial. Headache. Published online November 5, 2024. Source

Key clinical point: In patients with migraine and those with prior treatment failure and medication overuse (MO), eptinezumab significantly reduced acute headache medication (AHM), with sustained reductions for up to 18 months.

Major findings: Eptinezumab significantly reduced AHM compared with placebo in patients with migraine and those with MO (P < .001 for all). These reductions in AHM were sustained through the 18-month treatment period, with continued reductions in the extension period. 

Study details: This DELIVER trial post-hoc analysis of 890 patients, 49.2% had MO who failed 2-4 preventive treatments, among these 865 patients continued in the 48-week extension period. 

Disclosure: This study was funded by H. Lundbeck A/S. Two authors reported receiving speaking fees from various sources. Five authors declared being full-time employees of H. Lundbeck A/S. Other authors declared multiple ties with various sources.

Source: Gryglas-Dworak A, Schim J, Ettrup A, et al. Long-term reductions in acute headache medication use after eptinezumab treatment in patients with migraine and prior preventive treatment failures: Post hoc analysis of the DELIVER randomized trial. Headache. Published online November 5, 2024. Source

Key clinical point: In patients with migraine and those with prior treatment failure and medication overuse (MO), eptinezumab significantly reduced acute headache medication (AHM), with sustained reductions for up to 18 months.

Major findings: Eptinezumab significantly reduced AHM compared with placebo in patients with migraine and those with MO (P < .001 for all). These reductions in AHM were sustained through the 18-month treatment period, with continued reductions in the extension period. 

Study details: This DELIVER trial post-hoc analysis of 890 patients, 49.2% had MO who failed 2-4 preventive treatments, among these 865 patients continued in the 48-week extension period. 

Disclosure: This study was funded by H. Lundbeck A/S. Two authors reported receiving speaking fees from various sources. Five authors declared being full-time employees of H. Lundbeck A/S. Other authors declared multiple ties with various sources.

Source: Gryglas-Dworak A, Schim J, Ettrup A, et al. Long-term reductions in acute headache medication use after eptinezumab treatment in patients with migraine and prior preventive treatment failures: Post hoc analysis of the DELIVER randomized trial. Headache. Published online November 5, 2024. Source

Key clinical point: Patients with migraine, particularly those with severe symptoms, were at a higher risk for occupational burnout than those without migraine.

Major findings: Patients with vs without migraine experienced increased occupational burnout (mean burnout score, 3.46 vs 2.82), had higher rates of depression (mean Depression, Anxiety and Stress Scale–21 score, 0.864 vs 0.664), worked longer hours (median weekly hours, 40.0 vs 36.0), and preferred remote work (20.3% vs 10.3%). Migraine severity, as measured by the Migraine Disability Assessment, was significantly associated with increased occupational burnout (P < .001).

Study details: This observational cohort study included 675 patients with migraine and 232 patients without migraine, matched according to age, gender, and primary clinic. 

Disclosure: The study was funded by Teva Pharmaceuticals. Gal Ifergane received consulting fees and honoraria from various sources, including Teva Pharmaceuticals, and others declared no conflicts of interest.

Source: Peles I, Sharvit S, Zlotnik Y, et al. Migraine and work — beyond absenteeism: Migraine severity and occupational burnout — A cohort study. Cephalalgia. Published online October 18, 2024. Source

Key clinical point: Patients with migraine, particularly those with severe symptoms, were at a higher risk for occupational burnout than those without migraine.

Major findings: Patients with vs without migraine experienced increased occupational burnout (mean burnout score, 3.46 vs 2.82), had higher rates of depression (mean Depression, Anxiety and Stress Scale–21 score, 0.864 vs 0.664), worked longer hours (median weekly hours, 40.0 vs 36.0), and preferred remote work (20.3% vs 10.3%). Migraine severity, as measured by the Migraine Disability Assessment, was significantly associated with increased occupational burnout (P < .001).

Study details: This observational cohort study included 675 patients with migraine and 232 patients without migraine, matched according to age, gender, and primary clinic. 

