Migraine Briefs

Key clinical point: In patients with episodic migraine (EM), erenumab reduced both monthly migraine days (MMD) and monthly migraine attacks (MMA) by a similar magnitude. However, the impact on migraine attack duration was minor.

Major finding: Erenumab 70 mg and 140 mg vs. placebo were associated with a greater reduction in MMD (least square mean percent change [LSM%], −39% and −44% vs. 22%) and MMA (LSM%, −40% and −43% vs. −26%). The percentage change from baseline in migraine attack duration was minor with erenumab 70 mg and 140 mg vs. placebo (LSM%, −7% and −8% vs. −1%).

Study details: Findings are from a post hoc analysis of phase 3 STRIVE study including 955 patients with EM who were randomly allocated to receive either erenumab 70 mg or 140 mg or placebo once monthly for 6 months.

Disclosures: The study was supported by Amgen Inc., Thousand Oaks, CA, USA. HC Diener and M Ashina reported receiving honoraria, financial support, and/or serving as a consultant, speaker, or scientific advisor or primary investigator for various sources. GPDS Lima and S Rasmussen declared being employees and holding stocks at Amgen Inc.

Source: Diener HC et al. Cephalalgia. 2021 May 3. doi: 10.1177/03331024211010308.

Key clinical point: In patients with episodic migraine (EM), erenumab reduced both monthly migraine days (MMD) and monthly migraine attacks (MMA) by a similar magnitude. However, the impact on migraine attack duration was minor.

Major finding: Erenumab 70 mg and 140 mg vs. placebo were associated with a greater reduction in MMD (least square mean percent change [LSM%], −39% and −44% vs. 22%) and MMA (LSM%, −40% and −43% vs. −26%). The percentage change from baseline in migraine attack duration was minor with erenumab 70 mg and 140 mg vs. placebo (LSM%, −7% and −8% vs. −1%).

Study details: Findings are from a post hoc analysis of phase 3 STRIVE study including 955 patients with EM who were randomly allocated to receive either erenumab 70 mg or 140 mg or placebo once monthly for 6 months.

Disclosures: The study was supported by Amgen Inc., Thousand Oaks, CA, USA. HC Diener and M Ashina reported receiving honoraria, financial support, and/or serving as a consultant, speaker, or scientific advisor or primary investigator for various sources. GPDS Lima and S Rasmussen declared being employees and holding stocks at Amgen Inc.

Source: Diener HC et al. Cephalalgia. 2021 May 3. doi: 10.1177/03331024211010308.

Key clinical point: In patients with episodic migraine (EM), erenumab reduced both monthly migraine days (MMD) and monthly migraine attacks (MMA) by a similar magnitude. However, the impact on migraine attack duration was minor.

Major finding: Erenumab 70 mg and 140 mg vs. placebo were associated with a greater reduction in MMD (least square mean percent change [LSM%], −39% and −44% vs. 22%) and MMA (LSM%, −40% and −43% vs. −26%). The percentage change from baseline in migraine attack duration was minor with erenumab 70 mg and 140 mg vs. placebo (LSM%, −7% and −8% vs. −1%).

Study details: Findings are from a post hoc analysis of phase 3 STRIVE study including 955 patients with EM who were randomly allocated to receive either erenumab 70 mg or 140 mg or placebo once monthly for 6 months.

Disclosures: The study was supported by Amgen Inc., Thousand Oaks, CA, USA. HC Diener and M Ashina reported receiving honoraria, financial support, and/or serving as a consultant, speaker, or scientific advisor or primary investigator for various sources. GPDS Lima and S Rasmussen declared being employees and holding stocks at Amgen Inc.

Source: Diener HC et al. Cephalalgia. 2021 May 3. doi: 10.1177/03331024211010308.

Key clinical point: Erenumab significantly reduced acute medication use and health care resource utilization (HCRU) among patients with migraine in a real-world setting in the U.S.A.

Major finding: The mean number of claims (rate ratio [RR], 0.77) and number of patients using acute medication (both P less than .0001) significantly declined in 6 months postinitiation of erenumab. Similarly, 6-month HCRU of migraine-specific office visits (RR, 0.77) and all-cause office visits (RR, 0.92) decreased significantly (both P less than .0001).

