Key clinical point: Patients with migraine who received calcitonin gene-related peptide inhibitors (CGRPi) showed improved pain reduction compared with those on other preventative medications.

Major findings: Patients who received only CGRPi or switched to CGRPi had significant reductions in mean pain scores (−2.0 and −2.7, respectively; both P < .001), whereas those on other migraine-preventative medications did not. Patients adhering to CGRPi, including those who received only CGRPi (−3.1; P = .005) and those who switched from other medications to CGRPi (−3.7; P = .002), had significantly reduced pain scores; however, no reduction in pain scores was noted in patients not adhering to CGRPi.

Study details: This retrospective study analyzed Patient Reported Outcomes Measurement Information System data for adults with migraine over 12 months, including 1245 patients on other preventive medications (antiseizures, antidepressants, or beta-blockers), 148 receiving only CGRPi, and 112 switching to CGRPi.

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

Source: Peasah SK, Soh YH, Huang Y, Nguyen J, Hanmer J, Good C. Patient reported outcomes and the real-world use of calcitonin gene–related peptide medications in migraine. Headache. Published online September 30, 2024. Source

Key clinical point: Patients with migraine who received calcitonin gene-related peptide inhibitors (CGRPi) showed improved pain reduction compared with those on other preventative medications.

Major findings: Patients who received only CGRPi or switched to CGRPi had significant reductions in mean pain scores (−2.0 and −2.7, respectively; both P < .001), whereas those on other migraine-preventative medications did not. Patients adhering to CGRPi, including those who received only CGRPi (−3.1; P = .005) and those who switched from other medications to CGRPi (−3.7; P = .002), had significantly reduced pain scores; however, no reduction in pain scores was noted in patients not adhering to CGRPi.

Study details: This retrospective study analyzed Patient Reported Outcomes Measurement Information System data for adults with migraine over 12 months, including 1245 patients on other preventive medications (antiseizures, antidepressants, or beta-blockers), 148 receiving only CGRPi, and 112 switching to CGRPi.

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

Source: Peasah SK, Soh YH, Huang Y, Nguyen J, Hanmer J, Good C. Patient reported outcomes and the real-world use of calcitonin gene–related peptide medications in migraine. Headache. Published online September 30, 2024. Source

Key clinical point: Patients with migraine who received calcitonin gene-related peptide inhibitors (CGRPi) showed improved pain reduction compared with those on other preventative medications.

Major findings: Patients who received only CGRPi or switched to CGRPi had significant reductions in mean pain scores (−2.0 and −2.7, respectively; both P < .001), whereas those on other migraine-preventative medications did not. Patients adhering to CGRPi, including those who received only CGRPi (−3.1; P = .005) and those who switched from other medications to CGRPi (−3.7; P = .002), had significantly reduced pain scores; however, no reduction in pain scores was noted in patients not adhering to CGRPi.

Study details: This retrospective study analyzed Patient Reported Outcomes Measurement Information System data for adults with migraine over 12 months, including 1245 patients on other preventive medications (antiseizures, antidepressants, or beta-blockers), 148 receiving only CGRPi, and 112 switching to CGRPi.

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

Source: Peasah SK, Soh YH, Huang Y, Nguyen J, Hanmer J, Good C. Patient reported outcomes and the real-world use of calcitonin gene–related peptide medications in migraine. Headache. Published online September 30, 2024. Source

Key clinical point: Ubrogepant showed real-world effectiveness for the acute treatment of migraine, with increased treatment satisfaction and a strong intention to continue using the medication.

Major findings: A high proportion of patients reported using ubrogepant for relief from migraine, with satisfaction rates of 75.8% at 2 hours, 83.4% at 4 hours, and 78.5% at 24 hours. Additionally, 85.1% were satisfied with their ability to think clearly and 83.8% were satisfied with returning to normal function. Overall, 90.7% participants intended to continue using ubrogepant and 87.4% reported switching to ubrogepant due to inadequate response to previous migraine treatments.

Study details: This observational cross-sectional study included 302 adults who had received ubrogepant for the acute treatment of migraine within the preceding 14 days; 120 participants reported taking 50 mg ubrogepant and 182 reported taking 100 mg ubrogepant.

Disclosure: The study was funded by AbbVie. Four authors declared being current or former employees of AbbVie and may hold stock in the company. Several authors reported having ties with various sources.

Source: Shewale AR, Poh W, Reed ML, et al. Ubrogepant users' real-world experience: Patients on ubrogepant, characteristics, and outcomes (UNIVERSE) study. Headache. Published online September 26, 2024. Source

Key clinical point: Ubrogepant showed real-world effectiveness for the acute treatment of migraine, with increased treatment satisfaction and a strong intention to continue using the medication.

Major findings: A high proportion of patients reported using ubrogepant for relief from migraine, with satisfaction rates of 75.8% at 2 hours, 83.4% at 4 hours, and 78.5% at 24 hours. Additionally, 85.1% were satisfied with their ability to think clearly and 83.8% were satisfied with returning to normal function. Overall, 90.7% participants intended to continue using ubrogepant and 87.4% reported switching to ubrogepant due to inadequate response to previous migraine treatments.

Study details: This observational cross-sectional study included 302 adults who had received ubrogepant for the acute treatment of migraine within the preceding 14 days; 120 participants reported taking 50 mg ubrogepant and 182 reported taking 100 mg ubrogepant.

Disclosure: The study was funded by AbbVie. Four authors declared being current or former employees of AbbVie and may hold stock in the company. Several authors reported having ties with various sources.

Source: Shewale AR, Poh W, Reed ML, et al. Ubrogepant users' real-world experience: Patients on ubrogepant, characteristics, and outcomes (UNIVERSE) study. Headache. Published online September 26, 2024. Source

Key clinical point: Ubrogepant showed real-world effectiveness for the acute treatment of migraine, with increased treatment satisfaction and a strong intention to continue using the medication.

Major findings: A high proportion of patients reported using ubrogepant for relief from migraine, with satisfaction rates of 75.8% at 2 hours, 83.4% at 4 hours, and 78.5% at 24 hours. Additionally, 85.1% were satisfied with their ability to think clearly and 83.8% were satisfied with returning to normal function. Overall, 90.7% participants intended to continue using ubrogepant and 87.4% reported switching to ubrogepant due to inadequate response to previous migraine treatments.

Study details: This observational cross-sectional study included 302 adults who had received ubrogepant for the acute treatment of migraine within the preceding 14 days; 120 participants reported taking 50 mg ubrogepant and 182 reported taking 100 mg ubrogepant.

