Migraine Briefs

Key clinical points: Migraine and non-migraine headache show no association with all-cause mortality; however, the risk of cardiovascular mortality is higher in women experiencing from migraine with aura.

Major finding: All-cause mortality did not differ among individuals experiencing any migraine (hazard ratio [HR], 0.96; 95% confidence interval, 0.89-1.04) or non-migraine headache (HR, 1.01; 95% confidence interval, 0.93-1.10). Women experiencing migraine with aura had a higher risk of cardiovascular mortality vs. those with no history of migraine or headache (HR, 1.64; 95% confidence interval, 1.06-2.54).

Study details: The data come from an analysis of 27,844 Women’s Health Study participants, (aged ≥ 45 years) who were followed up for a median of 22.7 years.

Disclosures: Tobias Kurth reported receiving honoraria from Novartis and Daiichi-Sankyo for lectures on neuroepidemiology and research methods, from Lilly, Newsenselab, and Total for providing methodological advice, and from The BMJ for editorial services. The Women’s Health Study was funded by grants from the National Institutes of Health.

Citation: Rohmann JL et al. J Headache Pain. 2020 Mar 17. doi: 10.1186/s10194-020-01091-9. 

Key clinical points: Migraine and non-migraine headache show no association with all-cause mortality; however, the risk of cardiovascular mortality is higher in women experiencing from migraine with aura.

Major finding: All-cause mortality did not differ among individuals experiencing any migraine (hazard ratio [HR], 0.96; 95% confidence interval, 0.89-1.04) or non-migraine headache (HR, 1.01; 95% confidence interval, 0.93-1.10). Women experiencing migraine with aura had a higher risk of cardiovascular mortality vs. those with no history of migraine or headache (HR, 1.64; 95% confidence interval, 1.06-2.54).

Study details: The data come from an analysis of 27,844 Women’s Health Study participants, (aged ≥ 45 years) who were followed up for a median of 22.7 years.

Disclosures: Tobias Kurth reported receiving honoraria from Novartis and Daiichi-Sankyo for lectures on neuroepidemiology and research methods, from Lilly, Newsenselab, and Total for providing methodological advice, and from The BMJ for editorial services. The Women’s Health Study was funded by grants from the National Institutes of Health.

Citation: Rohmann JL et al. J Headache Pain. 2020 Mar 17. doi: 10.1186/s10194-020-01091-9. 

Key clinical points: Migraine and non-migraine headache show no association with all-cause mortality; however, the risk of cardiovascular mortality is higher in women experiencing from migraine with aura.

Major finding: All-cause mortality did not differ among individuals experiencing any migraine (hazard ratio [HR], 0.96; 95% confidence interval, 0.89-1.04) or non-migraine headache (HR, 1.01; 95% confidence interval, 0.93-1.10). Women experiencing migraine with aura had a higher risk of cardiovascular mortality vs. those with no history of migraine or headache (HR, 1.64; 95% confidence interval, 1.06-2.54).

Study details: The data come from an analysis of 27,844 Women’s Health Study participants, (aged ≥ 45 years) who were followed up for a median of 22.7 years.

Disclosures: Tobias Kurth reported receiving honoraria from Novartis and Daiichi-Sankyo for lectures on neuroepidemiology and research methods, from Lilly, Newsenselab, and Total for providing methodological advice, and from The BMJ for editorial services. The Women’s Health Study was funded by grants from the National Institutes of Health.

Citation: Rohmann JL et al. J Headache Pain. 2020 Mar 17. doi: 10.1186/s10194-020-01091-9. 

Key clinical point: After 10 years, a high proportion of migraineurs improve. Reduction in headache frequency, medical follow-up, and nonsmoking are independent factors associated with improvement.

Major finding: After 10 years, 48.2% of patients did not receive a medical follow-up for their migraine. Moreover, 47.4% (180/380) of patients had a decrease of 50% or higher in frequency (defined as improvement), which increased the proportion of episodic migraine (73.7% vs. 87.4%). Factors independently associated with improvement included a baseline frequency of greater than 10 headache days/month (odds ratio [OR], 3.04), having a medical follow-up (OR, 2.45), and nonsmoking (OR, 2.13).

Study details: A 10-year longitudinal study included 1,109 patients with migraine who answered an initial survey (380 completed the survey) and compared initial (2008) and final (2018) data, focusing on baseline prognostic factors of improvement (50% or higher frequency reduction) and no improvement (less than 50% frequency reduction).