Study details: Data come from a retrospective, exploratory analysis of 3,171 adult patients with migraine who initiated erenumab and had at least 3 doses in the 6 months post-index period.

Disclosures: The study was supported by Novartis Pharma AG. SJ Tepper reported serving as a consultant and/or on advisory boards, receiving grants, and CME honoraria from multiple sources. Some of the authors declared being employees and shareholders of Novartis.

Source: Tepper SJ et al. J Headache Pain. 2021 Apr 19. doi: 10.1186/s10194-021-01238-2.

Key clinical point: Erenumab significantly reduced acute medication use and health care resource utilization (HCRU) among patients with migraine in a real-world setting in the U.S.A.

Major finding: The mean number of claims (rate ratio [RR], 0.77) and number of patients using acute medication (both P less than .0001) significantly declined in 6 months postinitiation of erenumab. Similarly, 6-month HCRU of migraine-specific office visits (RR, 0.77) and all-cause office visits (RR, 0.92) decreased significantly (both P less than .0001).

Study details: Data come from a retrospective, exploratory analysis of 3,171 adult patients with migraine who initiated erenumab and had at least 3 doses in the 6 months post-index period.

Disclosures: The study was supported by Novartis Pharma AG. SJ Tepper reported serving as a consultant and/or on advisory boards, receiving grants, and CME honoraria from multiple sources. Some of the authors declared being employees and shareholders of Novartis.

Source: Tepper SJ et al. J Headache Pain. 2021 Apr 19. doi: 10.1186/s10194-021-01238-2.

Key clinical point: Erenumab significantly reduced acute medication use and health care resource utilization (HCRU) among patients with migraine in a real-world setting in the U.S.A.

Major finding: The mean number of claims (rate ratio [RR], 0.77) and number of patients using acute medication (both P less than .0001) significantly declined in 6 months postinitiation of erenumab. Similarly, 6-month HCRU of migraine-specific office visits (RR, 0.77) and all-cause office visits (RR, 0.92) decreased significantly (both P less than .0001).

Study details: Data come from a retrospective, exploratory analysis of 3,171 adult patients with migraine who initiated erenumab and had at least 3 doses in the 6 months post-index period.

Disclosures: The study was supported by Novartis Pharma AG. SJ Tepper reported serving as a consultant and/or on advisory boards, receiving grants, and CME honoraria from multiple sources. Some of the authors declared being employees and shareholders of Novartis.

Source: Tepper SJ et al. J Headache Pain. 2021 Apr 19. doi: 10.1186/s10194-021-01238-2.

Key clinical point: In patients with migraine, most calcitonin gene-related peptide (CGRP) monoclonal antibodies were similarly effective; however, galcanezumab was more likely to cause treatment-emerging adverse events (TEAEs).

Major finding: Fremanezumab vs. placebo had the highest probability to reduce monthly migraine days (mean difference [MD], −2.19; 95% credible interval [95% CrI], −3.15 to −1.25) followed by galcanezumab (MD, −2.10; 95% CrI, −2.76 to −1.45), erenumab (MD, −1.61; 95% CrI, −2.40 to −0.84), and eptinezumab (MD, −1.43; 95% CrI, −2.59 to −0.36). However, galcanezumab was more likely to cause TEAEs (relative risk, 1.11; 95% CrI, 1.01-1.22).

Study details: Findings are from a systematic review and network meta-analysis of 18 randomized clinical trials involving 8,926 patients with migraine.

Disclosures: No information on funding was available. The authors had no commercial or financial disclosures.

Source: Wang X et al. Front Pharmacol. 2021 Mar 25. doi: 10.3389/fphar.2021.649143.

Key clinical point: In patients with migraine, most calcitonin gene-related peptide (CGRP) monoclonal antibodies were similarly effective; however, galcanezumab was more likely to cause treatment-emerging adverse events (TEAEs).