Disclosure: The study was funded by AbbVie. Four authors declared being current or former employees of AbbVie and may hold stock in the company. Several authors reported having ties with various sources.

Source: Shewale AR, Poh W, Reed ML, et al. Ubrogepant users' real-world experience: Patients on ubrogepant, characteristics, and outcomes (UNIVERSE) study. Headache. Published online September 26, 2024. Source

Key clinical point: Patients with rheumatoid arthritis (RA) had a higher risk for migraine than those without RA, irrespective of the RA serologic status.

 Major findings: Patients with vs without RA had a 1.2-fold higher risk for migraine (adjusted hazard ratio (aHR), 1.21; 95% CI, 1.17-1.26). Both seropositive RA (aHR 1.20; 95% CI, 1.15-1.24) and seronegative RA (aHR, 1.26; 95% CI, 1.20-1.34) were associated with an increased risk for migraine. However, the risk was not significantly different between patients with seropositive RA and those with seronegative RA.

Study details: This longitudinal retrospective cohort study included 42,674 patients with RA (29,774 with seropositive RA and 12,900 with seronegative RA) and 213,370 age- and sex-matched control individuals without RA. Overall, 22,294 new migraine cases were reported during a mean follow-up of 4.4 years, following a 1-year lag period.

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

Source: Kang S, Eun Y, Han K, et al. Heightened migraine risk in patients with rheumatoid arthritis: A national retrospective cohort study. Headache. Published online September 13, 2024. Source

Key clinical point: Patients with rheumatoid arthritis (RA) had a higher risk for migraine than those without RA, irrespective of the RA serologic status.

 Major findings: Patients with vs without RA had a 1.2-fold higher risk for migraine (adjusted hazard ratio (aHR), 1.21; 95% CI, 1.17-1.26). Both seropositive RA (aHR 1.20; 95% CI, 1.15-1.24) and seronegative RA (aHR, 1.26; 95% CI, 1.20-1.34) were associated with an increased risk for migraine. However, the risk was not significantly different between patients with seropositive RA and those with seronegative RA.

Study details: This longitudinal retrospective cohort study included 42,674 patients with RA (29,774 with seropositive RA and 12,900 with seronegative RA) and 213,370 age- and sex-matched control individuals without RA. Overall, 22,294 new migraine cases were reported during a mean follow-up of 4.4 years, following a 1-year lag period.

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

Source: Kang S, Eun Y, Han K, et al. Heightened migraine risk in patients with rheumatoid arthritis: A national retrospective cohort study. Headache. Published online September 13, 2024. Source

Key clinical point: Patients with rheumatoid arthritis (RA) had a higher risk for migraine than those without RA, irrespective of the RA serologic status.

 Major findings: Patients with vs without RA had a 1.2-fold higher risk for migraine (adjusted hazard ratio (aHR), 1.21; 95% CI, 1.17-1.26). Both seropositive RA (aHR 1.20; 95% CI, 1.15-1.24) and seronegative RA (aHR, 1.26; 95% CI, 1.20-1.34) were associated with an increased risk for migraine. However, the risk was not significantly different between patients with seropositive RA and those with seronegative RA.

Study details: This longitudinal retrospective cohort study included 42,674 patients with RA (29,774 with seropositive RA and 12,900 with seronegative RA) and 213,370 age- and sex-matched control individuals without RA. Overall, 22,294 new migraine cases were reported during a mean follow-up of 4.4 years, following a 1-year lag period.

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

Source: Kang S, Eun Y, Han K, et al. Heightened migraine risk in patients with rheumatoid arthritis: A national retrospective cohort study. Headache. Published online September 13, 2024. Source

Key clinical point: Patients with epilepsy showed no significant increase in the overall prevalence of migraine or non-migraine headaches, but those with epilepsy and migraine had an increased frequency of headaches.

Major findings: Compared with individuals without epilepsy, patients with epilepsy had no significant increase in the overall prevalence of migraine (odds ratio [OR], 0.95; P = .78) or non-migraine headaches (OR, 1.18; P = .17). However, among patients with migraine, those with epilepsy were more likely to experience highly frequent headaches than those without epilepsy (OR, 1.73; P = .024).

Study details: This population-based case-control study included 63,622 participants (age, ≥ 20 years); 364 had epilepsy, including 210 without headaches, 46 with migraine, and 108 with non-migraine headaches.

Disclosure: The study was funded by the Norwegian Research Council. The authors declared no conflicts of interest.

Source: Engstrand H, Revdal E, Argren MB, et al. Relationship between migraine and epilepsy in a large population-based cohort: The HUNT Study. Eur J Neurol. Published online September 27, 2024. Source

Key clinical point: Patients with epilepsy showed no significant increase in the overall prevalence of migraine or non-migraine headaches, but those with epilepsy and migraine had an increased frequency of headaches.

Major findings: Compared with individuals without epilepsy, patients with epilepsy had no significant increase in the overall prevalence of migraine (odds ratio [OR], 0.95; P = .78) or non-migraine headaches (OR, 1.18; P = .17). However, among patients with migraine, those with epilepsy were more likely to experience highly frequent headaches than those without epilepsy (OR, 1.73; P = .024).

Study details: This population-based case-control study included 63,622 participants (age, ≥ 20 years); 364 had epilepsy, including 210 without headaches, 46 with migraine, and 108 with non-migraine headaches.

Disclosure: The study was funded by the Norwegian Research Council. The authors declared no conflicts of interest.

Source: Engstrand H, Revdal E, Argren MB, et al. Relationship between migraine and epilepsy in a large population-based cohort: The HUNT Study. Eur J Neurol. Published online September 27, 2024. Source

Key clinical point: Patients with epilepsy showed no significant increase in the overall prevalence of migraine or non-migraine headaches, but those with epilepsy and migraine had an increased frequency of headaches.

Major findings: Compared with individuals without epilepsy, patients with epilepsy had no significant increase in the overall prevalence of migraine (odds ratio [OR], 0.95; P = .78) or non-migraine headaches (OR, 1.18; P = .17). However, among patients with migraine, those with epilepsy were more likely to experience highly frequent headaches than those without epilepsy (OR, 1.73; P = .024).

Study details: This population-based case-control study included 63,622 participants (age, ≥ 20 years); 364 had epilepsy, including 210 without headaches, 46 with migraine, and 108 with non-migraine headaches.

Disclosure: The study was funded by the Norwegian Research Council. The authors declared no conflicts of interest.

