Migraine Briefs

Key clinical point: Patients with migraine who showed a favorable response to at least one triptan had a higher likelihood to respond to erenumab treatment than those not responding to triptans.

Major finding: Triptan responders had higher odds for responding to erenumab treatment than the triptan nonresponders (odds ratio, 3.64; P = .014).

Study details: Findings are from an ancillary study from a real-life observational study involving 140 patients with migraine treated with erenumab for at least 6 months.

Disclosures: The publication fee was unconditionally granted by Novartis Farma S.r.l. The lead author along with some other authors declared no competing interests. Some authors declared financial and nonfinancial relationships with various pharmaceutical sources such as Eli Lilly, Novartis, Allergan, Teva, Abbott, Innovet Italia Srl, Epitech Group, and Lusofarmaco.

Source:Frattale I et al. J Headache Pain. 2021 Jan 6. doi: 10.1186/s10194-020-01213-3.

Key clinical point: Patients with migraine who showed a favorable response to at least one triptan had a higher likelihood to respond to erenumab treatment than those not responding to triptans.

Major finding: Triptan responders had higher odds for responding to erenumab treatment than the triptan nonresponders (odds ratio, 3.64; P = .014).

Study details: Findings are from an ancillary study from a real-life observational study involving 140 patients with migraine treated with erenumab for at least 6 months.

Disclosures: The publication fee was unconditionally granted by Novartis Farma S.r.l. The lead author along with some other authors declared no competing interests. Some authors declared financial and nonfinancial relationships with various pharmaceutical sources such as Eli Lilly, Novartis, Allergan, Teva, Abbott, Innovet Italia Srl, Epitech Group, and Lusofarmaco.

Source:Frattale I et al. J Headache Pain. 2021 Jan 6. doi: 10.1186/s10194-020-01213-3.

Key clinical point: Patients with migraine who showed a favorable response to at least one triptan had a higher likelihood to respond to erenumab treatment than those not responding to triptans.

Major finding: Triptan responders had higher odds for responding to erenumab treatment than the triptan nonresponders (odds ratio, 3.64; P = .014).

Study details: Findings are from an ancillary study from a real-life observational study involving 140 patients with migraine treated with erenumab for at least 6 months.

Disclosures: The publication fee was unconditionally granted by Novartis Farma S.r.l. The lead author along with some other authors declared no competing interests. Some authors declared financial and nonfinancial relationships with various pharmaceutical sources such as Eli Lilly, Novartis, Allergan, Teva, Abbott, Innovet Italia Srl, Epitech Group, and Lusofarmaco.

Source:Frattale I et al. J Headache Pain. 2021 Jan 6. doi: 10.1186/s10194-020-01213-3.

Key clinical point: Erenumab 70 mg was effective for the treatment of high-frequency episodic migraine (HFEM) or chronic migraine (CM) in a real-world setting.

Major finding: Erenumab was effective with a rapid progressive decrease in monthly migraine days (week 12: HEFM, 4.5 days; CM, 9.3 days). More than 50% of HEFM and 75% of CM patients responded to the treatment.

Study details: The data come from a real-life prospective cohort study of 372 patients affected by HEFM or CM with 3 or more prior preventive therapeutic failures.

Disclosures: This work was partially supported by the Italian Ministry of Health (Institutional Funding Ricerca Corrente). C Altamura, N Brunelli, A Fallacara, CM Costa, D Santangelo, A Salerno, B Mercuri, and A Carnevale declared no conflicts of interest. The remaining authors reported ties with various institutions and/or pharmaceutical companies.

Source: Barbanti P et al. Headache. 2020 Dec 18. doi: 10.1111/head.14032.

Key clinical point: Erenumab 70 mg was effective for the treatment of high-frequency episodic migraine (HFEM) or chronic migraine (CM) in a real-world setting.

Major finding: Erenumab was effective with a rapid progressive decrease in monthly migraine days (week 12: HEFM, 4.5 days; CM, 9.3 days). More than 50% of HEFM and 75% of CM patients responded to the treatment.

Study details: The data come from a real-life prospective cohort study of 372 patients affected by HEFM or CM with 3 or more prior preventive therapeutic failures.