Major finding: Fremanezumab vs. placebo had the highest probability to reduce monthly migraine days (mean difference [MD], −2.19; 95% credible interval [95% CrI], −3.15 to −1.25) followed by galcanezumab (MD, −2.10; 95% CrI, −2.76 to −1.45), erenumab (MD, −1.61; 95% CrI, −2.40 to −0.84), and eptinezumab (MD, −1.43; 95% CrI, −2.59 to −0.36). However, galcanezumab was more likely to cause TEAEs (relative risk, 1.11; 95% CrI, 1.01-1.22).

Study details: Findings are from a systematic review and network meta-analysis of 18 randomized clinical trials involving 8,926 patients with migraine.

Disclosures: No information on funding was available. The authors had no commercial or financial disclosures.

Source: Wang X et al. Front Pharmacol. 2021 Mar 25. doi: 10.3389/fphar.2021.649143.

Key clinical point: In patients with migraine, most calcitonin gene-related peptide (CGRP) monoclonal antibodies were similarly effective; however, galcanezumab was more likely to cause treatment-emerging adverse events (TEAEs).

Major finding: Fremanezumab vs. placebo had the highest probability to reduce monthly migraine days (mean difference [MD], −2.19; 95% credible interval [95% CrI], −3.15 to −1.25) followed by galcanezumab (MD, −2.10; 95% CrI, −2.76 to −1.45), erenumab (MD, −1.61; 95% CrI, −2.40 to −0.84), and eptinezumab (MD, −1.43; 95% CrI, −2.59 to −0.36). However, galcanezumab was more likely to cause TEAEs (relative risk, 1.11; 95% CrI, 1.01-1.22).

Study details: Findings are from a systematic review and network meta-analysis of 18 randomized clinical trials involving 8,926 patients with migraine.

Disclosures: No information on funding was available. The authors had no commercial or financial disclosures.

Source: Wang X et al. Front Pharmacol. 2021 Mar 25. doi: 10.3389/fphar.2021.649143.

Key clinical point: Quarterly and monthly dose regimens of fremanezumab effectively reduced the average monthly migraine days (MMD) vs. placebo in patients with difficult-to-treat migraine irrespective of country and continents.

Major finding: Reduction in MMD over 12 weeks was significantly higher with fremanezumab dose regimens vs. placebo in 3 top-recruiting countries including Czech Republic (least squares mean difference [LSMD]: quarterly, −1.9; monthly, −3.0), the United States (LSMD: quarterly, −3.7; monthly, −4.2), and Finland (LSMD: quarterly, −3.0; monthly, −3.9; P less than or equal to .01 for all).

Study details: Data come from an exploratory analysis of phase 3b FOCUS study including 838 patients with episodic or chronic migraine who had an inadequate response to 2-4 migraine preventive medication classes and were randomly allocated to either quarterly fremanezumab, monthly fremanezumab, or matched placebo.

Disclosures: The study was funded by Teva Pharmaceuticals. Some of the authors reported receiving research grants and/or personal compensation from multiple sources, including Teva Pharmaceuticals. Some of the authors declared being current/former employees of Teva Pharmaceuticals.

Source: Spierings ELH et al. J Headache Pain. 2021 Apr 16. doi: 10.1186/s10194-021-01232-8.

Key clinical point: Quarterly and monthly dose regimens of fremanezumab effectively reduced the average monthly migraine days (MMD) vs. placebo in patients with difficult-to-treat migraine irrespective of country and continents.

Major finding: Reduction in MMD over 12 weeks was significantly higher with fremanezumab dose regimens vs. placebo in 3 top-recruiting countries including Czech Republic (least squares mean difference [LSMD]: quarterly, −1.9; monthly, −3.0), the United States (LSMD: quarterly, −3.7; monthly, −4.2), and Finland (LSMD: quarterly, −3.0; monthly, −3.9; P less than or equal to .01 for all).

Study details: Data come from an exploratory analysis of phase 3b FOCUS study including 838 patients with episodic or chronic migraine who had an inadequate response to 2-4 migraine preventive medication classes and were randomly allocated to either quarterly fremanezumab, monthly fremanezumab, or matched placebo.

