Chronic Migraine Treatment Tied to Nickel Allergy

Background The Phase 3 REsearch Evaluating Migraine Prophylaxis Therapy (PREEMPT) trials demonstrated efficacy/tolerability of onabotulinumtoxinA for headache prevention in adults with chronic migraine. This post hoc analysis assessed time of onset of onabotulinumtoxinA after the first treatment in total and responder populations and consistency weekly through five treatment cycles. Methods In the 24-week, double-blind, placebo-controlled phase of PREEMPT, individuals were randomized 1:1 to onabotulinumtoxinA (155-195 U) or placebo every 12 weeks for two cycles. The primary pooled efficacy variable was change in headache days per 28 days at week 24. We assessed change in headache and migraine/probable migraine (hereafter migraine) days/week compared with baseline week 4. Results Baseline mean (SD) headache days/week (week 4 of baseline) for onabotulinumtoxinA (n = 688) and placebo (n = 696) were similar (4.8 [1.6] vs. 4.8 [1.6] days/week, respectively), as were migraine days/week (4.6 [1.7] vs. 4.6 [1.7] days/week). The effect of onabotulinumtoxinA on change in headache and migraine days/week was significantly greater than placebo at week 1, persisting from week 3 after the first treatment (−1.6 [2.2] vs. −1.1 [2.2] headache days/week [ p < 0.001] and −1.6 [2.2] vs. −1.1 [2.2] migraine days/week [ p < 0.001]). Headache and migraine days decreased in onabotulinumtoxinA responders beginning 1 week after treatment 1. Conclusions Treatment with onabotulinumtoxinA is associated with significant reductions in headache and migraine days/week at week 1, persisting after week 3, compared with placebo. Combined with earlier reports showing onabotulinumtoxinA treatment results in a persistent and progressive reduction in headache days over 56 weeks, it is suggested peak benefit may require multiple treatments. Trial registration number ClinicalTrials.gov: NCT00156910 and NCT00168428.

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Early and sustained effect of onabotulinumtoxinA for chronic migraine treatment: Analysis of preempt data

Toxicon ◽

10.1016/j.toxicon.2018.11.060 ◽

2018 ◽

Vol 156 ◽

pp. S23-S24

Author(s):

David W. Dodick ◽

Stephen D. Silberstein ◽

Richard B. Lipton ◽

Ronald E. DeGryse ◽

Aubrey Manack Adams ◽

...

Keyword(s):

Chronic Migraine ◽

Migraine Treatment ◽

Sustained Effect ◽

Treatment Analysis

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Cognitive behavioral therapy for chronic migraine

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.626 ◽

2017 ◽

Vol 41 (S1) ◽

pp. s500-s500 ◽

Cited By ~ 1

Author(s):

O. Onur ◽

D.H. Ertem ◽

D. Uludüz ◽

Ç. Karşıdağ

Keyword(s):

Chronic Migraine ◽

Psychological Treatment ◽

Treatment Options ◽

Depression Scale ◽

Migraine Treatment ◽

Hamilton Depression Scale ◽

Post Traumatic Stress ◽

Current Standard ◽

Significant Difference ◽

Hamilton Anxiety

AimAlthough current standard treatment for migraine headache is medication, high levels of psychological comorbidity has led to migraine influencing by cognitive, emotional and environmental factors, as well as biological. Viewing migraine in a biopsychosocial framework introduces the possible utilisation of psychological treatment options, such as cognitive behavioural therapy (CBT). The aim of this study was to evaluate the efficacy of CBT for chronic migraine.MethodologyThirty-five participants diagnosed as chronic migraine were recruited from Headache Clinic. According to inclusion criteria 14 participants, underwent bi-weekly lasting 30 minutes CBT sessions for 6 months, were administered Hamilton Anxiety Scale, Hamilton Depression Scale, Visual Analog Scale (VAS) and the Migraine Disability Assessment Scale (MİDAS) before and after CBT.FindingsNine of the participants were female and 5 male. Mean age of group was 34.35 ± 8.17. Duration of illness was 13.07 ± 7.18 and 12 of participants had the history of a psychiatry illness whose diagnoses were depression (7), anxiety disorder (4) and post-traumatic stress disorder (1). Nine of the patients had prophylactic migraine treatment. There were statistically significant difference in Hamilton Depression scores between before CBT (29.07 ± 7.74) and after CBT (14.21 ± 7.7); in Hamilton Anxiety scores before CBT (26.8 ± 11.7) and after CBT (11.7 ± 2.6); in VAS scores before CBT (8.07± 0.91) and after CBT (3.71 ± 1.32); in frequency of migraine attacks between before CBT (10.85 ± 3.50 day) and after CBT (4.92 ± 2.70 day) and in MİDAS before CBT (55.5 ± 20.4) and after CBT (20.12 ± 16.6) (P < 0.05).ConclusionCBT might reduce the severity of symptoms in migraine patients especially with the comorbidity of psychiatric illness.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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EHMTI-0026. Neuroprolotherapy and acupuncture for clinical trial of acute and chronic migraine treatment