Source: Engstrand H, Revdal E, Argren MB, et al. Relationship between migraine and epilepsy in a large population-based cohort: The HUNT Study. Eur J Neurol. Published online September 27, 2024. Source

Key clinical point: Galcanezumab, a calcitonin gene-related peptide monoclonal antibody targeting the peripheral nervous system, led to early improvement in the severity of symptoms associated with central sensitization in patients with migraine.

Major findings: The Central Sensitization Inventory score significantly decreased from 36.0 at baseline to 29.7 at 3 months and 29.3 at 6 months after galcanezumab treatment (P < .001). The Allodynia Symptom Checklist score decreased from 5.55 at baseline to 4.09 at 3 months (P < .01) and 4.26 at 6 months (P < .01) with galcanezumab treatment.

Study details: This prospective real-world study included 86 patients with migraine (age, 20-65 years) who were treated with galcanezumab (240 mg administered initially, followed by 120 mg monthly) for 6 months.

Disclosure: This study was funded by the Ministry of Health, Labor and Welfare, Japan. Several authors reported having ties with various sources.

Source: Danno D, Imai N, Kitamura S, Ishizaki K, Kikui S, Takeshima T. Efficacy of galcanezumab in migraine central sensitization. Sci Rep. 2024; 14:21824. Source

Key clinical point: Galcanezumab, a calcitonin gene-related peptide monoclonal antibody targeting the peripheral nervous system, led to early improvement in the severity of symptoms associated with central sensitization in patients with migraine.

Major findings: The Central Sensitization Inventory score significantly decreased from 36.0 at baseline to 29.7 at 3 months and 29.3 at 6 months after galcanezumab treatment (P < .001). The Allodynia Symptom Checklist score decreased from 5.55 at baseline to 4.09 at 3 months (P < .01) and 4.26 at 6 months (P < .01) with galcanezumab treatment.

Study details: This prospective real-world study included 86 patients with migraine (age, 20-65 years) who were treated with galcanezumab (240 mg administered initially, followed by 120 mg monthly) for 6 months.

Disclosure: This study was funded by the Ministry of Health, Labor and Welfare, Japan. Several authors reported having ties with various sources.

Source: Danno D, Imai N, Kitamura S, Ishizaki K, Kikui S, Takeshima T. Efficacy of galcanezumab in migraine central sensitization. Sci Rep. 2024; 14:21824. Source

Key clinical point: Galcanezumab, a calcitonin gene-related peptide monoclonal antibody targeting the peripheral nervous system, led to early improvement in the severity of symptoms associated with central sensitization in patients with migraine.

Major findings: The Central Sensitization Inventory score significantly decreased from 36.0 at baseline to 29.7 at 3 months and 29.3 at 6 months after galcanezumab treatment (P < .001). The Allodynia Symptom Checklist score decreased from 5.55 at baseline to 4.09 at 3 months (P < .01) and 4.26 at 6 months (P < .01) with galcanezumab treatment.

Study details: This prospective real-world study included 86 patients with migraine (age, 20-65 years) who were treated with galcanezumab (240 mg administered initially, followed by 120 mg monthly) for 6 months.

Disclosure: This study was funded by the Ministry of Health, Labor and Welfare, Japan. Several authors reported having ties with various sources.

Source: Danno D, Imai N, Kitamura S, Ishizaki K, Kikui S, Takeshima T. Efficacy of galcanezumab in migraine central sensitization. Sci Rep. 2024; 14:21824. Source

Key clinical point: In American adults aged 20-50 years, a shorter telomere length was associated with an increased risk for migraine; however, no such association was found in adults older than 50 years.

 Major findings: In adults aged 20-50 years, a decrease in the ratio of telomeric repeats to single-copy genes was associated with an increased risk for migraine (odds ratio [OR], 1.48; P = .047). Those with the shortest telomeres were at a greater risk for migraine than those with the longest telomeres (OR, 1.35; P = .043). Such an association was not observed in adults older than 50 years.

Study details: This cross-sectional study analyzed data from the US National Health and Nutrition Examination Survey (1999-2002) on migraine and leukocyte telomere length in 6169 adults with or without migraine.

 Disclosure: The study was supported by the Natural Science Foundation of Hebei Province and the Central Government Guides Local Funds for Science and Technology Development. The authors declared no conflicts of interest.

Source: Geng D, Liu H, Wang H, et al. Telomere length exhibits inverse association with migraine among Americans aged 20–50 years, without implications beyond age 50: A cross-sectional study. Sci Rep. 2024;14:22597. Source

Key clinical point: In American adults aged 20-50 years, a shorter telomere length was associated with an increased risk for migraine; however, no such association was found in adults older than 50 years.

 Major findings: In adults aged 20-50 years, a decrease in the ratio of telomeric repeats to single-copy genes was associated with an increased risk for migraine (odds ratio [OR], 1.48; P = .047). Those with the shortest telomeres were at a greater risk for migraine than those with the longest telomeres (OR, 1.35; P = .043). Such an association was not observed in adults older than 50 years.

Study details: This cross-sectional study analyzed data from the US National Health and Nutrition Examination Survey (1999-2002) on migraine and leukocyte telomere length in 6169 adults with or without migraine.

 Disclosure: The study was supported by the Natural Science Foundation of Hebei Province and the Central Government Guides Local Funds for Science and Technology Development. The authors declared no conflicts of interest.

Source: Geng D, Liu H, Wang H, et al. Telomere length exhibits inverse association with migraine among Americans aged 20–50 years, without implications beyond age 50: A cross-sectional study. Sci Rep. 2024;14:22597. Source

Key clinical point: In American adults aged 20-50 years, a shorter telomere length was associated with an increased risk for migraine; however, no such association was found in adults older than 50 years.

 Major findings: In adults aged 20-50 years, a decrease in the ratio of telomeric repeats to single-copy genes was associated with an increased risk for migraine (odds ratio [OR], 1.48; P = .047). Those with the shortest telomeres were at a greater risk for migraine than those with the longest telomeres (OR, 1.35; P = .043). Such an association was not observed in adults older than 50 years.

Study details: This cross-sectional study analyzed data from the US National Health and Nutrition Examination Survey (1999-2002) on migraine and leukocyte telomere length in 6169 adults with or without migraine.

 Disclosure: The study was supported by the Natural Science Foundation of Hebei Province and the Central Government Guides Local Funds for Science and Technology Development. The authors declared no conflicts of interest.