Disclosures: The study was funded by Teva Pharmaceuticals. Some of the authors reported receiving research grants and/or personal compensation from multiple sources, including Teva Pharmaceuticals. Some of the authors declared being current/former employees of Teva Pharmaceuticals.

Source: Spierings ELH et al. J Headache Pain. 2021 Apr 16. doi: 10.1186/s10194-021-01232-8.

Key clinical point: Quarterly and monthly dose regimens of fremanezumab effectively reduced the average monthly migraine days (MMD) vs. placebo in patients with difficult-to-treat migraine irrespective of country and continents.

Major finding: Reduction in MMD over 12 weeks was significantly higher with fremanezumab dose regimens vs. placebo in 3 top-recruiting countries including Czech Republic (least squares mean difference [LSMD]: quarterly, −1.9; monthly, −3.0), the United States (LSMD: quarterly, −3.7; monthly, −4.2), and Finland (LSMD: quarterly, −3.0; monthly, −3.9; P less than or equal to .01 for all).

Study details: Data come from an exploratory analysis of phase 3b FOCUS study including 838 patients with episodic or chronic migraine who had an inadequate response to 2-4 migraine preventive medication classes and were randomly allocated to either quarterly fremanezumab, monthly fremanezumab, or matched placebo.

Disclosures: The study was funded by Teva Pharmaceuticals. Some of the authors reported receiving research grants and/or personal compensation from multiple sources, including Teva Pharmaceuticals. Some of the authors declared being current/former employees of Teva Pharmaceuticals.

Source: Spierings ELH et al. J Headache Pain. 2021 Apr 16. doi: 10.1186/s10194-021-01232-8.

Key clinical point: In a predominantly refractory chronic migraine population, the initiation of erenumab reduced the frequency of monthly headache and migraine days and shortened the duration of headache/migraine attack.

Major finding: After erenumab initiation, mean headache/migraine days per month and mean headache/migraine duration per attack decreased by a mean of 5.6 days and 5.1 hours, respectively.

Study details: Findings are from a retrospective chart review of 1,034 patients with chronic migraine who were treated with erenumab for at least 3 consecutive months at 5 major headache centers in the U.S.A.

Disclosures: This study was supported by Amgen Inc (Thousand Oaks, CA). Some of the authors declared being employees of Analysis Group and Amgen Inc. Z Ahmed and A Blumenfeld served as consultants and on the advisory board for Amgen Inc. The other authors had no conflicts of interest.

Source: Faust E et al. Neurol Ther. 2021 Apr 15. doi: 10.1007/s40120-021-00245-4.

Key clinical point: In a predominantly refractory chronic migraine population, the initiation of erenumab reduced the frequency of monthly headache and migraine days and shortened the duration of headache/migraine attack.

Major finding: After erenumab initiation, mean headache/migraine days per month and mean headache/migraine duration per attack decreased by a mean of 5.6 days and 5.1 hours, respectively.

Study details: Findings are from a retrospective chart review of 1,034 patients with chronic migraine who were treated with erenumab for at least 3 consecutive months at 5 major headache centers in the U.S.A.

Disclosures: This study was supported by Amgen Inc (Thousand Oaks, CA). Some of the authors declared being employees of Analysis Group and Amgen Inc. Z Ahmed and A Blumenfeld served as consultants and on the advisory board for Amgen Inc. The other authors had no conflicts of interest.

Source: Faust E et al. Neurol Ther. 2021 Apr 15. doi: 10.1007/s40120-021-00245-4.

Key clinical point: In a predominantly refractory chronic migraine population, the initiation of erenumab reduced the frequency of monthly headache and migraine days and shortened the duration of headache/migraine attack.

Major finding: After erenumab initiation, mean headache/migraine days per month and mean headache/migraine duration per attack decreased by a mean of 5.6 days and 5.1 hours, respectively.

Study details: Findings are from a retrospective chart review of 1,034 patients with chronic migraine who were treated with erenumab for at least 3 consecutive months at 5 major headache centers in the U.S.A.

