Article

Key clinical point: Early initiation of a single glucocorticoid injection with 1-year methotrexate treatment in patients with arthralgia at risk for rheumatoid arthritis (RA) did not prevent clinical arthritis but improved overall disease burden.

Major finding: At 2 years, the risk of developing clinical arthritis persisting for ≥2 weeks was similar (hazard ratio 0.81; 95% CI 0.45-1.48). However, methotrexate vs placebo showed sustained decrease in magnetic resonance imaging-detected joint inflammation (mean difference [MD] −1.4 points; P < .0001) and improvement in physical functioning (MD −0.09; P  =  .0042), pain (MD −8; P < .0001) and morning stiffness of joints (MD −12; P < .0001). No new adverse events were reported.

Study details: Findings are from TREAT-EARLIER, a randomized controlled proof-of-concept trial, including 236 patients with arthralgia clinically predisposed to RA who were randomly assigned to receive single glucocorticoid injection+methotrexate or placebo for 1 year.

Disclosures: This study was funded by the Dutch Research Council, supported by the Dutch Arthritis Society. The authors declared no conflicts of interest.

Source: Krijbolder DI et al. Intervention with methotrexate in patients with arthralgia at risk of rheumatoid arthritis to reduce the development of persistent arthritis and its disease burden (TREAT EARLIER): A randomised, double-blind, placebo-controlled, proof-of-concept trial. Lancet. 2022;400(10348):283-294 (Jul 23). Doi: 10.1016/S0140-6736(22)01193-X

Key clinical point: Early initiation of a single glucocorticoid injection with 1-year methotrexate treatment in patients with arthralgia at risk for rheumatoid arthritis (RA) did not prevent clinical arthritis but improved overall disease burden.

Major finding: At 2 years, the risk of developing clinical arthritis persisting for ≥2 weeks was similar (hazard ratio 0.81; 95% CI 0.45-1.48). However, methotrexate vs placebo showed sustained decrease in magnetic resonance imaging-detected joint inflammation (mean difference [MD] −1.4 points; P < .0001) and improvement in physical functioning (MD −0.09; P  =  .0042), pain (MD −8; P < .0001) and morning stiffness of joints (MD −12; P < .0001). No new adverse events were reported.

Study details: Findings are from TREAT-EARLIER, a randomized controlled proof-of-concept trial, including 236 patients with arthralgia clinically predisposed to RA who were randomly assigned to receive single glucocorticoid injection+methotrexate or placebo for 1 year.

Disclosures: This study was funded by the Dutch Research Council, supported by the Dutch Arthritis Society. The authors declared no conflicts of interest.

Source: Krijbolder DI et al. Intervention with methotrexate in patients with arthralgia at risk of rheumatoid arthritis to reduce the development of persistent arthritis and its disease burden (TREAT EARLIER): A randomised, double-blind, placebo-controlled, proof-of-concept trial. Lancet. 2022;400(10348):283-294 (Jul 23). Doi: 10.1016/S0140-6736(22)01193-X

Key clinical point: Early initiation of a single glucocorticoid injection with 1-year methotrexate treatment in patients with arthralgia at risk for rheumatoid arthritis (RA) did not prevent clinical arthritis but improved overall disease burden.

Major finding: At 2 years, the risk of developing clinical arthritis persisting for ≥2 weeks was similar (hazard ratio 0.81; 95% CI 0.45-1.48). However, methotrexate vs placebo showed sustained decrease in magnetic resonance imaging-detected joint inflammation (mean difference [MD] −1.4 points; P < .0001) and improvement in physical functioning (MD −0.09; P  =  .0042), pain (MD −8; P < .0001) and morning stiffness of joints (MD −12; P < .0001). No new adverse events were reported.

Study details: Findings are from TREAT-EARLIER, a randomized controlled proof-of-concept trial, including 236 patients with arthralgia clinically predisposed to RA who were randomly assigned to receive single glucocorticoid injection+methotrexate or placebo for 1 year.

Disclosures: This study was funded by the Dutch Research Council, supported by the Dutch Arthritis Society. The authors declared no conflicts of interest.

Source: Krijbolder DI et al. Intervention with methotrexate in patients with arthralgia at risk of rheumatoid arthritis to reduce the development of persistent arthritis and its disease burden (TREAT EARLIER): A randomised, double-blind, placebo-controlled, proof-of-concept trial. Lancet. 2022;400(10348):283-294 (Jul 23). Doi: 10.1016/S0140-6736(22)01193-X

Key clinical point: Monoclonal antibodies inhibiting calcitonin gene-related peptide (CGRP) effectively reduced monthly headache days, symptomatic drug consumption, and headache severity consistently over 12 months in patients with chronic migraine complicated by medication overuse headache (MOH).