Disclosures: This work was partially supported by the Italian Ministry of Health (Institutional Funding Ricerca Corrente). C Altamura, N Brunelli, A Fallacara, CM Costa, D Santangelo, A Salerno, B Mercuri, and A Carnevale declared no conflicts of interest. The remaining authors reported ties with various institutions and/or pharmaceutical companies.

Source: Barbanti P et al. Headache. 2020 Dec 18. doi: 10.1111/head.14032.

Key clinical point: Erenumab 70 mg was effective for the treatment of high-frequency episodic migraine (HFEM) or chronic migraine (CM) in a real-world setting.

Major finding: Erenumab was effective with a rapid progressive decrease in monthly migraine days (week 12: HEFM, 4.5 days; CM, 9.3 days). More than 50% of HEFM and 75% of CM patients responded to the treatment.

Study details: The data come from a real-life prospective cohort study of 372 patients affected by HEFM or CM with 3 or more prior preventive therapeutic failures.

Disclosures: This work was partially supported by the Italian Ministry of Health (Institutional Funding Ricerca Corrente). C Altamura, N Brunelli, A Fallacara, CM Costa, D Santangelo, A Salerno, B Mercuri, and A Carnevale declared no conflicts of interest. The remaining authors reported ties with various institutions and/or pharmaceutical companies.

Source: Barbanti P et al. Headache. 2020 Dec 18. doi: 10.1111/head.14032.

Key clinical point: Chronic migraine patients who achieved early reversal to episodic migraine are likely to have persistent reversion with long-term erenumab treatment.

Major finding: At 12 weeks, 54.1% (95% confidence interval [CI], 46.6%-61.6%) of patients showed reversal to episodic migraine. Continued treatment with erenumab showed a long-term persistent reversion in 96.8% (95% CI, 91.1%-99.3%) of patients at week 64.

Study details: Data on 181 migraine patients come from a post hoc analysis of a 12-week randomized double-blind trial and a 52-week open-label extension.

Disclosures: The study was funded by Amgen Inc. The authors reported ties with various institutions and/or pharmaceutical companies. F Zhang, GA Rippon, S Cheng, and DD Mikol are employed by and own stock in Amgen.

Source: Lipton RB et al. Cephalalgia. 2020 Dec 3. doi: 10.1177/0333102420973994.

Key clinical point: Chronic migraine patients who achieved early reversal to episodic migraine are likely to have persistent reversion with long-term erenumab treatment.

Major finding: At 12 weeks, 54.1% (95% confidence interval [CI], 46.6%-61.6%) of patients showed reversal to episodic migraine. Continued treatment with erenumab showed a long-term persistent reversion in 96.8% (95% CI, 91.1%-99.3%) of patients at week 64.

Study details: Data on 181 migraine patients come from a post hoc analysis of a 12-week randomized double-blind trial and a 52-week open-label extension.

Disclosures: The study was funded by Amgen Inc. The authors reported ties with various institutions and/or pharmaceutical companies. F Zhang, GA Rippon, S Cheng, and DD Mikol are employed by and own stock in Amgen.

Source: Lipton RB et al. Cephalalgia. 2020 Dec 3. doi: 10.1177/0333102420973994.

Key clinical point: Chronic migraine patients who achieved early reversal to episodic migraine are likely to have persistent reversion with long-term erenumab treatment.

Major finding: At 12 weeks, 54.1% (95% confidence interval [CI], 46.6%-61.6%) of patients showed reversal to episodic migraine. Continued treatment with erenumab showed a long-term persistent reversion in 96.8% (95% CI, 91.1%-99.3%) of patients at week 64.

Study details: Data on 181 migraine patients come from a post hoc analysis of a 12-week randomized double-blind trial and a 52-week open-label extension.

Disclosures: The study was funded by Amgen Inc. The authors reported ties with various institutions and/or pharmaceutical companies. F Zhang, GA Rippon, S Cheng, and DD Mikol are employed by and own stock in Amgen.

Source: Lipton RB et al. Cephalalgia. 2020 Dec 3. doi: 10.1177/0333102420973994.

Key clinical point: Interictal plasma amylin levels are higher in patients with chronic migraine and may serve as a better diagnostic marker than calcitonin gene-related peptide (CGRP).

Major finding: Plasma amylin levels were higher in chronic migraine patients than in episodic migraine patients and healthy controls (both P less than. 0001). Diagnostic performance was better with plasma amylin than CGRP in differentiating chronic migraine from healthy controls in adults.