Disclosures: No study sponsor was identified. The presenting author had no disclosures. Two coauthors received honoraria from pharmaceutical companies. 

Citation: Caronna E et al. Headache. 2020 Feb 18. doi: 10.1111/head.13774. 

Key clinical point: After 10 years, a high proportion of migraineurs improve. Reduction in headache frequency, medical follow-up, and nonsmoking are independent factors associated with improvement.

Major finding: After 10 years, 48.2% of patients did not receive a medical follow-up for their migraine. Moreover, 47.4% (180/380) of patients had a decrease of 50% or higher in frequency (defined as improvement), which increased the proportion of episodic migraine (73.7% vs. 87.4%). Factors independently associated with improvement included a baseline frequency of greater than 10 headache days/month (odds ratio [OR], 3.04), having a medical follow-up (OR, 2.45), and nonsmoking (OR, 2.13).

Study details: A 10-year longitudinal study included 1,109 patients with migraine who answered an initial survey (380 completed the survey) and compared initial (2008) and final (2018) data, focusing on baseline prognostic factors of improvement (50% or higher frequency reduction) and no improvement (less than 50% frequency reduction).

Disclosures: No study sponsor was identified. The presenting author had no disclosures. Two coauthors received honoraria from pharmaceutical companies. 

Citation: Caronna E et al. Headache. 2020 Feb 18. doi: 10.1111/head.13774. 

Key clinical point: After 10 years, a high proportion of migraineurs improve. Reduction in headache frequency, medical follow-up, and nonsmoking are independent factors associated with improvement.

Major finding: After 10 years, 48.2% of patients did not receive a medical follow-up for their migraine. Moreover, 47.4% (180/380) of patients had a decrease of 50% or higher in frequency (defined as improvement), which increased the proportion of episodic migraine (73.7% vs. 87.4%). Factors independently associated with improvement included a baseline frequency of greater than 10 headache days/month (odds ratio [OR], 3.04), having a medical follow-up (OR, 2.45), and nonsmoking (OR, 2.13).

Study details: A 10-year longitudinal study included 1,109 patients with migraine who answered an initial survey (380 completed the survey) and compared initial (2008) and final (2018) data, focusing on baseline prognostic factors of improvement (50% or higher frequency reduction) and no improvement (less than 50% frequency reduction).

Disclosures: No study sponsor was identified. The presenting author had no disclosures. Two coauthors received honoraria from pharmaceutical companies. 

Citation: Caronna E et al. Headache. 2020 Feb 18. doi: 10.1111/head.13774. 

Key clinical point: Calcitonin gene-related peptide-binding monoclonal antibody (CGRP mAb) is an effective and safe preventive treatment for episodic migraine.

Major finding: CGRP mAb therapy was associated with a significant reduction in monthly migraine days (weighted mean difference [WMD], −1.44; P less than .00001) and acute migraine-specific medication days (WMD, −1.28; P less than .00001), with an improvement in 50% responder rate (RR, 1.51; 95% CI,  1.37-1.66) compared with placebo. Adverse events and treatment withdrawal rates did not differ between groups.

Study details: Meta-analysis of 11 randomized controlled trials including 4,402 patients.

Disclosures: This study was supported by the National Natural Science Foundation of China and the Wuhan science and technology plan project. The authors declared no conflicts of interest.

Citation: Deng H et al. BMC Neurol. 2020 Feb 15. doi: 10.1186/s12883-020-01633-3. 

Key clinical point: Calcitonin gene-related peptide-binding monoclonal antibody (CGRP mAb) is an effective and safe preventive treatment for episodic migraine.

Major finding: CGRP mAb therapy was associated with a significant reduction in monthly migraine days (weighted mean difference [WMD], −1.44; P less than .00001) and acute migraine-specific medication days (WMD, −1.28; P less than .00001), with an improvement in 50% responder rate (RR, 1.51; 95% CI,  1.37-1.66) compared with placebo. Adverse events and treatment withdrawal rates did not differ between groups.

Study details: Meta-analysis of 11 randomized controlled trials including 4,402 patients.

Disclosures: This study was supported by the National Natural Science Foundation of China and the Wuhan science and technology plan project. The authors declared no conflicts of interest.

Citation: Deng H et al. BMC Neurol. 2020 Feb 15. doi: 10.1186/s12883-020-01633-3. 