Disclosure: The study was funded by Teva Pharmaceuticals. Gal Ifergane received consulting fees and honoraria from various sources, including Teva Pharmaceuticals, and others declared no conflicts of interest.

Source: Peles I, Sharvit S, Zlotnik Y, et al. Migraine and work — beyond absenteeism: Migraine severity and occupational burnout — A cohort study. Cephalalgia. Published online October 18, 2024. Source

Key clinical point: Patients with migraine, particularly those with severe symptoms, were at a higher risk for occupational burnout than those without migraine.

Major findings: Patients with vs without migraine experienced increased occupational burnout (mean burnout score, 3.46 vs 2.82), had higher rates of depression (mean Depression, Anxiety and Stress Scale–21 score, 0.864 vs 0.664), worked longer hours (median weekly hours, 40.0 vs 36.0), and preferred remote work (20.3% vs 10.3%). Migraine severity, as measured by the Migraine Disability Assessment, was significantly associated with increased occupational burnout (P < .001).

Study details: This observational cohort study included 675 patients with migraine and 232 patients without migraine, matched according to age, gender, and primary clinic. 

Disclosure: The study was funded by Teva Pharmaceuticals. Gal Ifergane received consulting fees and honoraria from various sources, including Teva Pharmaceuticals, and others declared no conflicts of interest.

Source: Peles I, Sharvit S, Zlotnik Y, et al. Migraine and work — beyond absenteeism: Migraine severity and occupational burnout — A cohort study. Cephalalgia. Published online October 18, 2024. Source

Key clinical point: Migraine, including migraine with aura (MWA) and migraine without aura (MWoA), was not a significant factor for stroke caused by cerebral small-vessel disease (CSVD) in adult patients hospitalized with first-ever ischemic stroke. 

Major findings: Patients with migraine (P = .003), those with MWA (P = .02), and those with MWoA (P = .04) were found to have a significantly lower prevalence of CSVD lesions than those without migraine. There was no significant association between CSVD lesions of any grade and migraine (P = .34), MWA (P = .60), and MWoA (P = .51).  

Study details: This retrospective case-control study included 646 patients who were hospitalized for their first-ever ischemic stroke, of whom 225 (34.82%) had migraine. Among those with migraine, 115 (17.8%) had MWA and 110 (17.02%) had MWoA. 

Disclosure: This study received no specific funding. One author declared receiving speaker fees from various pharmaceutical companies. 

Source: Cloet F, Gueyraud G, Lerebours F, Munio M, Larrue V, Gollion C. Stroke due to small-vessel disease and migraine: A case-control study of a young adult with ischemic stroke population. Cephalalgia. 2024;44:1-8. Source 

Key clinical point: Migraine, including migraine with aura (MWA) and migraine without aura (MWoA), was not a significant factor for stroke caused by cerebral small-vessel disease (CSVD) in adult patients hospitalized with first-ever ischemic stroke. 

Major findings: Patients with migraine (P = .003), those with MWA (P = .02), and those with MWoA (P = .04) were found to have a significantly lower prevalence of CSVD lesions than those without migraine. There was no significant association between CSVD lesions of any grade and migraine (P = .34), MWA (P = .60), and MWoA (P = .51).  

Study details: This retrospective case-control study included 646 patients who were hospitalized for their first-ever ischemic stroke, of whom 225 (34.82%) had migraine. Among those with migraine, 115 (17.8%) had MWA and 110 (17.02%) had MWoA. 

Disclosure: This study received no specific funding. One author declared receiving speaker fees from various pharmaceutical companies. 

Source: Cloet F, Gueyraud G, Lerebours F, Munio M, Larrue V, Gollion C. Stroke due to small-vessel disease and migraine: A case-control study of a young adult with ischemic stroke population. Cephalalgia. 2024;44:1-8. Source 

Key clinical point: Migraine, including migraine with aura (MWA) and migraine without aura (MWoA), was not a significant factor for stroke caused by cerebral small-vessel disease (CSVD) in adult patients hospitalized with first-ever ischemic stroke. 

Major findings: Patients with migraine (P = .003), those with MWA (P = .02), and those with MWoA (P = .04) were found to have a significantly lower prevalence of CSVD lesions than those without migraine. There was no significant association between CSVD lesions of any grade and migraine (P = .34), MWA (P = .60), and MWoA (P = .51).  