Study details: The data come from a prospective case-controlled study involving 191 patients with chronic migraine, 58 patients with episodic migraine, and 68 healthy controls.

Disclosures: This study was funded by the Spanish Research Network on Cerebrovascular Diseases, Center for Applied Medical Research, University of Navarra, and Spanish Ministry of Economy and Competitiveness. The authors declared no conflicts of interest.

Source: Irimia P et al. Cephalalgia. 2020 Dec 3. doi: 10.1177/0333102420977106.

Key clinical point: Interictal plasma amylin levels are higher in patients with chronic migraine and may serve as a better diagnostic marker than calcitonin gene-related peptide (CGRP).

Major finding: Plasma amylin levels were higher in chronic migraine patients than in episodic migraine patients and healthy controls (both P less than. 0001). Diagnostic performance was better with plasma amylin than CGRP in differentiating chronic migraine from healthy controls in adults.

Study details: The data come from a prospective case-controlled study involving 191 patients with chronic migraine, 58 patients with episodic migraine, and 68 healthy controls.

Disclosures: This study was funded by the Spanish Research Network on Cerebrovascular Diseases, Center for Applied Medical Research, University of Navarra, and Spanish Ministry of Economy and Competitiveness. The authors declared no conflicts of interest.

Source: Irimia P et al. Cephalalgia. 2020 Dec 3. doi: 10.1177/0333102420977106.

Key clinical point: Interictal plasma amylin levels are higher in patients with chronic migraine and may serve as a better diagnostic marker than calcitonin gene-related peptide (CGRP).

Major finding: Plasma amylin levels were higher in chronic migraine patients than in episodic migraine patients and healthy controls (both P less than. 0001). Diagnostic performance was better with plasma amylin than CGRP in differentiating chronic migraine from healthy controls in adults.

Study details: The data come from a prospective case-controlled study involving 191 patients with chronic migraine, 58 patients with episodic migraine, and 68 healthy controls.

Disclosures: This study was funded by the Spanish Research Network on Cerebrovascular Diseases, Center for Applied Medical Research, University of Navarra, and Spanish Ministry of Economy and Competitiveness. The authors declared no conflicts of interest.

Source: Irimia P et al. Cephalalgia. 2020 Dec 3. doi: 10.1177/0333102420977106.

Key clinical point: Sex differences in recovery time were observed in pediatric patients with mild traumatic brain injury or concussion, with girls and women taking longer to recover than boys and men. Patients with comorbidities of emotional distress (i.e., anxiety or depression) and migraine recovered more slowly, independent of sex.

Major finding: Girls and women experienced slower recovery (persistent symptoms after injury: week 4, 81.6% vs. 71.2%; week 8, 58.9% vs. 44.3%; and week 12, 42.6% vs. 30.2%; P = .01) and were more likely to have preexisting anxiety (26.7% vs. 18.7%) vs. boys and men. Patients with a history of emotional distress (persistent symptoms after injury: week 4, 80.9% vs. 75.6%; week 8, 57.8% vs. 50.5%; and week 12, 48.0% vs. 33.3%; P = .009) and migraine (persistent symptoms after injury: week 4, 87.3% vs. 73.9%; week 8, 67.7% vs. 49.0%; and week 12, 55.7% vs. 33.2%; P = .001) recovered more slowly vs. those without.

Study details: A prospective cohort study of 600 pediatric patients (54% females, 72.5% adolescents) enrolled at multicenter concussion specialty clinics from the Four Corners Youth Consortium from December 2017 to July 2019.

Disclosures: The study was supported by funds from the UCLA Steve Tisch BrainSPORT Program, the Easton Clinic for Brain Health, the UCLA Brain Injury Research Center, Stan and Patti Silver, the Satterberg Foundation, and the Sports Institute at UW Medicine. The presenting author had no disclosures. Three coauthors reported various disclosures.

Source: Rosenbaum PE et al. JAMA Netw Open. 2020 Nov 2. doi: 10.1001/jamanetworkopen.2020.21463.

Key clinical point: Sex differences in recovery time were observed in pediatric patients with mild traumatic brain injury or concussion, with girls and women taking longer to recover than boys and men. Patients with comorbidities of emotional distress (i.e., anxiety or depression) and migraine recovered more slowly, independent of sex.