Key clinical point: Calcitonin gene-related peptide-binding monoclonal antibody (CGRP mAb) is an effective and safe preventive treatment for episodic migraine.

Major finding: CGRP mAb therapy was associated with a significant reduction in monthly migraine days (weighted mean difference [WMD], −1.44; P less than .00001) and acute migraine-specific medication days (WMD, −1.28; P less than .00001), with an improvement in 50% responder rate (RR, 1.51; 95% CI,  1.37-1.66) compared with placebo. Adverse events and treatment withdrawal rates did not differ between groups.

Study details: Meta-analysis of 11 randomized controlled trials including 4,402 patients.

Disclosures: This study was supported by the National Natural Science Foundation of China and the Wuhan science and technology plan project. The authors declared no conflicts of interest.

Citation: Deng H et al. BMC Neurol. 2020 Feb 15. doi: 10.1186/s12883-020-01633-3. 

Key clinical point: Long-term treatment with lasmiditan is associated with progressive and clinically meaningful reductions in migraine-related disability, including fewer missed days of work and school.

Major finding: Total scores of Migraine Disability Assessment (MIDAS) scale significantly reduced from baseline to months 3, 6, 9, and 12 for both 100 and 200 mg doses of lasmiditan, with no significant differences between the dose groups. Work and/or school absenteeism and presenteeism, monthly headache days, and mean headache pain intensity improved significantly with lasmiditan for up to 1 year.

Study details: Patients in GLADIATOR trial were randomly assigned to lasmiditan 100 mg (n=974) or 200 mg (n=1063).

Disclosures: The GLADIATOR study was funded by Eli Lilly and Company. The presenting author had received consultant fees, honoraria, and/or research grants from various pharmaceutical companies, including Eli Lilly and Company. Five of the authors were employees and minor stockholders of Eli Lilly and Company and one was an employee of Syneos Health, Inc., under contract to Eli Lilly and Company.

Citation: Lipton RB et al. J Headache Pain. 2020 Feb 24. doi: 10.1186/s10194-020-01088-4. 

Key clinical point: Long-term treatment with lasmiditan is associated with progressive and clinically meaningful reductions in migraine-related disability, including fewer missed days of work and school.

Major finding: Total scores of Migraine Disability Assessment (MIDAS) scale significantly reduced from baseline to months 3, 6, 9, and 12 for both 100 and 200 mg doses of lasmiditan, with no significant differences between the dose groups. Work and/or school absenteeism and presenteeism, monthly headache days, and mean headache pain intensity improved significantly with lasmiditan for up to 1 year.

Study details: Patients in GLADIATOR trial were randomly assigned to lasmiditan 100 mg (n=974) or 200 mg (n=1063).

Disclosures: The GLADIATOR study was funded by Eli Lilly and Company. The presenting author had received consultant fees, honoraria, and/or research grants from various pharmaceutical companies, including Eli Lilly and Company. Five of the authors were employees and minor stockholders of Eli Lilly and Company and one was an employee of Syneos Health, Inc., under contract to Eli Lilly and Company.

Citation: Lipton RB et al. J Headache Pain. 2020 Feb 24. doi: 10.1186/s10194-020-01088-4. 

Key clinical point: Long-term treatment with lasmiditan is associated with progressive and clinically meaningful reductions in migraine-related disability, including fewer missed days of work and school.

Major finding: Total scores of Migraine Disability Assessment (MIDAS) scale significantly reduced from baseline to months 3, 6, 9, and 12 for both 100 and 200 mg doses of lasmiditan, with no significant differences between the dose groups. Work and/or school absenteeism and presenteeism, monthly headache days, and mean headache pain intensity improved significantly with lasmiditan for up to 1 year.

Study details: Patients in GLADIATOR trial were randomly assigned to lasmiditan 100 mg (n=974) or 200 mg (n=1063).

Disclosures: The GLADIATOR study was funded by Eli Lilly and Company. The presenting author had received consultant fees, honoraria, and/or research grants from various pharmaceutical companies, including Eli Lilly and Company. Five of the authors were employees and minor stockholders of Eli Lilly and Company and one was an employee of Syneos Health, Inc., under contract to Eli Lilly and Company.

Citation: Lipton RB et al. J Headache Pain. 2020 Feb 24. doi: 10.1186/s10194-020-01088-4. 