Source: Geng D, Liu H, Wang H, et al. Telomere length exhibits inverse association with migraine among Americans aged 20–50 years, without implications beyond age 50: A cross-sectional study. Sci Rep. 2024;14:22597. Source

Key clinical point: Erenumab was effective in achieving and sustaining the remission of medication overuse headache (MOH) in adults with chronic migraine (CM) and nonopioid MOH, with adverse events reflecting the known safety profile of erenumab.

Major findings: At 6 months, 140 mg erenumab was significantly more effective than placebo in achieving increased MOH remission (odds ratio [OR], 2.01; P < .001) and sustained MOH remission (OR, 2.63; P < .001). The most common treatment-emergent adverse events in both erunumab groups were constipation (15.2%) and COVID-19 (13.9%); no new adverse events were reported.

Study details: This phase 4 randomized controlled trial included 584 adults with CM and MOH in the nonopioid-treated cohort who did not respond to one or more preventive treatments. Participants were randomly assigned to receive monthly injections of erenumab (70 mg or 140 mg) or placebo for 24 weeks.

Disclosures: This study was funded by Amgen. Some authors declared being employees or stockholders of Amgen, and others declared having ties with various sources, including Amgen.

Source: Tepper SJ, Dodick DW, Lanteri-Minet M, et al. Efficacy and safety of erenumab for nonopioid medication overuse headache in chronic migraine: A phase 4, randomized, placebo-controlled trial. JAMA Neurol. Published online September 16, 2024. Source

Key clinical point: Erenumab was effective in achieving and sustaining the remission of medication overuse headache (MOH) in adults with chronic migraine (CM) and nonopioid MOH, with adverse events reflecting the known safety profile of erenumab.

Major findings: At 6 months, 140 mg erenumab was significantly more effective than placebo in achieving increased MOH remission (odds ratio [OR], 2.01; P < .001) and sustained MOH remission (OR, 2.63; P < .001). The most common treatment-emergent adverse events in both erunumab groups were constipation (15.2%) and COVID-19 (13.9%); no new adverse events were reported.

Study details: This phase 4 randomized controlled trial included 584 adults with CM and MOH in the nonopioid-treated cohort who did not respond to one or more preventive treatments. Participants were randomly assigned to receive monthly injections of erenumab (70 mg or 140 mg) or placebo for 24 weeks.

Disclosures: This study was funded by Amgen. Some authors declared being employees or stockholders of Amgen, and others declared having ties with various sources, including Amgen.

Source: Tepper SJ, Dodick DW, Lanteri-Minet M, et al. Efficacy and safety of erenumab for nonopioid medication overuse headache in chronic migraine: A phase 4, randomized, placebo-controlled trial. JAMA Neurol. Published online September 16, 2024. Source

Key clinical point: Erenumab was effective in achieving and sustaining the remission of medication overuse headache (MOH) in adults with chronic migraine (CM) and nonopioid MOH, with adverse events reflecting the known safety profile of erenumab.

Major findings: At 6 months, 140 mg erenumab was significantly more effective than placebo in achieving increased MOH remission (odds ratio [OR], 2.01; P < .001) and sustained MOH remission (OR, 2.63; P < .001). The most common treatment-emergent adverse events in both erunumab groups were constipation (15.2%) and COVID-19 (13.9%); no new adverse events were reported.

Study details: This phase 4 randomized controlled trial included 584 adults with CM and MOH in the nonopioid-treated cohort who did not respond to one or more preventive treatments. Participants were randomly assigned to receive monthly injections of erenumab (70 mg or 140 mg) or placebo for 24 weeks.

Disclosures: This study was funded by Amgen. Some authors declared being employees or stockholders of Amgen, and others declared having ties with various sources, including Amgen.

Source: Tepper SJ, Dodick DW, Lanteri-Minet M, et al. Efficacy and safety of erenumab for nonopioid medication overuse headache in chronic migraine: A phase 4, randomized, placebo-controlled trial. JAMA Neurol. Published online September 16, 2024. Source

Key clinical point: Triptans, including eletriptan, rizatriptan, sumatriptan, and zolmitriptan, were more efficacious than newer and more expensive medications, such as lasmiditan and rimegepant, for the acute treatment of migraine.

Major findings: All active interventions were superior to placebo in achieving freedom from pain at 2 hours (odds ratio [OR], 1.73) with naratriptan and (OR, 5.19) for eletriptan. Eletriptan was the most effective for pain relief at two hours (OR, 1.46-3.01), followed by rizatriptan (OR, 1.59-2.44), sumatriptan (OR, 1.35-2.04), and zolmitriptan (OR, 1.47-1.96). For sustained pain freedom, eletriptan and ibuprofen were the most effective.

Study details: This network meta-analysis of 137 randomized controlled trials included 89,445 adults with migraine who received one of 17 drugs, including antipyretics, ditans, gepants, nonsteroidal anti-inflammatory drugs, and triptans, or placebo.

Disclosures: This study was funded by the National Institute for Health and Care Research Oxford Health Biomedical Research Centre and the Lundbeck Foundation. Several authors reported having ties with various sources.

Source: Karlsson WK, Ostinelli EG, Zhuang ZA, et al. Comparative effects of drug interventions for the acute management of migraine episodes in adults: Systematic review and network meta-analysis. BMJ. 2024;386:e080107. Source

Key clinical point: Triptans, including eletriptan, rizatriptan, sumatriptan, and zolmitriptan, were more efficacious than newer and more expensive medications, such as lasmiditan and rimegepant, for the acute treatment of migraine.

Major findings: All active interventions were superior to placebo in achieving freedom from pain at 2 hours (odds ratio [OR], 1.73) with naratriptan and (OR, 5.19) for eletriptan. Eletriptan was the most effective for pain relief at two hours (OR, 1.46-3.01), followed by rizatriptan (OR, 1.59-2.44), sumatriptan (OR, 1.35-2.04), and zolmitriptan (OR, 1.47-1.96). For sustained pain freedom, eletriptan and ibuprofen were the most effective.

Study details: This network meta-analysis of 137 randomized controlled trials included 89,445 adults with migraine who received one of 17 drugs, including antipyretics, ditans, gepants, nonsteroidal anti-inflammatory drugs, and triptans, or placebo.

Disclosures: This study was funded by the National Institute for Health and Care Research Oxford Health Biomedical Research Centre and the Lundbeck Foundation. Several authors reported having ties with various sources.