Disclosures: This study was supported by Amgen Inc (Thousand Oaks, CA). Some of the authors declared being employees of Analysis Group and Amgen Inc. Z Ahmed and A Blumenfeld served as consultants and on the advisory board for Amgen Inc. The other authors had no conflicts of interest.

Source: Faust E et al. Neurol Ther. 2021 Apr 15. doi: 10.1007/s40120-021-00245-4.

Key clinical point: Lasmiditan showed relatively better efficacy outcomes in migraine attacks when initiated at mild vs. moderate or severe pain.

Major finding: In GLADIATOR, a significantly greater proportion of patients treated with lasmiditan (200 mg) at mild vs. moderate or severe pain achieved 2-hour pain freedom (PF; both P less than .001) and 24-hour sustained PF (SPF; P less than .05). In SAMURAI and SPARTAN, numerically higher proportion of patients treated with lasmiditan (200 mg) at mild vs. moderate or severe pain achieved 2-hour PF (45.5% vs. 37.6% or 29.4%) and 24-hour SPF (31.8% vs. 22.7% or 15.0%).

Study details: Findings are from pooled analysis of phase 3 studies SAMURAI, SPARTAN, and GLADIATOR.

Disclosures: The work was funded by Eli Lilly and Company. Some of the authors declared serving as an advisory board member, speaker, and/or consultant and receiving advisory board fees, grant support, and/or consultant fees from multiple sources. Some of the authors declared being employees and stockholders of Eli Lilly and Company.

Source: Peres MFP et al. Curr Med Res Opin. 2021 Mar 31. doi: 10.1080/03007995.2021.1903846.

Key clinical point: Lasmiditan showed relatively better efficacy outcomes in migraine attacks when initiated at mild vs. moderate or severe pain.

Major finding: In GLADIATOR, a significantly greater proportion of patients treated with lasmiditan (200 mg) at mild vs. moderate or severe pain achieved 2-hour pain freedom (PF; both P less than .001) and 24-hour sustained PF (SPF; P less than .05). In SAMURAI and SPARTAN, numerically higher proportion of patients treated with lasmiditan (200 mg) at mild vs. moderate or severe pain achieved 2-hour PF (45.5% vs. 37.6% or 29.4%) and 24-hour SPF (31.8% vs. 22.7% or 15.0%).

Study details: Findings are from pooled analysis of phase 3 studies SAMURAI, SPARTAN, and GLADIATOR.

Disclosures: The work was funded by Eli Lilly and Company. Some of the authors declared serving as an advisory board member, speaker, and/or consultant and receiving advisory board fees, grant support, and/or consultant fees from multiple sources. Some of the authors declared being employees and stockholders of Eli Lilly and Company.

Source: Peres MFP et al. Curr Med Res Opin. 2021 Mar 31. doi: 10.1080/03007995.2021.1903846.

Key clinical point: Lasmiditan showed relatively better efficacy outcomes in migraine attacks when initiated at mild vs. moderate or severe pain.

Major finding: In GLADIATOR, a significantly greater proportion of patients treated with lasmiditan (200 mg) at mild vs. moderate or severe pain achieved 2-hour pain freedom (PF; both P less than .001) and 24-hour sustained PF (SPF; P less than .05). In SAMURAI and SPARTAN, numerically higher proportion of patients treated with lasmiditan (200 mg) at mild vs. moderate or severe pain achieved 2-hour PF (45.5% vs. 37.6% or 29.4%) and 24-hour SPF (31.8% vs. 22.7% or 15.0%).

Study details: Findings are from pooled analysis of phase 3 studies SAMURAI, SPARTAN, and GLADIATOR.

Disclosures: The work was funded by Eli Lilly and Company. Some of the authors declared serving as an advisory board member, speaker, and/or consultant and receiving advisory board fees, grant support, and/or consultant fees from multiple sources. Some of the authors declared being employees and stockholders of Eli Lilly and Company.

Source: Peres MFP et al. Curr Med Res Opin. 2021 Mar 31. doi: 10.1080/03007995.2021.1903846.