Key clinical point: Increased subcutaneous abdominal fat is independently associated with cutaneous allodynia (CA), a marker of central sensitization in patients with migraine.

Major finding: Migraine patients with CA had a higher proportion of abdominal fat values than patients without CA (P = .04). The use of migraine prophylaxis (odds ratio [OR], 3.26), abdominal fat (OR, 1.13), and sleep disorders (OR, 1.13) were independent risk factors for the development of CA.

Study details: This prospective study investigated the association between CA and percentages of body fat and abdominal fat in 80 patients with migraine and 39 nonmigraine controls.

Disclosures: No study sponsor was identified. Allergan Inc. funded editorial assistance and statistical advice. María Rosario Luquin has received honoraria from TEVA, Zambon, AbbVie, and Bial for activities unrelated to the study. Pablo Irimia has received honoraria from Allergan, Novartis, Lilly, and Teva Pharmaceuticals as a consultant and speaker.

Citation: Mínguez-Olaondo A et al. J Headache Pain. 2020 Feb 4. doi: 10.1186/s10194-020-1082-0. 

Key clinical point: Increased subcutaneous abdominal fat is independently associated with cutaneous allodynia (CA), a marker of central sensitization in patients with migraine.

Major finding: Migraine patients with CA had a higher proportion of abdominal fat values than patients without CA (P = .04). The use of migraine prophylaxis (odds ratio [OR], 3.26), abdominal fat (OR, 1.13), and sleep disorders (OR, 1.13) were independent risk factors for the development of CA.

Study details: This prospective study investigated the association between CA and percentages of body fat and abdominal fat in 80 patients with migraine and 39 nonmigraine controls.

Disclosures: No study sponsor was identified. Allergan Inc. funded editorial assistance and statistical advice. María Rosario Luquin has received honoraria from TEVA, Zambon, AbbVie, and Bial for activities unrelated to the study. Pablo Irimia has received honoraria from Allergan, Novartis, Lilly, and Teva Pharmaceuticals as a consultant and speaker.

Citation: Mínguez-Olaondo A et al. J Headache Pain. 2020 Feb 4. doi: 10.1186/s10194-020-1082-0. 

Key clinical point: Increased subcutaneous abdominal fat is independently associated with cutaneous allodynia (CA), a marker of central sensitization in patients with migraine.

Major finding: Migraine patients with CA had a higher proportion of abdominal fat values than patients without CA (P = .04). The use of migraine prophylaxis (odds ratio [OR], 3.26), abdominal fat (OR, 1.13), and sleep disorders (OR, 1.13) were independent risk factors for the development of CA.

Study details: This prospective study investigated the association between CA and percentages of body fat and abdominal fat in 80 patients with migraine and 39 nonmigraine controls.

Disclosures: No study sponsor was identified. Allergan Inc. funded editorial assistance and statistical advice. María Rosario Luquin has received honoraria from TEVA, Zambon, AbbVie, and Bial for activities unrelated to the study. Pablo Irimia has received honoraria from Allergan, Novartis, Lilly, and Teva Pharmaceuticals as a consultant and speaker.

Citation: Mínguez-Olaondo A et al. J Headache Pain. 2020 Feb 4. doi: 10.1186/s10194-020-1082-0. 

Key clinical point: Galcanezumab is safe and effective in the prophylactic treatment of adult migraine.

Major finding: Compared with placebo, galcanezumab at doses of 120, 150, 240, and 300 mg significantly reduced monthly migraine days (mean difference [MD], −1.79, −1.20, −1.85, and –0.62, respectively). Reduction in migraine-specific medication days was statistically significant for galcanezumab doses of 120 and 240 mg vs. placebo. Total adverse events did not differ significantly between galcanezumab and placebo.

Study details: Meta-analysis of 5 studies evaluated the safety and efficacy of galcanezumab in the prophylactic treatment of adult migraine. 

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

Citation: Zhao X et al. J Neurol. 2020 Jan 31. doi: 10.1007/s00415-020-09707-5. 

Key clinical point: Galcanezumab is safe and effective in the prophylactic treatment of adult migraine.

Major finding: Compared with placebo, galcanezumab at doses of 120, 150, 240, and 300 mg significantly reduced monthly migraine days (mean difference [MD], −1.79, −1.20, −1.85, and –0.62, respectively). Reduction in migraine-specific medication days was statistically significant for galcanezumab doses of 120 and 240 mg vs. placebo. Total adverse events did not differ significantly between galcanezumab and placebo.