Source: Karlsson WK, Ostinelli EG, Zhuang ZA, et al. Comparative effects of drug interventions for the acute management of migraine episodes in adults: Systematic review and network meta-analysis. BMJ. 2024;386:e080107. Source

Key clinical point: Triptans, including eletriptan, rizatriptan, sumatriptan, and zolmitriptan, were more efficacious than newer and more expensive medications, such as lasmiditan and rimegepant, for the acute treatment of migraine.

Major findings: All active interventions were superior to placebo in achieving freedom from pain at 2 hours (odds ratio [OR], 1.73) with naratriptan and (OR, 5.19) for eletriptan. Eletriptan was the most effective for pain relief at two hours (OR, 1.46-3.01), followed by rizatriptan (OR, 1.59-2.44), sumatriptan (OR, 1.35-2.04), and zolmitriptan (OR, 1.47-1.96). For sustained pain freedom, eletriptan and ibuprofen were the most effective.

Study details: This network meta-analysis of 137 randomized controlled trials included 89,445 adults with migraine who received one of 17 drugs, including antipyretics, ditans, gepants, nonsteroidal anti-inflammatory drugs, and triptans, or placebo.

Disclosures: This study was funded by the National Institute for Health and Care Research Oxford Health Biomedical Research Centre and the Lundbeck Foundation. Several authors reported having ties with various sources.

Source: Karlsson WK, Ostinelli EG, Zhuang ZA, et al. Comparative effects of drug interventions for the acute management of migraine episodes in adults: Systematic review and network meta-analysis. BMJ. 2024;386:e080107. Source

Glucagon-like peptide 1 receptor agonists (GLP-1 RAs) given to adolescents with obesity was associated with a one-third decreased risk for suicidal ideation and suicide attempts compared with lifestyle intervention alone, a large international retrospective study found.

A study published in JAMA Pediatrics suggested that GLP-1 RAs such as semaglutide, liraglutide, and tirzepatide, which are widely used to treat type 2 diabetes (T2D), have a favorable psychiatric safety profile and open up potential avenues for prospective studies of psychiatric outcomes in adolescents with obesity.

Investigators Liya Kerem, MD, MSc, and Joshua Stokar, MD, of Hadassah University Medical Center in Jerusalem, Israel, reported that the reduced risk in GLP-1 RA recipients was maintained up to 3 years follow-up compared with propensity score–matched controls treated with behavioral interventions alone.

“These findings support the notion that childhood obesity does not result from lack of willpower and shed light on underlying mechanisms that can be targeted by pharmacotherapy.” Kerem and Stokar wrote.

Other research has suggested these agents have neurobiologic effects unrelated to weight loss that positively affect mood and mental health.
 

Study Details

The analysis included data from December 2019 to June 2024, drawn from 120 international healthcare organizations, mainly in the United States. A total of 4052 racially and ethnically diverse adolescents with obesity (aged 12-18 years [mean age, about 15.5 years]) being treated with an anti-obesity intervention were identified for the GLP-1 RA cohort and 50,112 for the control cohort. The arms were balanced for baseline demographic characteristics, psychiatric medications and comorbidities, and diagnoses associated with socioeconomic status and healthcare access.

Propensity score matching (PSM) resulted in 3456 participants in each of two balanced cohorts.

Before PSM, intervention patients were older (mean age, 15.5 vs 14.7 years), were more likely to be female (59% vs 49%), and had a higher body mass index (41.9 vs 33.8). They also had a higher prevalence of diabetes (40% vs 4%) and treatment with antidiabetic medications.

GLP-1 RA recipients also had a history of psychiatric diagnoses (17% vs 9% for mood disorders) and psychiatric medications (18% vs 7% for antidepressants). Previous use of non–GLP-1 RA anti-obesity medications was uncommon in the cohort overall, although more common in the GLP-1 RA cohort (2.5% vs 0.2% for phentermine).

Prescription of GLP-1 RA was associated with a 33% reduced risk for suicidal ideation or attempts over 12 months of follow-up: 1.45% vs 2.26% (hazard ratio [HR], 0.67; 95% CI, 0.47-0.95; P = .02). It was also associated with a higher rate of gastrointestinal symptoms: 6.9% vs 5.4% (HR, 1.41; 95% CI, 1.12-1.78; P = .003). There was no difference in rates of upper respiratory tract infections (URTIs), although some research suggests these agents reduce URTIs.
 

Mechanisms

The etiology of childhood obesity is complex and multifactorial, the authors wrote, and genetic predisposition to adiposity, an obesogenic environment, and a sedentary lifestyle synergistically contribute to its development. Variants in genes active in the hypothalamic appetite-regulation neurocircuitry appear to be associated with the development of childhood and adolescent obesity.

The authors noted that adolescence carries an increased risk for psychiatric disorders and suicidal ideation. “The amelioration of obesity could indirectly improve these psychiatric comorbidities,” they wrote. In addition, preclinical studies suggested that GLP-1 RA may improve depression-related neuropathology, including neuroinflammation and neurotransmitter imbalance, and may promote neurogenesis.

A recent meta-analysis found that adults with T2D treated with GLP-1 RA showed significant reduction in depression scale scores compared with those treated with non-GLP-1 RA antidiabetic medications.

Commenting on the study but not involved in it, psychiatrist Robert H. Dicker, MD, associate director of child and adolescent psychiatry at Northwell Zucker Hillside Hospital in Glen Oaks, New York, cautioned that these are preliminary data limited by a retrospective review, not a prospective double-blind, placebo-controlled study.

“The mechanism is unknown — is it a direct effect on weight loss with an improvement of quality of life, more positive feedback by the community, enhanced ability to exercise, and a decrease in depressive symptoms?” he asked.

Dicker suggested an alternative hypothesis: Does the GLP-1 RA have a direct effect on neurotransmitters and inflammation and, thus, an impact on mood, emotional regulation, impulse control, and suicide?

“To further answer these questions, prospective studies must be conducted. It is far too early to conclude that these medications are effective in treating mood disorders in our youth,” Dicker said. “But it is promising that these treatments do not appear to increase suicidal ideas and behavior.”

Adding another outsider’s perspective on the study, Suzanne E. Cuda, MD, FOMA, FAAP, a pediatrician who treats childhood obesity in San Antonio, said that while there was no risk for increased psychiatric disease and a suggestion that GLP-1 RAs may reduce suicidal ideation or attempts, “I don’t think this translates to a treatment for depression in adolescents. Nor does this study indicate there could be a decrease in depression due specifically to the use of GLP1Rs. If the results in this study are replicated, however, it would be reassuring to know that adolescents would not be at risk for an increase in suicidal ideation or attempts.”