Study details: This retrospective case-control study included 646 patients who were hospitalized for their first-ever ischemic stroke, of whom 225 (34.82%) had migraine. Among those with migraine, 115 (17.8%) had MWA and 110 (17.02%) had MWoA. 

Disclosure: This study received no specific funding. One author declared receiving speaker fees from various pharmaceutical companies. 

Source: Cloet F, Gueyraud G, Lerebours F, Munio M, Larrue V, Gollion C. Stroke due to small-vessel disease and migraine: A case-control study of a young adult with ischemic stroke population. Cephalalgia. 2024;44:1-8. Source 

Key clinical point: Switching to intravenous eptinezumab may benefit patients with treatment-refractory migraine who have previously failed subcutaneous calcitonin gene-related peptide-receptor (CGRP-R) monoclonal antibodies (mAbs).

Major findings: At 12 and 24 weeks of eptinezumab treatment, 23.1% and 29.7% of patients had ≥30% reduction in monthly migraine days, whereas 15.4% and 21.4% had ≥30% reduction in monthly headache days, respectively. At 21-24 weeks, 38.5% and 52.4% of patients showed significant reductions in the Headache Impact Test and Migraine Disability Assessment scores, respectively. No adverse events were reported during the 24-week treatment period.

Study details: This monocentric retrospective longitudinal cohort study included 41 patients with migraine unresponsive to ≥1 subcutaneous CGRP mAb, who received an initial 100 mg dose of intravenous eptinezumab, followed by 100 or 300 mg after 12 weeks.

Disclosure: This study was supported by the Lundbeck Foundation. Several authors declared receiving personal fees from various sources. 

Source: Triller P, Blessing VN, Overeem LH, et al. Efficacy of eptinezumab in non-responders to subcutaneous monoclonal antibodies against CGRP and the CGRP receptor: A retrospective cohort study. Cephalalgia. Published online October 29, 2024. Source

Key clinical point: Switching to intravenous eptinezumab may benefit patients with treatment-refractory migraine who have previously failed subcutaneous calcitonin gene-related peptide-receptor (CGRP-R) monoclonal antibodies (mAbs).

Major findings: At 12 and 24 weeks of eptinezumab treatment, 23.1% and 29.7% of patients had ≥30% reduction in monthly migraine days, whereas 15.4% and 21.4% had ≥30% reduction in monthly headache days, respectively. At 21-24 weeks, 38.5% and 52.4% of patients showed significant reductions in the Headache Impact Test and Migraine Disability Assessment scores, respectively. No adverse events were reported during the 24-week treatment period.

Study details: This monocentric retrospective longitudinal cohort study included 41 patients with migraine unresponsive to ≥1 subcutaneous CGRP mAb, who received an initial 100 mg dose of intravenous eptinezumab, followed by 100 or 300 mg after 12 weeks.

Disclosure: This study was supported by the Lundbeck Foundation. Several authors declared receiving personal fees from various sources. 

Source: Triller P, Blessing VN, Overeem LH, et al. Efficacy of eptinezumab in non-responders to subcutaneous monoclonal antibodies against CGRP and the CGRP receptor: A retrospective cohort study. Cephalalgia. Published online October 29, 2024. Source

Key clinical point: Switching to intravenous eptinezumab may benefit patients with treatment-refractory migraine who have previously failed subcutaneous calcitonin gene-related peptide-receptor (CGRP-R) monoclonal antibodies (mAbs).

Major findings: At 12 and 24 weeks of eptinezumab treatment, 23.1% and 29.7% of patients had ≥30% reduction in monthly migraine days, whereas 15.4% and 21.4% had ≥30% reduction in monthly headache days, respectively. At 21-24 weeks, 38.5% and 52.4% of patients showed significant reductions in the Headache Impact Test and Migraine Disability Assessment scores, respectively. No adverse events were reported during the 24-week treatment period.

Study details: This monocentric retrospective longitudinal cohort study included 41 patients with migraine unresponsive to ≥1 subcutaneous CGRP mAb, who received an initial 100 mg dose of intravenous eptinezumab, followed by 100 or 300 mg after 12 weeks.