Study details: Meta-analysis of 5 studies evaluated the safety and efficacy of galcanezumab in the prophylactic treatment of adult migraine. 

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

Citation: Zhao X et al. J Neurol. 2020 Jan 31. doi: 10.1007/s00415-020-09707-5. 

Key clinical point: Galcanezumab is safe and effective in the prophylactic treatment of adult migraine.

Major finding: Compared with placebo, galcanezumab at doses of 120, 150, 240, and 300 mg significantly reduced monthly migraine days (mean difference [MD], −1.79, −1.20, −1.85, and –0.62, respectively). Reduction in migraine-specific medication days was statistically significant for galcanezumab doses of 120 and 240 mg vs. placebo. Total adverse events did not differ significantly between galcanezumab and placebo.

Study details: Meta-analysis of 5 studies evaluated the safety and efficacy of galcanezumab in the prophylactic treatment of adult migraine. 

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

Citation: Zhao X et al. J Neurol. 2020 Jan 31. doi: 10.1007/s00415-020-09707-5. 

Key clinical point: Intravenous (IV) eptinezumab could be a safe and effective preventive therapy for adult patients with episodic migraine.

Main finding: Eptinezumab 100 and 300 mg significantly reduced monthly migraine days across weeks 1-12 compared with the placebo (difference from placebo for 100 and 300 mg: –0.69; P = .0182 and –1.11; P = .0001, respectively). Safety and tolerability of eptinezumab across doses were acceptable compared with placebo, with no dose-related trend in the nature, frequency, or severity of treatment-related adverse events.

Study details: In phase 3, multicenter, double-blind, parallel-group study, 888 patients were randomly assigned to IV eptinezumab (30, 100, and 300 mg) or placebo administered every 12 weeks. 

Disclosures: The study was funded by H. Lundbeck A/S, Copenhagen, Denmark. Some of the authors were full-time employees of or contracted to Lundbeck Seattle BioPharmaceuticals, Inc. (previously known as Alder BioPharmaceuticals, Inc.), a subsidiary H. Lundbeck A/S. Some also were stockholders of Lundbeck Seattle BioPharmaceuticals, Inc.

Citation: Ashina M et al. Cephalalgia. 2020 Feb 19. doi: 10.1177/0333102420905132.

Key clinical point: Intravenous (IV) eptinezumab could be a safe and effective preventive therapy for adult patients with episodic migraine.

Main finding: Eptinezumab 100 and 300 mg significantly reduced monthly migraine days across weeks 1-12 compared with the placebo (difference from placebo for 100 and 300 mg: –0.69; P = .0182 and –1.11; P = .0001, respectively). Safety and tolerability of eptinezumab across doses were acceptable compared with placebo, with no dose-related trend in the nature, frequency, or severity of treatment-related adverse events.

Study details: In phase 3, multicenter, double-blind, parallel-group study, 888 patients were randomly assigned to IV eptinezumab (30, 100, and 300 mg) or placebo administered every 12 weeks. 

Disclosures: The study was funded by H. Lundbeck A/S, Copenhagen, Denmark. Some of the authors were full-time employees of or contracted to Lundbeck Seattle BioPharmaceuticals, Inc. (previously known as Alder BioPharmaceuticals, Inc.), a subsidiary H. Lundbeck A/S. Some also were stockholders of Lundbeck Seattle BioPharmaceuticals, Inc.

Citation: Ashina M et al. Cephalalgia. 2020 Feb 19. doi: 10.1177/0333102420905132.

Key clinical point: Intravenous (IV) eptinezumab could be a safe and effective preventive therapy for adult patients with episodic migraine.

Main finding: Eptinezumab 100 and 300 mg significantly reduced monthly migraine days across weeks 1-12 compared with the placebo (difference from placebo for 100 and 300 mg: –0.69; P = .0182 and –1.11; P = .0001, respectively). Safety and tolerability of eptinezumab across doses were acceptable compared with placebo, with no dose-related trend in the nature, frequency, or severity of treatment-related adverse events.

Study details: In phase 3, multicenter, double-blind, parallel-group study, 888 patients were randomly assigned to IV eptinezumab (30, 100, and 300 mg) or placebo administered every 12 weeks. 

