Real-life assessment of erenumab in refractory chronic migraine with medication overuse headache

2021 ◽  
Author(s):  
Umberto Pensato ◽  
Carlo Baraldi ◽  
Valentina Favoni ◽  
Maria Michela Cainazzo ◽  
Paola Torelli ◽  
...  
Keyword(s):  
Chronic Migraine ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Real Life ◽  
Life Assessment ◽  
Refractory Chronic Migraine

Real life experience of one year treatment with Galcanezumab in chronic migraine with and without medication overuse headache

2021 ◽  
Vol 429 ◽  
pp. 119292
Author(s):  
Gloria Vaghi ◽  
Vito Bitetto ◽  
Roberto De Icco ◽  
Elena Guaschino ◽  
Marta Allena ◽  
...  
Keyword(s):  
Chronic Migraine ◽  
Life Experience ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Real Life ◽  
One Year

HLA class I alleles are associated with clinic-based migraine and increased risks of chronic migraine and medication overuse

Cephalalgia ◽  
2020 ◽  
Vol 40 (5) ◽  
pp. 493-502
Author(s):  
Claire Huang ◽  
Shih-Pin Chen ◽  
Yu-Han Huang ◽  
Hsuan-Yu Chen ◽  
Yen-Feng Wang ◽  
...  
Keyword(s):  
Human Leukocyte Antigen ◽  
Chronic Migraine ◽  
Medication Overuse ◽  
Medical Center ◽  
Medication Overuse Headache ◽  
Human Leukocyte ◽  
Population Based ◽  
Class I ◽  
Leukocyte Antigen ◽  
Antigen B

Objective We aimed to evaluate associations of human leukocyte antigen variants with migraine or headache in hospital and population-based settings. Methods The case-control study population, aged 30–70, included 605 clinic-based migraine patients in a medical center and 8449 population-based participants in Taiwan Biobank (TWB). Clinic-based cases were ascertained by neurologists. Participants in Taiwan Biobank were interviewed by a structured questionnaire including headache and migraine history; among them, 2394 had headache or migraine history while 6055 were free of headache and served as controls. All subjects were genotyped by Axiom Genome-Wide Single Nucleotide Polymorphism Arrays and imputed for eight classical human leukocyte antigen genes. Human leukocyte antigen frequencies were compared between clinic-based and self-reported patients and controls. We utilized likelihood ratio tests to examine human leukocyte antigen-disease associations and logistic regressions to estimate the effect of human leukocyte antigen alleles on migraine. Results Human leukocyte antigen -B and C showed significant associations with clinic-based migraine ( q-value < 0.05). Human leukocyte antigen -B*39:01, human leukocyte antigen -B*51:01, human leukocyte antigen -B*58:01 and human leukocyte antigen -C*03:02 were significantly associated with migraine, with age and sex-adjusted odds ratios (95% CIs) of 1.80 (1.28–2.53), 1.50 (1.15–1.97), 1.36 (1.14–1.62) and 1.36 (1.14–1.62), correspondingly. Clinic-based migraineurs carrying human leukocyte antigen -B*58:01 or human leukocyte antigen -C*03:02 had 1.63 (1.11–2.39) -fold likelihood to have chronic migraine with medication-overuse headache compared to episodic migraine. However, no human leukocyte antigen genes were associated with self-reported headache or migraine in the community. Conclusions Human leukocyte antigen class I genetic variants are positively associated with risk of clinic-based migraine but not self-reported migraine or headache and may contribute to migraine chronification and medication overuse.

scholarly journals Increased cerebral responses to salient transitions between alternating stimuli in chronic migraine with medication overuse headache and during migraine attacks

Cephalalgia ◽  
2019 ◽  
Vol 39 (8) ◽  
pp. 988-999 ◽  
Author(s):  
Volodymyr B Bogdanov ◽  
Olena V Bogdanova ◽  
Alessandro Viganò ◽  
Quentin Noirhomme ◽  
Steven Laureys ◽  
...  
Keyword(s):  
Healthy Volunteers ◽  
Chronic Migraine ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Blood Oxygenation Level Dependent ◽  
Pain Modulation ◽  
Blood Oxygenation ◽  
Blood Oxygenation Level ◽  
Oxygenation Level ◽  
Headache Patients