Major finding: Overall, 80% of patients showed both ≥50% reduction in monthly headache days and ≥50% reduction in analgesics intake at the 3-month follow-up visit and 78.8% continued to show the improvements at the 6-month follow-up visit. The mean Migraine Impact and Disability Assessment Scale score decreased from 56.5 (range 27-63) at baseline to 13.1 (range 11-37) at 9 months, with 71% of patients being responders even at 1 year.

Study details: The data come from a prospective study of 303 patients with chronic migraine complicated by MOH who received CGRP antagonists for at least 6 months up to 1 year.

Disclosures: No source of funding was declared. The authors declared no competing interests.

Source: Curone M et al. Overview on effectiveness of erenumab, fremanezumab, and galcanezumab in reducing medication overuse headache in chronic migraine patients. Neurol Sci. 2022 (Jul 14). Doi: 10.1007/s10072-022-06265-8

Key clinical point: Monoclonal antibodies inhibiting calcitonin gene-related peptide (CGRP) effectively reduced monthly headache days, symptomatic drug consumption, and headache severity consistently over 12 months in patients with chronic migraine complicated by medication overuse headache (MOH).

Major finding: Overall, 80% of patients showed both ≥50% reduction in monthly headache days and ≥50% reduction in analgesics intake at the 3-month follow-up visit and 78.8% continued to show the improvements at the 6-month follow-up visit. The mean Migraine Impact and Disability Assessment Scale score decreased from 56.5 (range 27-63) at baseline to 13.1 (range 11-37) at 9 months, with 71% of patients being responders even at 1 year.

Study details: The data come from a prospective study of 303 patients with chronic migraine complicated by MOH who received CGRP antagonists for at least 6 months up to 1 year.

Disclosures: No source of funding was declared. The authors declared no competing interests.

Source: Curone M et al. Overview on effectiveness of erenumab, fremanezumab, and galcanezumab in reducing medication overuse headache in chronic migraine patients. Neurol Sci. 2022 (Jul 14). Doi: 10.1007/s10072-022-06265-8

Key clinical point: Monoclonal antibodies inhibiting calcitonin gene-related peptide (CGRP) effectively reduced monthly headache days, symptomatic drug consumption, and headache severity consistently over 12 months in patients with chronic migraine complicated by medication overuse headache (MOH).

Major finding: Overall, 80% of patients showed both ≥50% reduction in monthly headache days and ≥50% reduction in analgesics intake at the 3-month follow-up visit and 78.8% continued to show the improvements at the 6-month follow-up visit. The mean Migraine Impact and Disability Assessment Scale score decreased from 56.5 (range 27-63) at baseline to 13.1 (range 11-37) at 9 months, with 71% of patients being responders even at 1 year.

Study details: The data come from a prospective study of 303 patients with chronic migraine complicated by MOH who received CGRP antagonists for at least 6 months up to 1 year.

Disclosures: No source of funding was declared. The authors declared no competing interests.

Source: Curone M et al. Overview on effectiveness of erenumab, fremanezumab, and galcanezumab in reducing medication overuse headache in chronic migraine patients. Neurol Sci. 2022 (Jul 14). Doi: 10.1007/s10072-022-06265-8

Key clinical point: The occurrence of unclear days, defined as headache-free but not crystal-clear days, is prevalent in migraine, with the number of crystal-clear days being significantly lower and unclear days being significantly higher in participants with migraine vs non-migraine headache.

Major finding: Overall, 97.1% of participants had unclear days, with the number of crystal-clear days per 30 days being significantly lower (median, 20.0 vs 25.0) and the number of severe headache days (2.0 vs 1.0), days with acute medications (2.0 vs 1.0), and unclear days (4.0 vs 1.0) per 30 days being significantly higher in participants with vs without migraine headache (all P < .001).

Study details: The data come from a cross-sectional and case-control analysis of longitudinally collected data from 170 and 1768 participants with migraine and nonmigraine headaches, respectively.

Disclosures: This study was funded by the National Research Foundation of Korea. S-J Cho and MK Chu declared being site investigators of a multicenter trial or an advisory board members or receiving lecture honoraria or grants from various sources.

Source: Lee W et al. Crystal-clear days and unclear days in migraine: A population-based study. Headache. 2022;62: 818- 827 (Jul 14). Doi: 10.1111/head.14359

Key clinical point: The occurrence of unclear days, defined as headache-free but not crystal-clear days, is prevalent in migraine, with the number of crystal-clear days being significantly lower and unclear days being significantly higher in participants with migraine vs non-migraine headache.