Major finding: Girls and women experienced slower recovery (persistent symptoms after injury: week 4, 81.6% vs. 71.2%; week 8, 58.9% vs. 44.3%; and week 12, 42.6% vs. 30.2%; P = .01) and were more likely to have preexisting anxiety (26.7% vs. 18.7%) vs. boys and men. Patients with a history of emotional distress (persistent symptoms after injury: week 4, 80.9% vs. 75.6%; week 8, 57.8% vs. 50.5%; and week 12, 48.0% vs. 33.3%; P = .009) and migraine (persistent symptoms after injury: week 4, 87.3% vs. 73.9%; week 8, 67.7% vs. 49.0%; and week 12, 55.7% vs. 33.2%; P = .001) recovered more slowly vs. those without.

Study details: A prospective cohort study of 600 pediatric patients (54% females, 72.5% adolescents) enrolled at multicenter concussion specialty clinics from the Four Corners Youth Consortium from December 2017 to July 2019.

Disclosures: The study was supported by funds from the UCLA Steve Tisch BrainSPORT Program, the Easton Clinic for Brain Health, the UCLA Brain Injury Research Center, Stan and Patti Silver, the Satterberg Foundation, and the Sports Institute at UW Medicine. The presenting author had no disclosures. Three coauthors reported various disclosures.

Source: Rosenbaum PE et al. JAMA Netw Open. 2020 Nov 2. doi: 10.1001/jamanetworkopen.2020.21463.

Key clinical point: Sex differences in recovery time were observed in pediatric patients with mild traumatic brain injury or concussion, with girls and women taking longer to recover than boys and men. Patients with comorbidities of emotional distress (i.e., anxiety or depression) and migraine recovered more slowly, independent of sex.

Major finding: Girls and women experienced slower recovery (persistent symptoms after injury: week 4, 81.6% vs. 71.2%; week 8, 58.9% vs. 44.3%; and week 12, 42.6% vs. 30.2%; P = .01) and were more likely to have preexisting anxiety (26.7% vs. 18.7%) vs. boys and men. Patients with a history of emotional distress (persistent symptoms after injury: week 4, 80.9% vs. 75.6%; week 8, 57.8% vs. 50.5%; and week 12, 48.0% vs. 33.3%; P = .009) and migraine (persistent symptoms after injury: week 4, 87.3% vs. 73.9%; week 8, 67.7% vs. 49.0%; and week 12, 55.7% vs. 33.2%; P = .001) recovered more slowly vs. those without.

Study details: A prospective cohort study of 600 pediatric patients (54% females, 72.5% adolescents) enrolled at multicenter concussion specialty clinics from the Four Corners Youth Consortium from December 2017 to July 2019.

Disclosures: The study was supported by funds from the UCLA Steve Tisch BrainSPORT Program, the Easton Clinic for Brain Health, the UCLA Brain Injury Research Center, Stan and Patti Silver, the Satterberg Foundation, and the Sports Institute at UW Medicine. The presenting author had no disclosures. Three coauthors reported various disclosures.

Source: Rosenbaum PE et al. JAMA Netw Open. 2020 Nov 2. doi: 10.1001/jamanetworkopen.2020.21463.

Key clinical point: This meta-analysis suggests that ginger is safe and effective in treating migraine patients with pain outcomes assessed at 2 hours.

Major finding: Ginger treatment was associated with substantially improved pain-free at 2 hours (risk ratio [RR], 1.79; P = .04) and decreased pain scores at 2 hours (mean difference, −1.27; P less than .00001), but showed no notable influence on treatment response (RR, 2.04; P = .43). The incidence of nausea and vomiting was lower in the ginger group vs. control group. The total adverse events were similar between groups (RR, 0.80; P = .44).

Study details: A meta-analysis of 3 randomized controlled trials including 227 participants.

Disclosures: No study sponsor was identified. The authors declared no conflicts of interest.

Source: Chen L et al. Am J Emerg Med. 2020 Nov 17. doi: 10.1016/j.ajem.2020.11.030.

Key clinical point: This meta-analysis suggests that ginger is safe and effective in treating migraine patients with pain outcomes assessed at 2 hours.