Introduction In a previous study exploring central pain modulation with heterotopic stimuli in healthy volunteers, we found that transitions between sustained noxious and innocuous thermal stimulations on the foot activated the “salience matrix”. Knowing that central sensory processing is abnormal in migraine, we searched in the present study for possible abnormalities of these salient transitional responses in different forms of migraine and at different time points of the migraine cycle. Methods Participants of both sexes, mostly females, took part in a conditioned pain modulation experiment: Migraineurs between (n = 14) and during attacks (n = 5), chronic migraine patients with medication overuse headache (n = 7) and healthy volunteers (n = 24). To evoke the salience response, continuous noxious cold or innocuous warm stimulations were alternatively applied on the right foot. Cerebral blood oxygenation level dependent responses were recorded with fMRI. Results Switching between the two stimulations caused a significant transition response in the “salience matrix” in all subject groups (effect of the condition). Moreover, some group effects appeared on subsequent post-hoc analyses. Augmented transitional blood oxygenation level dependent responses in the motor cortex and superior temporal sulcus were found in two patient groups compared to healthy controls: chronic migraine with medication overuse headache patients and migraineurs recorded during an attack. In chronic migraine with medication overuse headache patients, salience-related responses were moreover greater in the premotor cortex, supplementary motor area, lingual gyrus and dorso-medial prefrontal cortex and other “salience matrix” areas, such as the anterior cingulate and primary somatosensory cortices. Conclusion This study shows salience-related hyperactivation of affective and motor control areas in chronic migraine with medication overuse headache patients and, to a lesser extent, in episodic migraine patients during an attack. The greater extension of exaggerated blood oxygenation level dependent responses to unspecific salient stimuli in chronic migraine with medication overuse headache than during a migraine attack could be relevant for headache chronification.

Involvement of Corticotrophin-Releasing Factor and Orexin-A in Chronic Migraine and Medication-Overuse Headache: Findings From Cerebrospinal Fluid

Cephalalgia ◽  
2008 ◽  
Vol 28 (7) ◽  
pp. 714-722 ◽  
Author(s):  
P Sarchielli ◽  
I Rainero ◽  
F Coppola ◽  
C Rossi ◽  
ML Mancini ◽  
...  
Keyword(s):  
Chronic Migraine ◽  
Potential Role ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Orexin A ◽  
Compensatory Response ◽  
Corticotrophin Releasing Factor ◽  
Response To Stress ◽  
The Brain

The study set out to investigate the role of corticotrophin-releasing factor (CRF) and orexin-A in chronic migraine (CM) and medication-overuse headache (MOH). Twenty-seven patients affected by CM and 30 with MOH were enrolled. Control CSF specimens were obtained from 20 age-matched subjects who underwent lumbar puncture for diagnostic purposes, and in all of them CSF and blood tests excluded central nervous system or systemic diseases. Orexin-A and CRF were determined by radioimmunoassay methods. Significantly higher levels of orexin-A and CRF were found in the CSF of MOH and to a lesser extent in patients with CM compared with control subjects (orexin-A: P < 0.001 and P < 0.02; CRF: P < 0.002 and P < 0.0003). A significant positive correlation was also found between CSF orexin-A values and those of CRF ( R = 0.71; P < 0.0008), monthly drug intake group ( R = 0.39; P < 0.03) and scores of a self-completion 10-item instrument to measure dependence upon a variety of substances, the Leeds Dependence Questionnaire (LDQ) in the MOH group ( R = 0.68; P < 0.0003). The significantly higher orexin-A levels found in CM and MOH can be interpreted as a compensatory response to chronic head pain or, alternatively, as an expression of hypothalamic response to stress due to chronic pain. A potential role for orexin-A in driving drug seeking in MOH patients through activation of stress pathways in the brain can also be hypothesized.

scholarly journals P.033 Eptinezumab reduced acute medication use in patients with chronic migraine and medication-overuse headache: subgroup analysis of Promise-2

2021 ◽  
Vol 48 (s3) ◽  
pp. S29-S29
Author(s):  
MJ Marmura ◽  
H Diener ◽  
J Hirman ◽  
R Cady ◽  
T Brevig ◽  
...  
Keyword(s):  
Chronic Migraine ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Baseline Period ◽  
Migraine Treatment ◽  
Medication History ◽  
Medication Class ◽  
The Us ◽  
Acute Headache ◽  
The Impact