Disclosure: This study was supported by the Lundbeck Foundation. Several authors declared receiving personal fees from various sources. 

Source: Triller P, Blessing VN, Overeem LH, et al. Efficacy of eptinezumab in non-responders to subcutaneous monoclonal antibodies against CGRP and the CGRP receptor: A retrospective cohort study. Cephalalgia. Published online October 29, 2024. Source

Key clinical point: An increased waist-to-height ratio (WHtR), indicating central obesity, was associated with an increased incidence of migraine, particularly in individuals aged <60 years. 

Major findings: Each unit increase in WHtR was associated with a 70% increase in the incidence of migraines (odds ratio [OR], 1.70; 95% CI, 1.04-2.78). Individuals in the highest WHtR quartile (WHtR values, 0.64-1.01) had a 13% greater incidence of migraines than those in the lowest quartile (WHtR values, 0.35-0.52; OR, 1.13; 95% CI, 0.99-1.28). For individuals aged <60 years, each unit increase in WHtR was associated with an 82% increased risk for migraine (P < .01); however, WHtR was negatively associated with migraine risk among those aged ≥60 years. 

Study details: This cross-sectional study analyzed data from the National Health and Nutrition Examination Survey, including 13,344 participants, of whom 2764 had migraines. Disclosure: The study did not receive any funding. The authors declared no conflicts of interest. 

Source: Jin J, Zheng Y, Gao T, Lin X, Li S, Huang C. Associations between the waist-to-height ratio index and migraine: A cross-section study of the NHANES 1999–2004. PLoS ONE. Published online October 23, 2024. Source

Key clinical point: An increased waist-to-height ratio (WHtR), indicating central obesity, was associated with an increased incidence of migraine, particularly in individuals aged <60 years. 

Major findings: Each unit increase in WHtR was associated with a 70% increase in the incidence of migraines (odds ratio [OR], 1.70; 95% CI, 1.04-2.78). Individuals in the highest WHtR quartile (WHtR values, 0.64-1.01) had a 13% greater incidence of migraines than those in the lowest quartile (WHtR values, 0.35-0.52; OR, 1.13; 95% CI, 0.99-1.28). For individuals aged <60 years, each unit increase in WHtR was associated with an 82% increased risk for migraine (P < .01); however, WHtR was negatively associated with migraine risk among those aged ≥60 years. 

Study details: This cross-sectional study analyzed data from the National Health and Nutrition Examination Survey, including 13,344 participants, of whom 2764 had migraines. Disclosure: The study did not receive any funding. The authors declared no conflicts of interest. 

Source: Jin J, Zheng Y, Gao T, Lin X, Li S, Huang C. Associations between the waist-to-height ratio index and migraine: A cross-section study of the NHANES 1999–2004. PLoS ONE. Published online October 23, 2024. Source

Key clinical point: An increased waist-to-height ratio (WHtR), indicating central obesity, was associated with an increased incidence of migraine, particularly in individuals aged <60 years. 

Major findings: Each unit increase in WHtR was associated with a 70% increase in the incidence of migraines (odds ratio [OR], 1.70; 95% CI, 1.04-2.78). Individuals in the highest WHtR quartile (WHtR values, 0.64-1.01) had a 13% greater incidence of migraines than those in the lowest quartile (WHtR values, 0.35-0.52; OR, 1.13; 95% CI, 0.99-1.28). For individuals aged <60 years, each unit increase in WHtR was associated with an 82% increased risk for migraine (P < .01); however, WHtR was negatively associated with migraine risk among those aged ≥60 years. 

Study details: This cross-sectional study analyzed data from the National Health and Nutrition Examination Survey, including 13,344 participants, of whom 2764 had migraines. Disclosure: The study did not receive any funding. The authors declared no conflicts of interest. 

Source: Jin J, Zheng Y, Gao T, Lin X, Li S, Huang C. Associations between the waist-to-height ratio index and migraine: A cross-section study of the NHANES 1999–2004. PLoS ONE. Published online October 23, 2024. Source