Major finding: Ginger treatment was associated with substantially improved pain-free at 2 hours (risk ratio [RR], 1.79; P = .04) and decreased pain scores at 2 hours (mean difference, −1.27; P less than .00001), but showed no notable influence on treatment response (RR, 2.04; P = .43). The incidence of nausea and vomiting was lower in the ginger group vs. control group. The total adverse events were similar between groups (RR, 0.80; P = .44).

Study details: A meta-analysis of 3 randomized controlled trials including 227 participants.

Disclosures: No study sponsor was identified. The authors declared no conflicts of interest.

Source: Chen L et al. Am J Emerg Med. 2020 Nov 17. doi: 10.1016/j.ajem.2020.11.030.

Key clinical point: This meta-analysis suggests that ginger is safe and effective in treating migraine patients with pain outcomes assessed at 2 hours.

Major finding: Ginger treatment was associated with substantially improved pain-free at 2 hours (risk ratio [RR], 1.79; P = .04) and decreased pain scores at 2 hours (mean difference, −1.27; P less than .00001), but showed no notable influence on treatment response (RR, 2.04; P = .43). The incidence of nausea and vomiting was lower in the ginger group vs. control group. The total adverse events were similar between groups (RR, 0.80; P = .44).

Study details: A meta-analysis of 3 randomized controlled trials including 227 participants.

Disclosures: No study sponsor was identified. The authors declared no conflicts of interest.

Source: Chen L et al. Am J Emerg Med. 2020 Nov 17. doi: 10.1016/j.ajem.2020.11.030.

Key clinical point: Along with its efficacy as a migraine preventive treatment, fremanezumab demonstrates the potential benefit for reversion from chronic migraine (CM) to episodic migraine (EM).

Major finding: The rates of reversion from CM to EM were higher in patients treated with fremanezumab vs. those treated with placebo, when reversion was defined either as an average of less than 15 headache days per month during the 3-month treatment period (quarterly: 50.5%; P = .108 and monthly: 53.7%; P = .012 vs. placebo: 44.5%) or, more stringently, as less than 15 headache days per month at months 1, 2, and 3 (quarterly: 31.2%; P = .008 and monthly: 33.7%; P = .001 vs. placebo: 22.4%).

Study details: The findings are based on a post hoc analysis of the HALO CM trial. Patients with CM (n=1,088) were randomly assigned to 1 of the 3 treatment groups (fremanezumab quarterly, n=376; fremanezumab monthly, n=379; or placebo, n=375).

Disclosures: The study was funded by Teva Pharmaceutical Industries Ltd., Petach Tikva, Israel. Some study investigators reported being an employee of Teva Branded Pharmaceutical Products R&D, Inc., receiving honoraria from, and/or consulting for Teva Pharmaceuticals.

Source: Lipton RB et al. Headache. 2020 Nov 11. doi: 10.1111/head.13997.

Key clinical point: Along with its efficacy as a migraine preventive treatment, fremanezumab demonstrates the potential benefit for reversion from chronic migraine (CM) to episodic migraine (EM).

Major finding: The rates of reversion from CM to EM were higher in patients treated with fremanezumab vs. those treated with placebo, when reversion was defined either as an average of less than 15 headache days per month during the 3-month treatment period (quarterly: 50.5%; P = .108 and monthly: 53.7%; P = .012 vs. placebo: 44.5%) or, more stringently, as less than 15 headache days per month at months 1, 2, and 3 (quarterly: 31.2%; P = .008 and monthly: 33.7%; P = .001 vs. placebo: 22.4%).

Study details: The findings are based on a post hoc analysis of the HALO CM trial. Patients with CM (n=1,088) were randomly assigned to 1 of the 3 treatment groups (fremanezumab quarterly, n=376; fremanezumab monthly, n=379; or placebo, n=375).

Disclosures: The study was funded by Teva Pharmaceutical Industries Ltd., Petach Tikva, Israel. Some study investigators reported being an employee of Teva Branded Pharmaceutical Products R&D, Inc., receiving honoraria from, and/or consulting for Teva Pharmaceuticals.

Source: Lipton RB et al. Headache. 2020 Nov 11. doi: 10.1111/head.13997.

Key clinical point: Along with its efficacy as a migraine preventive treatment, fremanezumab demonstrates the potential benefit for reversion from chronic migraine (CM) to episodic migraine (EM).