This study had no external funding. Kerem reported receiving personal fees from Novo Nordisk for lectures on childhood obesity outside of the submitted work. No other disclosures were reported. Dicker and Cuda had no competing interests relevant to their comments.

A version of this article appeared on Medscape.com.

Glucagon-like peptide 1 receptor agonists (GLP-1 RAs) given to adolescents with obesity was associated with a one-third decreased risk for suicidal ideation and suicide attempts compared with lifestyle intervention alone, a large international retrospective study found.

A study published in JAMA Pediatrics suggested that GLP-1 RAs such as semaglutide, liraglutide, and tirzepatide, which are widely used to treat type 2 diabetes (T2D), have a favorable psychiatric safety profile and open up potential avenues for prospective studies of psychiatric outcomes in adolescents with obesity.

Investigators Liya Kerem, MD, MSc, and Joshua Stokar, MD, of Hadassah University Medical Center in Jerusalem, Israel, reported that the reduced risk in GLP-1 RA recipients was maintained up to 3 years follow-up compared with propensity score–matched controls treated with behavioral interventions alone.

“These findings support the notion that childhood obesity does not result from lack of willpower and shed light on underlying mechanisms that can be targeted by pharmacotherapy.” Kerem and Stokar wrote.

Other research has suggested these agents have neurobiologic effects unrelated to weight loss that positively affect mood and mental health.
 

Study Details

The analysis included data from December 2019 to June 2024, drawn from 120 international healthcare organizations, mainly in the United States. A total of 4052 racially and ethnically diverse adolescents with obesity (aged 12-18 years [mean age, about 15.5 years]) being treated with an anti-obesity intervention were identified for the GLP-1 RA cohort and 50,112 for the control cohort. The arms were balanced for baseline demographic characteristics, psychiatric medications and comorbidities, and diagnoses associated with socioeconomic status and healthcare access.

Propensity score matching (PSM) resulted in 3456 participants in each of two balanced cohorts.

Before PSM, intervention patients were older (mean age, 15.5 vs 14.7 years), were more likely to be female (59% vs 49%), and had a higher body mass index (41.9 vs 33.8). They also had a higher prevalence of diabetes (40% vs 4%) and treatment with antidiabetic medications.

GLP-1 RA recipients also had a history of psychiatric diagnoses (17% vs 9% for mood disorders) and psychiatric medications (18% vs 7% for antidepressants). Previous use of non–GLP-1 RA anti-obesity medications was uncommon in the cohort overall, although more common in the GLP-1 RA cohort (2.5% vs 0.2% for phentermine).

Prescription of GLP-1 RA was associated with a 33% reduced risk for suicidal ideation or attempts over 12 months of follow-up: 1.45% vs 2.26% (hazard ratio [HR], 0.67; 95% CI, 0.47-0.95; P = .02). It was also associated with a higher rate of gastrointestinal symptoms: 6.9% vs 5.4% (HR, 1.41; 95% CI, 1.12-1.78; P = .003). There was no difference in rates of upper respiratory tract infections (URTIs), although some research suggests these agents reduce URTIs.
 

Mechanisms

The etiology of childhood obesity is complex and multifactorial, the authors wrote, and genetic predisposition to adiposity, an obesogenic environment, and a sedentary lifestyle synergistically contribute to its development. Variants in genes active in the hypothalamic appetite-regulation neurocircuitry appear to be associated with the development of childhood and adolescent obesity.

The authors noted that adolescence carries an increased risk for psychiatric disorders and suicidal ideation. “The amelioration of obesity could indirectly improve these psychiatric comorbidities,” they wrote. In addition, preclinical studies suggested that GLP-1 RA may improve depression-related neuropathology, including neuroinflammation and neurotransmitter imbalance, and may promote neurogenesis.

A recent meta-analysis found that adults with T2D treated with GLP-1 RA showed significant reduction in depression scale scores compared with those treated with non-GLP-1 RA antidiabetic medications.

Commenting on the study but not involved in it, psychiatrist Robert H. Dicker, MD, associate director of child and adolescent psychiatry at Northwell Zucker Hillside Hospital in Glen Oaks, New York, cautioned that these are preliminary data limited by a retrospective review, not a prospective double-blind, placebo-controlled study.

“The mechanism is unknown — is it a direct effect on weight loss with an improvement of quality of life, more positive feedback by the community, enhanced ability to exercise, and a decrease in depressive symptoms?” he asked.

Dicker suggested an alternative hypothesis: Does the GLP-1 RA have a direct effect on neurotransmitters and inflammation and, thus, an impact on mood, emotional regulation, impulse control, and suicide?

“To further answer these questions, prospective studies must be conducted. It is far too early to conclude that these medications are effective in treating mood disorders in our youth,” Dicker said. “But it is promising that these treatments do not appear to increase suicidal ideas and behavior.”

Adding another outsider’s perspective on the study, Suzanne E. Cuda, MD, FOMA, FAAP, a pediatrician who treats childhood obesity in San Antonio, said that while there was no risk for increased psychiatric disease and a suggestion that GLP-1 RAs may reduce suicidal ideation or attempts, “I don’t think this translates to a treatment for depression in adolescents. Nor does this study indicate there could be a decrease in depression due specifically to the use of GLP1Rs. If the results in this study are replicated, however, it would be reassuring to know that adolescents would not be at risk for an increase in suicidal ideation or attempts.”

This study had no external funding. Kerem reported receiving personal fees from Novo Nordisk for lectures on childhood obesity outside of the submitted work. No other disclosures were reported. Dicker and Cuda had no competing interests relevant to their comments.

A version of this article appeared on Medscape.com.

Glucagon-like peptide 1 receptor agonists (GLP-1 RAs) given to adolescents with obesity was associated with a one-third decreased risk for suicidal ideation and suicide attempts compared with lifestyle intervention alone, a large international retrospective study found.

A study published in JAMA Pediatrics suggested that GLP-1 RAs such as semaglutide, liraglutide, and tirzepatide, which are widely used to treat type 2 diabetes (T2D), have a favorable psychiatric safety profile and open up potential avenues for prospective studies of psychiatric outcomes in adolescents with obesity.

Investigators Liya Kerem, MD, MSc, and Joshua Stokar, MD, of Hadassah University Medical Center in Jerusalem, Israel, reported that the reduced risk in GLP-1 RA recipients was maintained up to 3 years follow-up compared with propensity score–matched controls treated with behavioral interventions alone.