Background: Eptinezumab is a preventive migraine treatment approved in the US. We evaluated the impact of eptinezumab on acute headache medication (AHM) use in patients diagnosed with chronic migraine (CM) and medication-overuse headache (MOH) in PROMISE-2. Methods: PROMISE-2 randomized patients with CM to eptinezumab 100mg, 300mg, or placebo for 2 intravenous doses administered every 12 weeks. Trained investigators diagnosed MOH at screening using 3-month medication history and ICHD-3b criteria. Endpoints included days/month of any AHM use (days of ≥1 medication class), total AHM use (summed days for each medication class), and triptan use over Weeks 1-12 and 13-24. AHM classes included triptan, ergot, opioid, simple analgesic, and combination analgesic. Results: Of 1072 PROMISE-2 patients, 431 (40.2%) were diagnosed with MOH (100mg, n=139; 300mg, n=147; placebo, n=145). During the 28-day baseline period, mean days of any AHM was ~16.4, total AHM was ~20.4, and triptan was ~8.9 across treatment arms. Over Weeks 1-12, mean days/month of any AHM was 8.8 (100mg), 9.9 (300mg), and 11.8 (placebo); total AHM was 10.8, 12.2, and 14.8; triptan was 4.3, 4.4, and 6.4. Similar or lower rates were observed over Weeks 13-24. Conclusions: In patients diagnosed with both CM and MOH, eptinezumab treatment reduced AHM use.

scholarly journals Initial experience with novel CGRP-receptor inhibitor therapy in Migraine in the United Arab Emirates: a retrospective observational study

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bui Bao Khanh Dinh ◽  
Waseem Hamed Aziz ◽  
Alessandro Terruzzi ◽  
Derk Wolfgang Krieger
Keyword(s):  
Observational Study ◽  
Odds Ratio ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Real Life ◽  
Retrospective Observational Study ◽  
Lower Probability ◽  
P Value ◽  
Cgrp Receptor ◽  
Number Of Patients

Abstract Background Erenumab is a calcitonin gene-related peptide (CGRP)-receptor antibody inhibiting CGRP function. CGRP is prominently involved in the pathophysiology of migraine through nociceptive modulation in the trigeminovascular system. This study aims to explore the treatment effect of erenumab in a real-life setting. Methods In this retrospective observational study, we analyzed the data of 91 patients with migraine receiving at least three consecutive monthly injections of erenumab and followed up for 3–12 months. The primary objective was to describe the reduction in monthly migraine days throughout the follow-up period. To identify patients who responded to treatment, we analyzed the association between different patient characteristics and their treatment outcomes. Results Seventy-three patients (80.2%) responded to erenumab treatment, defined as ≥50% reduction of migraine days per month, across all migraine types. It was noted that ethnicity (p-value = 0.015) and older age (p-value = 0.035) were associated with clinically relevant improvement of symptoms. Middle Eastern ethnicity was related to less improvement of symptoms while Europeans were more likely to benefit from erenumab therapy (odds ratio: 12.788, p = 0.037). Patients aged from 31 to 40 and 41–65 years benefited most from erenumab treatment with a response rate of 77.8 and 89.9%, respectively, also confirmed by logistic regression (p = 0.047). Neither gender nor dose increase of erenumab showed association with the reported clinically relevant improvement of the symptoms. An association between clinically relevant improvement of headaches and the type of migraine was also noted. Around 87.9% of patients with episodic migraine responded to treatment, followed by 84.1% of chronic migraine patients and 50% of medication overuse headache patients. Medication overuse headache showed a lower probability of therapy success with erenumab (odds ratio: 0.126, p = 0.039). An improvement of headaches was eminent in patients who received 140 mg erenumab monthly (2 × 70 mg injections) and patients who had one injection every two weeks. Conclusions Erenumab is a novel preventive treatment for all migraine types. Clinically relevant improvement of headaches and reduction of monthly migraine days were demonstrated in patients that continued the treatment course. In real-life, a substantial number of patients suspended therapy early, reasons for which need further investigation.

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