Major finding: The rates of reversion from CM to EM were higher in patients treated with fremanezumab vs. those treated with placebo, when reversion was defined either as an average of less than 15 headache days per month during the 3-month treatment period (quarterly: 50.5%; P = .108 and monthly: 53.7%; P = .012 vs. placebo: 44.5%) or, more stringently, as less than 15 headache days per month at months 1, 2, and 3 (quarterly: 31.2%; P = .008 and monthly: 33.7%; P = .001 vs. placebo: 22.4%).

Study details: The findings are based on a post hoc analysis of the HALO CM trial. Patients with CM (n=1,088) were randomly assigned to 1 of the 3 treatment groups (fremanezumab quarterly, n=376; fremanezumab monthly, n=379; or placebo, n=375).

Disclosures: The study was funded by Teva Pharmaceutical Industries Ltd., Petach Tikva, Israel. Some study investigators reported being an employee of Teva Branded Pharmaceutical Products R&D, Inc., receiving honoraria from, and/or consulting for Teva Pharmaceuticals.

Source: Lipton RB et al. Headache. 2020 Nov 11. doi: 10.1111/head.13997.

Key clinical point: Mindfulness-based stress reduction (MBSR) did not improve migraine frequency more than headache education as both groups had similar decreases; however, mindfulness meditation may help treat the total burden of migraine.

Major finding: Decrease in headache frequency did not differ between the 2 groups (MBSR, −2.0 vs headache education, −2.4; P = .52). The MBSR vs. headache education group had significantly greater improvements at 36 weeks in disability (P less than .001), quality of life (P =.01), self-efficacy (P = .04), pain catastrophizing (P less than .001), depression scores (P =.008), decrease in pain intensity (P =.004), and decrease in pain unpleasantness (P =.005).

Study details: In this double-blinded, randomized clinical trial, 89 adults with a history of migraine were assigned to receive training in MBSR/yoga (n=45) or health education instruction on headaches, pathophysiology, triggers, stress, and treatment approaches (n=44).

Disclosures: This study was funded by an American Pain Society Grant from the Sharon S. Keller Chronic Pain Research Program and the National Center for Complementary and Integrative Health. RE Wells and F Zeidan reported grants from the National Institutes of Health. TT Houle reported receiving personal fees from GlaxoSmithKline, Eli Lilly, and StatReviewer. The remaining authors declared no conflicts of interest.

Source: Wells RE et al. JAMA Intern Med. 2020 Dec 14. doi: 10.1001/jamainternmed.2020.7090.

Key clinical point: Mindfulness-based stress reduction (MBSR) did not improve migraine frequency more than headache education as both groups had similar decreases; however, mindfulness meditation may help treat the total burden of migraine.

Major finding: Decrease in headache frequency did not differ between the 2 groups (MBSR, −2.0 vs headache education, −2.4; P = .52). The MBSR vs. headache education group had significantly greater improvements at 36 weeks in disability (P less than .001), quality of life (P =.01), self-efficacy (P = .04), pain catastrophizing (P less than .001), depression scores (P =.008), decrease in pain intensity (P =.004), and decrease in pain unpleasantness (P =.005).

Study details: In this double-blinded, randomized clinical trial, 89 adults with a history of migraine were assigned to receive training in MBSR/yoga (n=45) or health education instruction on headaches, pathophysiology, triggers, stress, and treatment approaches (n=44).

Disclosures: This study was funded by an American Pain Society Grant from the Sharon S. Keller Chronic Pain Research Program and the National Center for Complementary and Integrative Health. RE Wells and F Zeidan reported grants from the National Institutes of Health. TT Houle reported receiving personal fees from GlaxoSmithKline, Eli Lilly, and StatReviewer. The remaining authors declared no conflicts of interest.

Source: Wells RE et al. JAMA Intern Med. 2020 Dec 14. doi: 10.1001/jamainternmed.2020.7090.

Key clinical point: Mindfulness-based stress reduction (MBSR) did not improve migraine frequency more than headache education as both groups had similar decreases; however, mindfulness meditation may help treat the total burden of migraine.