“These findings support the notion that childhood obesity does not result from lack of willpower and shed light on underlying mechanisms that can be targeted by pharmacotherapy.” Kerem and Stokar wrote.

Other research has suggested these agents have neurobiologic effects unrelated to weight loss that positively affect mood and mental health.
 

Study Details

The analysis included data from December 2019 to June 2024, drawn from 120 international healthcare organizations, mainly in the United States. A total of 4052 racially and ethnically diverse adolescents with obesity (aged 12-18 years [mean age, about 15.5 years]) being treated with an anti-obesity intervention were identified for the GLP-1 RA cohort and 50,112 for the control cohort. The arms were balanced for baseline demographic characteristics, psychiatric medications and comorbidities, and diagnoses associated with socioeconomic status and healthcare access.

Propensity score matching (PSM) resulted in 3456 participants in each of two balanced cohorts.

Before PSM, intervention patients were older (mean age, 15.5 vs 14.7 years), were more likely to be female (59% vs 49%), and had a higher body mass index (41.9 vs 33.8). They also had a higher prevalence of diabetes (40% vs 4%) and treatment with antidiabetic medications.

GLP-1 RA recipients also had a history of psychiatric diagnoses (17% vs 9% for mood disorders) and psychiatric medications (18% vs 7% for antidepressants). Previous use of non–GLP-1 RA anti-obesity medications was uncommon in the cohort overall, although more common in the GLP-1 RA cohort (2.5% vs 0.2% for phentermine).

Prescription of GLP-1 RA was associated with a 33% reduced risk for suicidal ideation or attempts over 12 months of follow-up: 1.45% vs 2.26% (hazard ratio [HR], 0.67; 95% CI, 0.47-0.95; P = .02). It was also associated with a higher rate of gastrointestinal symptoms: 6.9% vs 5.4% (HR, 1.41; 95% CI, 1.12-1.78; P = .003). There was no difference in rates of upper respiratory tract infections (URTIs), although some research suggests these agents reduce URTIs.
 

Mechanisms

The etiology of childhood obesity is complex and multifactorial, the authors wrote, and genetic predisposition to adiposity, an obesogenic environment, and a sedentary lifestyle synergistically contribute to its development. Variants in genes active in the hypothalamic appetite-regulation neurocircuitry appear to be associated with the development of childhood and adolescent obesity.

The authors noted that adolescence carries an increased risk for psychiatric disorders and suicidal ideation. “The amelioration of obesity could indirectly improve these psychiatric comorbidities,” they wrote. In addition, preclinical studies suggested that GLP-1 RA may improve depression-related neuropathology, including neuroinflammation and neurotransmitter imbalance, and may promote neurogenesis.

A recent meta-analysis found that adults with T2D treated with GLP-1 RA showed significant reduction in depression scale scores compared with those treated with non-GLP-1 RA antidiabetic medications.

Commenting on the study but not involved in it, psychiatrist Robert H. Dicker, MD, associate director of child and adolescent psychiatry at Northwell Zucker Hillside Hospital in Glen Oaks, New York, cautioned that these are preliminary data limited by a retrospective review, not a prospective double-blind, placebo-controlled study.

“The mechanism is unknown — is it a direct effect on weight loss with an improvement of quality of life, more positive feedback by the community, enhanced ability to exercise, and a decrease in depressive symptoms?” he asked.

Dicker suggested an alternative hypothesis: Does the GLP-1 RA have a direct effect on neurotransmitters and inflammation and, thus, an impact on mood, emotional regulation, impulse control, and suicide?

“To further answer these questions, prospective studies must be conducted. It is far too early to conclude that these medications are effective in treating mood disorders in our youth,” Dicker said. “But it is promising that these treatments do not appear to increase suicidal ideas and behavior.”

Adding another outsider’s perspective on the study, Suzanne E. Cuda, MD, FOMA, FAAP, a pediatrician who treats childhood obesity in San Antonio, said that while there was no risk for increased psychiatric disease and a suggestion that GLP-1 RAs may reduce suicidal ideation or attempts, “I don’t think this translates to a treatment for depression in adolescents. Nor does this study indicate there could be a decrease in depression due specifically to the use of GLP1Rs. If the results in this study are replicated, however, it would be reassuring to know that adolescents would not be at risk for an increase in suicidal ideation or attempts.”

This study had no external funding. Kerem reported receiving personal fees from Novo Nordisk for lectures on childhood obesity outside of the submitted work. No other disclosures were reported. Dicker and Cuda had no competing interests relevant to their comments.

A version of this article appeared on Medscape.com.

Losses of muscle and strength are inescapable effects of the aging process. Left unchecked, these progressive losses will start to impair physical function. 

Once a certain level of impairment occurs, an individual can be diagnosed with sarcopenia, which comes from the Greek words “sarco” (flesh) and “penia” (poverty). Individuals with sarcopenia have a significant increase in the risk for falls and death, as well as diminished quality of life.

Muscle mass losses generally occur with weight loss, and the increasing use of glucagon-like peptide 1 (GLP-1) medications may lead to greater incidence and prevalence of sarcopenia in the years to come.

A recent meta-analysis of 56 studies (mean participant age, 50 years) found a twofold greater risk for mortality in those with sarcopenia vs those without. Despite its health consequences, sarcopenia tends to be underdiagnosed and, consequently, undertreated at a population and individual level. Part of the reason probably stems from the lack of health insurance reimbursement for individual clinicians and hospital systems to perform sarcopenia screening assessments. 

In aging and obesity, it appears justified to include and emphasize a recommendation for sarcopenia screening in medical society guidelines; however, individual patients and clinicians do not need to wait for updated guidelines to implement sarcopenia screening, treatment, and prevention strategies in their own lives and/or clinical practice. 
 

Simple Prevention and Treatment Strategy

Much can be done to help prevent sarcopenia. The primary strategy, unsurprisingly, is engaging in frequent strength training. But that doesn’t mean hours in the gym every week. 

With just one session per week over 10 weeks, lean body mass (LBM), a common proxy for muscle mass, increased by 0.33 kg, according to a study which evaluated LBM improvements across different strength training frequencies. Adding a second weekly session was significantly better. In the twice-weekly group, LBM increased by 1.4 kg over 10 weeks, resulting in an increase in LBM more than four times greater than the once-a-week group. (There was no greater improvement in LBM by adding a third weekly session vs two weekly sessions.) 

Although that particular study didn’t identify greater benefit at three times a week, compared with twice a week, the specific training routines and lack of a protein consumption assessment may have played a role in that finding. 