Key clinical point: The safety and efficacy of ubrogepant for acute treatment of migraine did not differ by the presence of cardiovascular risk factors.

Major finding: The efficacy of ubrogepant vs. placebo to achieve 2-hour pain freedom (P interaction = .1358) and absence of most bothersome migraine-associated symptom at 2 hours (P interaction = .7014) was comparable across cardiovascular risk categories. The adverse event profile of ubrogepant was similar across cardiovascular risk categories and to placebo.

Study details: This was a post hoc analysis that pooled data from ubrogepant 50 mg and placebo arms of phase 3 ACHIEVE I and II trials involving patients with migraine with or without aura. In the safety population, patients were categorized into moderate-high (n=311), low (n=920), and no (n=1,670) cardiovascular risk categories.

Disclosures: ACHIEVE I and II were funded by Allergan plc (prior to its acquisition by AbbVie). Some of the authors reported serving as advisory board members, speakers, consultants, and/or receiving honoraria from multiple sources. Three authors declared being full-time employees and stockholders of AbbVie.

Source: Hutchinson S et al. Cephalalgia. 2021 Apr 19. doi: 10.1177/03331024211000311.

Key clinical point: The safety and efficacy of ubrogepant for acute treatment of migraine did not differ by the presence of cardiovascular risk factors.

Major finding: The efficacy of ubrogepant vs. placebo to achieve 2-hour pain freedom (P interaction = .1358) and absence of most bothersome migraine-associated symptom at 2 hours (P interaction = .7014) was comparable across cardiovascular risk categories. The adverse event profile of ubrogepant was similar across cardiovascular risk categories and to placebo.

Study details: This was a post hoc analysis that pooled data from ubrogepant 50 mg and placebo arms of phase 3 ACHIEVE I and II trials involving patients with migraine with or without aura. In the safety population, patients were categorized into moderate-high (n=311), low (n=920), and no (n=1,670) cardiovascular risk categories.

Disclosures: ACHIEVE I and II were funded by Allergan plc (prior to its acquisition by AbbVie). Some of the authors reported serving as advisory board members, speakers, consultants, and/or receiving honoraria from multiple sources. Three authors declared being full-time employees and stockholders of AbbVie.

Source: Hutchinson S et al. Cephalalgia. 2021 Apr 19. doi: 10.1177/03331024211000311.

Key clinical point: The safety and efficacy of ubrogepant for acute treatment of migraine did not differ by the presence of cardiovascular risk factors.

Major finding: The efficacy of ubrogepant vs. placebo to achieve 2-hour pain freedom (P interaction = .1358) and absence of most bothersome migraine-associated symptom at 2 hours (P interaction = .7014) was comparable across cardiovascular risk categories. The adverse event profile of ubrogepant was similar across cardiovascular risk categories and to placebo.

Study details: This was a post hoc analysis that pooled data from ubrogepant 50 mg and placebo arms of phase 3 ACHIEVE I and II trials involving patients with migraine with or without aura. In the safety population, patients were categorized into moderate-high (n=311), low (n=920), and no (n=1,670) cardiovascular risk categories.

Disclosures: ACHIEVE I and II were funded by Allergan plc (prior to its acquisition by AbbVie). Some of the authors reported serving as advisory board members, speakers, consultants, and/or receiving honoraria from multiple sources. Three authors declared being full-time employees and stockholders of AbbVie.

Source: Hutchinson S et al. Cephalalgia. 2021 Apr 19. doi: 10.1177/03331024211000311.

Key clinical point: Eptinezumab, particularly at a dosage of 300 mg, has significant efficacy and an acceptable safety profile for treatment of migraine.

Major finding: Eptinezumab significantly reduced the mean monthly migraine days (MMDs) compared with placebo at week 12 at a dosage of 30 mg (change in MMDs, −0.29; P = .0001), 100 mg (change in MMDs, −0.31; P less than .00001), and 300 mg (change in MMDs, −0.41; P less than .00001). Treatment-emergent adverse events were not significantly different between eptinezumab and placebo.

Study details: This was a meta-analysis of 4 randomized controlled trials including 2,739 patients with migraine.