Major finding: Decrease in headache frequency did not differ between the 2 groups (MBSR, −2.0 vs headache education, −2.4; P = .52). The MBSR vs. headache education group had significantly greater improvements at 36 weeks in disability (P less than .001), quality of life (P =.01), self-efficacy (P = .04), pain catastrophizing (P less than .001), depression scores (P =.008), decrease in pain intensity (P =.004), and decrease in pain unpleasantness (P =.005).

Study details: In this double-blinded, randomized clinical trial, 89 adults with a history of migraine were assigned to receive training in MBSR/yoga (n=45) or health education instruction on headaches, pathophysiology, triggers, stress, and treatment approaches (n=44).

Disclosures: This study was funded by an American Pain Society Grant from the Sharon S. Keller Chronic Pain Research Program and the National Center for Complementary and Integrative Health. RE Wells and F Zeidan reported grants from the National Institutes of Health. TT Houle reported receiving personal fees from GlaxoSmithKline, Eli Lilly, and StatReviewer. The remaining authors declared no conflicts of interest.

Source: Wells RE et al. JAMA Intern Med. 2020 Dec 14. doi: 10.1001/jamainternmed.2020.7090.

Key clinical point: Delivery by cesarean section is not associated with migraine later in life. However, cesarean section is associated with a modestly reduced risk of non-migrainous headache.

Major finding: Delivery by cesarean section was not associated with later development of migraine (adjusted odds ratio [aOR], 0.93; P = .63). A negative association was seen between cesarean section and non-migrainous headache (aOR, 0.77; P = .04).

Study details: The findings are based on a retrospective register-linked HUNT population cohort study of 11,194 participants (age, 19-41 years; migraine group, n=1,855 and non-migrainous headache group, n=3,358).

Disclosures: This study was supported by grants from the University of Oslo, Akershus University Hospital, and Oslo University Hospital. The authors declared no conflicts of interest.

Source: Kristoffersen ES et al. BMJ Open. 2020 Nov 18. doi: 10.1136/bmjopen-2020-040685.

Key clinical point: Delivery by cesarean section is not associated with migraine later in life. However, cesarean section is associated with a modestly reduced risk of non-migrainous headache.

Major finding: Delivery by cesarean section was not associated with later development of migraine (adjusted odds ratio [aOR], 0.93; P = .63). A negative association was seen between cesarean section and non-migrainous headache (aOR, 0.77; P = .04).

Study details: The findings are based on a retrospective register-linked HUNT population cohort study of 11,194 participants (age, 19-41 years; migraine group, n=1,855 and non-migrainous headache group, n=3,358).

Disclosures: This study was supported by grants from the University of Oslo, Akershus University Hospital, and Oslo University Hospital. The authors declared no conflicts of interest.

Source: Kristoffersen ES et al. BMJ Open. 2020 Nov 18. doi: 10.1136/bmjopen-2020-040685.

Key clinical point: Delivery by cesarean section is not associated with migraine later in life. However, cesarean section is associated with a modestly reduced risk of non-migrainous headache.

Major finding: Delivery by cesarean section was not associated with later development of migraine (adjusted odds ratio [aOR], 0.93; P = .63). A negative association was seen between cesarean section and non-migrainous headache (aOR, 0.77; P = .04).

Study details: The findings are based on a retrospective register-linked HUNT population cohort study of 11,194 participants (age, 19-41 years; migraine group, n=1,855 and non-migrainous headache group, n=3,358).

Disclosures: This study was supported by grants from the University of Oslo, Akershus University Hospital, and Oslo University Hospital. The authors declared no conflicts of interest.

Source: Kristoffersen ES et al. BMJ Open. 2020 Nov 18. doi: 10.1136/bmjopen-2020-040685.

Key clinical point: In adults with episodic migraine, intravenous eptinezumab administered every 12 weeks for up to 4 doses provides early and sustained migraine preventive efficacy and is well tolerated with an acceptable safety profile.

Major finding: The reduction in mean monthly migraine days was maintained with eptinezumab throughout the study period (100 mg: −3.9, −4.5, −4.7, and −4.5 days; 300 mg: −4.3, −4.8, −5.1, and −5.3 days; and placebo: −3.2, −3.8, −4.0, and −4.0 days during weeks 1-12, 13-24, 25-36, and 37-48, respectively). The percentage of patients with a reduction of 50% or greater and 75% or greater in migraine for each 12-week interval was consistently higher in the eptinezumab group vs. placebo group. Adverse events were similar across dosing periods.