The Journal of Headache and Pain ◽

10.1186/1129-2377-15-s1-g34 ◽

2014 ◽

Vol 15 (S1) ◽

Author(s):

R Schulman

Keyword(s):

Clinical Trial ◽

Chronic Migraine ◽

Migraine Treatment

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

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/cjn.2021.315 ◽

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.

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First Confirmed Case of Nonimmediate Hypersensitivity to Fremanezumab during Chronic Migraine Treatment

Contact Dermatitis ◽

10.1111/cod.14018 ◽

2021 ◽

Author(s):

Moya Beatriz ◽

Barranco Ruth ◽

García‐Moguel Ismael ◽

Puerta‐Peña Mario ◽

Alonso Lucía ◽

...

Keyword(s):

Chronic Migraine ◽

Migraine Treatment

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Progress in the Treatment of Migraine Attacks: From Traditional Approaches to Eptinezumab

Pharmaceuticals ◽

10.3390/ph14090924 ◽

2021 ◽

Vol 14 (9) ◽

pp. 924

Author(s):

Damiana Scuteri ◽

Giacinto Bagetta

Keyword(s):

Chronic Migraine ◽

Specific Treatment ◽

Episodic Migraine ◽

Migraine Treatment ◽

Acute Migraine ◽

Bothersome Symptom ◽

Post Marketing ◽

Marketing Data ◽

Artery Disease ◽

Traditional Approaches

Migraine is the second cause of disability and of lost years of healthy life worldwide. Migraine is characterized by recurrent headache attacks and accompanying disabling symptoms lasting 4–48 h. In episodic migraine, attacks occur in less than 15 days per month and in chronic migraine, in more than 15 monthly days. Whilst successful translation of pharmacological discoveries into efficacious therapeutics has been achieved in the preventative therapy of chronic migraine, treatment of acute migraine suffers the lack of effective advancements. An effective treatment affords complete freedom from pain two hours after therapy and provides the absence of the most bothersome symptom (MBS) associated with migraine after 2 h. However, available anti-migraine abortive treatments for acute attacks do not represent an effective and safe treatment for all the populations treated. In particular, the most used specific treatment is represented by triptans that offer 2-h sustained freedom from pain achieved in 18–50% of patients but they are contraindicated in coronary artery disease, stroke and peripheral vascular disease due to the vasoconstriction at the basis of their pharmacologic action. The most novel therapies, i.e., gepants and ditans, are without sufficient post-marketing data for secure use. Here, an attempt is proposed to analyse the rational basis and evidence in favour of investigating the efficacy and safety in acute migraine attacks of eptinezumab, i.e., monoclonal antibody (mAb) directed towards calcitonin gene-related peptide (CGRP) unique for intravenous infusion administration.

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Chronic Migraine

Migraine ◽

10.5772/intechopen.93314 ◽

2020 ◽

Author(s):

Diana Obelieniene ◽

Ruta Pestininkaite ◽

Daiva Rastenyte

Keyword(s):

Valproic Acid ◽

Chronic Migraine ◽

Migraine Headache ◽

Treatment Options ◽

Migraine Treatment ◽

Evidence Based ◽

New Developments ◽

Onabotulinumtoxin A ◽

History Of ◽

Over Time

Chronic migraine as a disease was initially recognized in patients with a large burden of disability from frequent headaches and a history of prior migraines. Over time, this observation was operationalized into multiple diagnostic criteria with requirements for frequent headache days, typically 15 or more, which, on at least 8 days in a month, have the features of migraine headache. Chronic migraine affects 1–2% of the general population, and about 8% of patients with migraine. Understanding disease mechanisms still remains a challenge. Inflammation and central sensitization play significant role in the evolutive mechanisms of chronic migraine. Treatment of this condition should primarily focus on the prevention. The currently available evidence-based prophylactic treatment options are topiramate, valproic acid, onabotulinumtoxin A and recently developed promising anti-CGRP monoclonal antibodies. Chronic migraine research is a dynamic and rapidly advancing area. New developments in this field have the potential to improve the diagnosis, to provide more personalized treatments and to reduce burden of disability.

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