Underlying the diminishing benefits, a different study found a marginally greater benefit in favor of performing ≥ five sets per major muscle group per week, compared with < five sets per week for increasing muscle in the legs, arms, back, chest, and shoulders. 

Expensive gym memberships and fancy equipment are not necessary. While the use of strength training machines and free weights have been viewed by many as the optimal approach, a recent systematic review and meta-analysis found that comparable improvements to strength can be achieved with workouts using resistance bands. For those who struggle to find the time to go to a gym, or for whom gym fees are not financially affordable, resistance bands are a cheaper and more convenient alternative. 

Lucas, Assistant Professor of Clinical Medicine, Comprehensive Weight Control Center, Weill Cornell Medicine, New York City, disclosed ties with Measured (Better Health Labs).

A version of this article appeared on Medscape.com.

Losses of muscle and strength are inescapable effects of the aging process. Left unchecked, these progressive losses will start to impair physical function. 

Once a certain level of impairment occurs, an individual can be diagnosed with sarcopenia, which comes from the Greek words “sarco” (flesh) and “penia” (poverty). Individuals with sarcopenia have a significant increase in the risk for falls and death, as well as diminished quality of life.

Muscle mass losses generally occur with weight loss, and the increasing use of glucagon-like peptide 1 (GLP-1) medications may lead to greater incidence and prevalence of sarcopenia in the years to come.

A recent meta-analysis of 56 studies (mean participant age, 50 years) found a twofold greater risk for mortality in those with sarcopenia vs those without. Despite its health consequences, sarcopenia tends to be underdiagnosed and, consequently, undertreated at a population and individual level. Part of the reason probably stems from the lack of health insurance reimbursement for individual clinicians and hospital systems to perform sarcopenia screening assessments. 

In aging and obesity, it appears justified to include and emphasize a recommendation for sarcopenia screening in medical society guidelines; however, individual patients and clinicians do not need to wait for updated guidelines to implement sarcopenia screening, treatment, and prevention strategies in their own lives and/or clinical practice. 
 

Simple Prevention and Treatment Strategy

Much can be done to help prevent sarcopenia. The primary strategy, unsurprisingly, is engaging in frequent strength training. But that doesn’t mean hours in the gym every week. 

With just one session per week over 10 weeks, lean body mass (LBM), a common proxy for muscle mass, increased by 0.33 kg, according to a study which evaluated LBM improvements across different strength training frequencies. Adding a second weekly session was significantly better. In the twice-weekly group, LBM increased by 1.4 kg over 10 weeks, resulting in an increase in LBM more than four times greater than the once-a-week group. (There was no greater improvement in LBM by adding a third weekly session vs two weekly sessions.) 

Although that particular study didn’t identify greater benefit at three times a week, compared with twice a week, the specific training routines and lack of a protein consumption assessment may have played a role in that finding. 

Underlying the diminishing benefits, a different study found a marginally greater benefit in favor of performing ≥ five sets per major muscle group per week, compared with < five sets per week for increasing muscle in the legs, arms, back, chest, and shoulders. 

Expensive gym memberships and fancy equipment are not necessary. While the use of strength training machines and free weights have been viewed by many as the optimal approach, a recent systematic review and meta-analysis found that comparable improvements to strength can be achieved with workouts using resistance bands. For those who struggle to find the time to go to a gym, or for whom gym fees are not financially affordable, resistance bands are a cheaper and more convenient alternative. 

Lucas, Assistant Professor of Clinical Medicine, Comprehensive Weight Control Center, Weill Cornell Medicine, New York City, disclosed ties with Measured (Better Health Labs).

A version of this article appeared on Medscape.com.

Losses of muscle and strength are inescapable effects of the aging process. Left unchecked, these progressive losses will start to impair physical function. 

Once a certain level of impairment occurs, an individual can be diagnosed with sarcopenia, which comes from the Greek words “sarco” (flesh) and “penia” (poverty). Individuals with sarcopenia have a significant increase in the risk for falls and death, as well as diminished quality of life.

Muscle mass losses generally occur with weight loss, and the increasing use of glucagon-like peptide 1 (GLP-1) medications may lead to greater incidence and prevalence of sarcopenia in the years to come.

A recent meta-analysis of 56 studies (mean participant age, 50 years) found a twofold greater risk for mortality in those with sarcopenia vs those without. Despite its health consequences, sarcopenia tends to be underdiagnosed and, consequently, undertreated at a population and individual level. Part of the reason probably stems from the lack of health insurance reimbursement for individual clinicians and hospital systems to perform sarcopenia screening assessments. 

In aging and obesity, it appears justified to include and emphasize a recommendation for sarcopenia screening in medical society guidelines; however, individual patients and clinicians do not need to wait for updated guidelines to implement sarcopenia screening, treatment, and prevention strategies in their own lives and/or clinical practice. 
 

Simple Prevention and Treatment Strategy

Much can be done to help prevent sarcopenia. The primary strategy, unsurprisingly, is engaging in frequent strength training. But that doesn’t mean hours in the gym every week. 

With just one session per week over 10 weeks, lean body mass (LBM), a common proxy for muscle mass, increased by 0.33 kg, according to a study which evaluated LBM improvements across different strength training frequencies. Adding a second weekly session was significantly better. In the twice-weekly group, LBM increased by 1.4 kg over 10 weeks, resulting in an increase in LBM more than four times greater than the once-a-week group. (There was no greater improvement in LBM by adding a third weekly session vs two weekly sessions.) 

Although that particular study didn’t identify greater benefit at three times a week, compared with twice a week, the specific training routines and lack of a protein consumption assessment may have played a role in that finding. 

Underlying the diminishing benefits, a different study found a marginally greater benefit in favor of performing ≥ five sets per major muscle group per week, compared with < five sets per week for increasing muscle in the legs, arms, back, chest, and shoulders. 

Expensive gym memberships and fancy equipment are not necessary. While the use of strength training machines and free weights have been viewed by many as the optimal approach, a recent systematic review and meta-analysis found that comparable improvements to strength can be achieved with workouts using resistance bands. For those who struggle to find the time to go to a gym, or for whom gym fees are not financially affordable, resistance bands are a cheaper and more convenient alternative. 

Lucas, Assistant Professor of Clinical Medicine, Comprehensive Weight Control Center, Weill Cornell Medicine, New York City, disclosed ties with Measured (Better Health Labs).

A version of this article appeared on Medscape.com.