Study details: Results of phase 3 PROMISE-1 through 1 year of treatment (up to 4 doses). In PROMISE-1, 888 patients with episodic migraine were randomly assigned in a ratio of 1:1:1:1 to receive eptinezumab 30 mg, 100 mg, 300 mg, or placebo every 12 weeks.

Disclosures: No study sponsor was identified. The presenting author has been a consultant and/or scientific advisor for Alder/Lundbeck, Amgen, Biohaven, Eli Lilly, Impel Neuropharma, and Theranica, and has received research support from Alder/Lundbeck, Allergan, Amgen, Biohaven, Charleston Labs, Eli Lilly, Electrocore, Novartis, Novo Nordisk, Satsuma, Theranica, and Vorso.

Source: Smith TR et al. Clin Ther. 2020 Nov 27. doi: 10.1016/j.clinthera.2020.11.007.

Key clinical point: In adults with episodic migraine, intravenous eptinezumab administered every 12 weeks for up to 4 doses provides early and sustained migraine preventive efficacy and is well tolerated with an acceptable safety profile.

Major finding: The reduction in mean monthly migraine days was maintained with eptinezumab throughout the study period (100 mg: −3.9, −4.5, −4.7, and −4.5 days; 300 mg: −4.3, −4.8, −5.1, and −5.3 days; and placebo: −3.2, −3.8, −4.0, and −4.0 days during weeks 1-12, 13-24, 25-36, and 37-48, respectively). The percentage of patients with a reduction of 50% or greater and 75% or greater in migraine for each 12-week interval was consistently higher in the eptinezumab group vs. placebo group. Adverse events were similar across dosing periods.

Study details: Results of phase 3 PROMISE-1 through 1 year of treatment (up to 4 doses). In PROMISE-1, 888 patients with episodic migraine were randomly assigned in a ratio of 1:1:1:1 to receive eptinezumab 30 mg, 100 mg, 300 mg, or placebo every 12 weeks.

Disclosures: No study sponsor was identified. The presenting author has been a consultant and/or scientific advisor for Alder/Lundbeck, Amgen, Biohaven, Eli Lilly, Impel Neuropharma, and Theranica, and has received research support from Alder/Lundbeck, Allergan, Amgen, Biohaven, Charleston Labs, Eli Lilly, Electrocore, Novartis, Novo Nordisk, Satsuma, Theranica, and Vorso.

Source: Smith TR et al. Clin Ther. 2020 Nov 27. doi: 10.1016/j.clinthera.2020.11.007.

Key clinical point: In adults with episodic migraine, intravenous eptinezumab administered every 12 weeks for up to 4 doses provides early and sustained migraine preventive efficacy and is well tolerated with an acceptable safety profile.

Major finding: The reduction in mean monthly migraine days was maintained with eptinezumab throughout the study period (100 mg: −3.9, −4.5, −4.7, and −4.5 days; 300 mg: −4.3, −4.8, −5.1, and −5.3 days; and placebo: −3.2, −3.8, −4.0, and −4.0 days during weeks 1-12, 13-24, 25-36, and 37-48, respectively). The percentage of patients with a reduction of 50% or greater and 75% or greater in migraine for each 12-week interval was consistently higher in the eptinezumab group vs. placebo group. Adverse events were similar across dosing periods.

Study details: Results of phase 3 PROMISE-1 through 1 year of treatment (up to 4 doses). In PROMISE-1, 888 patients with episodic migraine were randomly assigned in a ratio of 1:1:1:1 to receive eptinezumab 30 mg, 100 mg, 300 mg, or placebo every 12 weeks.

Disclosures: No study sponsor was identified. The presenting author has been a consultant and/or scientific advisor for Alder/Lundbeck, Amgen, Biohaven, Eli Lilly, Impel Neuropharma, and Theranica, and has received research support from Alder/Lundbeck, Allergan, Amgen, Biohaven, Charleston Labs, Eli Lilly, Electrocore, Novartis, Novo Nordisk, Satsuma, Theranica, and Vorso.

Source: Smith TR et al. Clin Ther. 2020 Nov 27. doi: 10.1016/j.clinthera.2020.11.007.