Disclosures: The study was funded by H. Lundbeck A/S, Copenhagen, Denmark. Some of the authors were full-time employees of or contracted to Lundbeck Seattle BioPharmaceuticals, Inc. (previously known as Alder BioPharmaceuticals, Inc.), a subsidiary H. Lundbeck A/S. Some also were stockholders of Lundbeck Seattle BioPharmaceuticals, Inc.

Citation: Ashina M et al. Cephalalgia. 2020 Feb 19. doi: 10.1177/0333102420905132.

Key clinical point: Migraineurs with aura are more likely to show a higher anger response, but not impulsivity, compared with migraineurs without aura and healthy control individuals.

Main finding: Scores of anger symptoms were significantly higher migraineurs with aura than those without aura and control individuals (P less than .001); however, there was no significant difference in total Barratt impulsiveness scale-11 score, attentional impulsiveness, motor impulsiveness, and nonplanning impulsiveness between the 3 groups (P greater than .05).

Study details: The prospective cross-sectional study included 55 patients aged 18-55 years with episodic migraine (31 with aura and 24 without aura) and 40 healthy control individuals.

Disclosures: The authors declared no conflict of interest.

Citation: Tanik N et al. Neurol Res. 2020 Feb 5. doi: 10.1080/01616412.2020.1723974.

Key clinical point: Migraineurs with aura are more likely to show a higher anger response, but not impulsivity, compared with migraineurs without aura and healthy control individuals.

Main finding: Scores of anger symptoms were significantly higher migraineurs with aura than those without aura and control individuals (P less than .001); however, there was no significant difference in total Barratt impulsiveness scale-11 score, attentional impulsiveness, motor impulsiveness, and nonplanning impulsiveness between the 3 groups (P greater than .05).

Study details: The prospective cross-sectional study included 55 patients aged 18-55 years with episodic migraine (31 with aura and 24 without aura) and 40 healthy control individuals.

Disclosures: The authors declared no conflict of interest.

Citation: Tanik N et al. Neurol Res. 2020 Feb 5. doi: 10.1080/01616412.2020.1723974.

Key clinical point: Migraineurs with aura are more likely to show a higher anger response, but not impulsivity, compared with migraineurs without aura and healthy control individuals.

Main finding: Scores of anger symptoms were significantly higher migraineurs with aura than those without aura and control individuals (P less than .001); however, there was no significant difference in total Barratt impulsiveness scale-11 score, attentional impulsiveness, motor impulsiveness, and nonplanning impulsiveness between the 3 groups (P greater than .05).

Study details: The prospective cross-sectional study included 55 patients aged 18-55 years with episodic migraine (31 with aura and 24 without aura) and 40 healthy control individuals.

Disclosures: The authors declared no conflict of interest.

Citation: Tanik N et al. Neurol Res. 2020 Feb 5. doi: 10.1080/01616412.2020.1723974.

Key clinical point: Plasma glucose level increases during spontaneous migraine attacks, and the increase is independent of the presence of aura symptoms and pain intensity.

Main finding: Plasma glucose levels were higher in the ictal phase than in the interictal phase of migraine (mean, 98.83 vs. 88.63 mg/dL; P = .0014) after adjusting for diurnal variation. The attack-related elevation in plasma glucose level was not influenced by pain intensity or the presence of aura symptoms.

Study details: In this study, plasma glucose levels were measured during and outside of spontaneous attacks of migraine in 31 patients (13 with aura and 18 without aura).

Disclosures: The study was funded by the Lundbeck Foundation, the Novo Nordisk Foundation, the University of Copenhagen, the Research Foundation of the Capital Region of Denmark, and the Danish Council for Independent Research-Medical Sciences. Faisal Mohammad Amin and Anders Hougaard reported receiving personal fees and/or honoraria from multiple pharmaceutical companies. Messoud Ashina reported consultancy/advisory for multiple pharmaceutical companies. Other authors declared no disclosures. 

Citation: Zhang DG et al. Headache. 2020 Feb 7. doi: 10.1111/head.13760.

Key clinical point: Plasma glucose level increases during spontaneous migraine attacks, and the increase is independent of the presence of aura symptoms and pain intensity.

Main finding: Plasma glucose levels were higher in the ictal phase than in the interictal phase of migraine (mean, 98.83 vs. 88.63 mg/dL; P = .0014) after adjusting for diurnal variation. The attack-related elevation in plasma glucose level was not influenced by pain intensity or the presence of aura symptoms.