Disclosures: This work was supported by the Suzhou Health Talents Training Project. The authors declared no competing interests.

Source: Yan Z et al. J Headache Pain. 2021 Mar 6. doi: 10.1186/s10194-021-01220-y.

Key clinical point: Eptinezumab, particularly at a dosage of 300 mg, has significant efficacy and an acceptable safety profile for treatment of migraine.

Major finding: Eptinezumab significantly reduced the mean monthly migraine days (MMDs) compared with placebo at week 12 at a dosage of 30 mg (change in MMDs, −0.29; P = .0001), 100 mg (change in MMDs, −0.31; P less than .00001), and 300 mg (change in MMDs, −0.41; P less than .00001). Treatment-emergent adverse events were not significantly different between eptinezumab and placebo.

Study details: This was a meta-analysis of 4 randomized controlled trials including 2,739 patients with migraine.

Disclosures: This work was supported by the Suzhou Health Talents Training Project. The authors declared no competing interests.

Source: Yan Z et al. J Headache Pain. 2021 Mar 6. doi: 10.1186/s10194-021-01220-y.

Key clinical point: Eptinezumab, particularly at a dosage of 300 mg, has significant efficacy and an acceptable safety profile for treatment of migraine.

Major finding: Eptinezumab significantly reduced the mean monthly migraine days (MMDs) compared with placebo at week 12 at a dosage of 30 mg (change in MMDs, −0.29; P = .0001), 100 mg (change in MMDs, −0.31; P less than .00001), and 300 mg (change in MMDs, −0.41; P less than .00001). Treatment-emergent adverse events were not significantly different between eptinezumab and placebo.

Study details: This was a meta-analysis of 4 randomized controlled trials including 2,739 patients with migraine.

Disclosures: This work was supported by the Suzhou Health Talents Training Project. The authors declared no competing interests.

Source: Yan Z et al. J Headache Pain. 2021 Mar 6. doi: 10.1186/s10194-021-01220-y.

Key clinical point: Components of nonpharmacological interventions are effective for treatment of pediatric migraine.

Major finding: Short-term self-administered treatments (standardized mean difference [SMD], 1.44; 95% confidence interval [95% CI], 0.26-2.62), biofeedback (SMD, 1.41; 95% CI, 0.64-2.17), relaxation (SMD, 1.38; 95% CI, 0.61-2.14), and psychological treatments (SMD, 1.36; 95% CI, 0.15-2.57) were more effective than the waiting list, with findings being similar for long-term treatments.

Study details: A network meta-analysis of 12 randomized clinical trials that evaluated nonpharmacological treatments for pediatric migraine in 576 children and adolescents with episodic migraine.

Disclosures: The study was supported in part by the Sara Page Mayo Endowment for Pediatric Pain Research, Education, and Treatment. The authors reported no potential conflicts of interest.

Source: Koechlin H et al. Pediatrics. 2021 Mar 9. doi: 10.1542/peds.2019-4107.

Key clinical point: Components of nonpharmacological interventions are effective for treatment of pediatric migraine.

Major finding: Short-term self-administered treatments (standardized mean difference [SMD], 1.44; 95% confidence interval [95% CI], 0.26-2.62), biofeedback (SMD, 1.41; 95% CI, 0.64-2.17), relaxation (SMD, 1.38; 95% CI, 0.61-2.14), and psychological treatments (SMD, 1.36; 95% CI, 0.15-2.57) were more effective than the waiting list, with findings being similar for long-term treatments.

Study details: A network meta-analysis of 12 randomized clinical trials that evaluated nonpharmacological treatments for pediatric migraine in 576 children and adolescents with episodic migraine.

Disclosures: The study was supported in part by the Sara Page Mayo Endowment for Pediatric Pain Research, Education, and Treatment. The authors reported no potential conflicts of interest.

Source: Koechlin H et al. Pediatrics. 2021 Mar 9. doi: 10.1542/peds.2019-4107.

Key clinical point: Components of nonpharmacological interventions are effective for treatment of pediatric migraine.