Study details: In this study, plasma glucose levels were measured during and outside of spontaneous attacks of migraine in 31 patients (13 with aura and 18 without aura).

Disclosures: The study was funded by the Lundbeck Foundation, the Novo Nordisk Foundation, the University of Copenhagen, the Research Foundation of the Capital Region of Denmark, and the Danish Council for Independent Research-Medical Sciences. Faisal Mohammad Amin and Anders Hougaard reported receiving personal fees and/or honoraria from multiple pharmaceutical companies. Messoud Ashina reported consultancy/advisory for multiple pharmaceutical companies. Other authors declared no disclosures. 

Citation: Zhang DG et al. Headache. 2020 Feb 7. doi: 10.1111/head.13760.

Key clinical point: Plasma glucose level increases during spontaneous migraine attacks, and the increase is independent of the presence of aura symptoms and pain intensity.

Main finding: Plasma glucose levels were higher in the ictal phase than in the interictal phase of migraine (mean, 98.83 vs. 88.63 mg/dL; P = .0014) after adjusting for diurnal variation. The attack-related elevation in plasma glucose level was not influenced by pain intensity or the presence of aura symptoms.

Study details: In this study, plasma glucose levels were measured during and outside of spontaneous attacks of migraine in 31 patients (13 with aura and 18 without aura).

Disclosures: The study was funded by the Lundbeck Foundation, the Novo Nordisk Foundation, the University of Copenhagen, the Research Foundation of the Capital Region of Denmark, and the Danish Council for Independent Research-Medical Sciences. Faisal Mohammad Amin and Anders Hougaard reported receiving personal fees and/or honoraria from multiple pharmaceutical companies. Messoud Ashina reported consultancy/advisory for multiple pharmaceutical companies. Other authors declared no disclosures. 

Citation: Zhang DG et al. Headache. 2020 Feb 7. doi: 10.1111/head.13760.

Key clinical point: Quarterly treatment with OnabotulinumtoxinA (BoNT-A) up to 4 years can provide long-lasting prevention of chronic migraine in real-life settings.

Main finding: From baseline to 48 months, there was a significant reduction in the mean number of monthly headache days and hours, consumption of analgesics, and latency time (P less than .001 for all). With repeated BoNT-A treatment, a progressive shift toward lower degrees of disability was seen at each subsequent timepoint (P less than .001 for trend). Six patients experienced transitory neck pain. 

Study details: The data come from a retrospective real-life study of patients with chronic migraine who received quarterly treatment with BoNT-A up to 16 cycles (n = 109).

Disclosures: The authors declared no conflict of interest.

Citation: Santoro A et al. Neurol Sci. 2020 Feb 12. doi: 10.1007/s10072-020-04283-y.

Key clinical point: Quarterly treatment with OnabotulinumtoxinA (BoNT-A) up to 4 years can provide long-lasting prevention of chronic migraine in real-life settings.

Main finding: From baseline to 48 months, there was a significant reduction in the mean number of monthly headache days and hours, consumption of analgesics, and latency time (P less than .001 for all). With repeated BoNT-A treatment, a progressive shift toward lower degrees of disability was seen at each subsequent timepoint (P less than .001 for trend). Six patients experienced transitory neck pain. 

Study details: The data come from a retrospective real-life study of patients with chronic migraine who received quarterly treatment with BoNT-A up to 16 cycles (n = 109).

Disclosures: The authors declared no conflict of interest.

Citation: Santoro A et al. Neurol Sci. 2020 Feb 12. doi: 10.1007/s10072-020-04283-y.

Key clinical point: Quarterly treatment with OnabotulinumtoxinA (BoNT-A) up to 4 years can provide long-lasting prevention of chronic migraine in real-life settings.

Main finding: From baseline to 48 months, there was a significant reduction in the mean number of monthly headache days and hours, consumption of analgesics, and latency time (P less than .001 for all). With repeated BoNT-A treatment, a progressive shift toward lower degrees of disability was seen at each subsequent timepoint (P less than .001 for trend). Six patients experienced transitory neck pain. 

Study details: The data come from a retrospective real-life study of patients with chronic migraine who received quarterly treatment with BoNT-A up to 16 cycles (n = 109).

Disclosures: The authors declared no conflict of interest.

Citation: Santoro A et al. Neurol Sci. 2020 Feb 12. doi: 10.1007/s10072-020-04283-y.