Major finding: Short-term self-administered treatments (standardized mean difference [SMD], 1.44; 95% confidence interval [95% CI], 0.26-2.62), biofeedback (SMD, 1.41; 95% CI, 0.64-2.17), relaxation (SMD, 1.38; 95% CI, 0.61-2.14), and psychological treatments (SMD, 1.36; 95% CI, 0.15-2.57) were more effective than the waiting list, with findings being similar for long-term treatments.

Study details: A network meta-analysis of 12 randomized clinical trials that evaluated nonpharmacological treatments for pediatric migraine in 576 children and adolescents with episodic migraine.

Disclosures: The study was supported in part by the Sara Page Mayo Endowment for Pediatric Pain Research, Education, and Treatment. The authors reported no potential conflicts of interest.

Source: Koechlin H et al. Pediatrics. 2021 Mar 9. doi: 10.1542/peds.2019-4107.

Key clinical point: Poor sleep and higher stress level is associated with a higher rate of headache recurrence over next 6 weeks in patients with episodic migraine.

Major finding: Poor sleep quality was associated with a 22% higher rate of headache recurrence (adjusted hazard ratio [aHR], 1.22; 95% confidence interval [95% CI], 1.02-1.46), and the combination of poor sleep and moderate/high stress vs. good sleep and low stress was associated with a 31% higher rate of headache recurrence (aHR, 1.31; 95% CI, 1.05-1.65).

Study details: Findings are from a priori secondary analysis of a prospective cohort study of 98 patients with episodic migraine.

Disclosures: The work was funded by the National Institute of Neurological Disorders and Stroke, the American Sleep Medicine Foundation, the Harvard Clinical and Translational Science Center, and Harvard University and its affiliated academic health care centers. Dr. SM Bertisch reported receiving research support from and serving as a consultant for various sources. All other authors declared no financial conflicts of interest.

Source: Vgontzas A et al. Headache. 2021 Mar 22. doi: 10.1111/head.14105.

Key clinical point: Poor sleep and higher stress level is associated with a higher rate of headache recurrence over next 6 weeks in patients with episodic migraine.

Major finding: Poor sleep quality was associated with a 22% higher rate of headache recurrence (adjusted hazard ratio [aHR], 1.22; 95% confidence interval [95% CI], 1.02-1.46), and the combination of poor sleep and moderate/high stress vs. good sleep and low stress was associated with a 31% higher rate of headache recurrence (aHR, 1.31; 95% CI, 1.05-1.65).

Study details: Findings are from a priori secondary analysis of a prospective cohort study of 98 patients with episodic migraine.

Disclosures: The work was funded by the National Institute of Neurological Disorders and Stroke, the American Sleep Medicine Foundation, the Harvard Clinical and Translational Science Center, and Harvard University and its affiliated academic health care centers. Dr. SM Bertisch reported receiving research support from and serving as a consultant for various sources. All other authors declared no financial conflicts of interest.

Source: Vgontzas A et al. Headache. 2021 Mar 22. doi: 10.1111/head.14105.

Key clinical point: Poor sleep and higher stress level is associated with a higher rate of headache recurrence over next 6 weeks in patients with episodic migraine.

Major finding: Poor sleep quality was associated with a 22% higher rate of headache recurrence (adjusted hazard ratio [aHR], 1.22; 95% confidence interval [95% CI], 1.02-1.46), and the combination of poor sleep and moderate/high stress vs. good sleep and low stress was associated with a 31% higher rate of headache recurrence (aHR, 1.31; 95% CI, 1.05-1.65).

Study details: Findings are from a priori secondary analysis of a prospective cohort study of 98 patients with episodic migraine.

Disclosures: The work was funded by the National Institute of Neurological Disorders and Stroke, the American Sleep Medicine Foundation, the Harvard Clinical and Translational Science Center, and Harvard University and its affiliated academic health care centers. Dr. SM Bertisch reported receiving research support from and serving as a consultant for various sources. All other authors declared no financial conflicts of interest.

Source: Vgontzas A et al. Headache. 2021 Mar 22. doi: 10.1111/head.14105.