Major finding: Overall, 97.1% of participants had unclear days, with the number of crystal-clear days per 30 days being significantly lower (median, 20.0 vs 25.0) and the number of severe headache days (2.0 vs 1.0), days with acute medications (2.0 vs 1.0), and unclear days (4.0 vs 1.0) per 30 days being significantly higher in participants with vs without migraine headache (all P < .001).

Study details: The data come from a cross-sectional and case-control analysis of longitudinally collected data from 170 and 1768 participants with migraine and nonmigraine headaches, respectively.

Disclosures: This study was funded by the National Research Foundation of Korea. S-J Cho and MK Chu declared being site investigators of a multicenter trial or an advisory board members or receiving lecture honoraria or grants from various sources.

Source: Lee W et al. Crystal-clear days and unclear days in migraine: A population-based study. Headache. 2022;62: 818- 827 (Jul 14). Doi: 10.1111/head.14359

Key clinical point: The occurrence of unclear days, defined as headache-free but not crystal-clear days, is prevalent in migraine, with the number of crystal-clear days being significantly lower and unclear days being significantly higher in participants with migraine vs non-migraine headache.

Major finding: Overall, 97.1% of participants had unclear days, with the number of crystal-clear days per 30 days being significantly lower (median, 20.0 vs 25.0) and the number of severe headache days (2.0 vs 1.0), days with acute medications (2.0 vs 1.0), and unclear days (4.0 vs 1.0) per 30 days being significantly higher in participants with vs without migraine headache (all P < .001).

Study details: The data come from a cross-sectional and case-control analysis of longitudinally collected data from 170 and 1768 participants with migraine and nonmigraine headaches, respectively.

Disclosures: This study was funded by the National Research Foundation of Korea. S-J Cho and MK Chu declared being site investigators of a multicenter trial or an advisory board members or receiving lecture honoraria or grants from various sources.

Source: Lee W et al. Crystal-clear days and unclear days in migraine: A population-based study. Headache. 2022;62: 818- 827 (Jul 14). Doi: 10.1111/head.14359

Key clinical point: Erenumab was effective and generally well tolerated over the 3 months of follow-up in a real-world population of patients with difficult-to-treat chronic migraine.

Major finding: At 3 months follow-up, the median total and severe monthly migraine days reduced significantly from 28 to 20 and from 15 to 5, respectively (both P < .0001), with 39.8%, 22.3%, and 7.8% of patients achieving at least 30%, 50%, and 75% reductions in mean monthly headache days, respectively. Overall, 43% of patients reported ≥1 adverse event, with constipation being the most common adverse event.

Study details: The data come from a prospective clinical audit of a treatment-resistant population of 103 patients with chronic migraine, high prevalence of medication overuse, and high headache burden who received 140 mg erenumab monthly for 3 months.

Disclosures: This study did not receive any funding. Some authors declared serving on advisory boards or as principal investigators for clinical trials or receiving speaker honoraria, conference sponsorship, or grants from various sources.

Source: Lowe M et al. Efficacy of erenumab and factors predicting response after 3 months in treatment resistant chronic migraine: A clinical service evaluation. J Headache Pain. 2022;23:86 (Jul 22). Doi: 10.1186/s10194-022-01456-2

Key clinical point: Erenumab was effective and generally well tolerated over the 3 months of follow-up in a real-world population of patients with difficult-to-treat chronic migraine.

Major finding: At 3 months follow-up, the median total and severe monthly migraine days reduced significantly from 28 to 20 and from 15 to 5, respectively (both P < .0001), with 39.8%, 22.3%, and 7.8% of patients achieving at least 30%, 50%, and 75% reductions in mean monthly headache days, respectively. Overall, 43% of patients reported ≥1 adverse event, with constipation being the most common adverse event.

Study details: The data come from a prospective clinical audit of a treatment-resistant population of 103 patients with chronic migraine, high prevalence of medication overuse, and high headache burden who received 140 mg erenumab monthly for 3 months.

Disclosures: This study did not receive any funding. Some authors declared serving on advisory boards or as principal investigators for clinical trials or receiving speaker honoraria, conference sponsorship, or grants from various sources.

Source: Lowe M et al. Efficacy of erenumab and factors predicting response after 3 months in treatment resistant chronic migraine: A clinical service evaluation. J Headache Pain. 2022;23:86 (Jul 22). Doi: 10.1186/s10194-022-01456-2

Key clinical point: Erenumab was effective and generally well tolerated over the 3 months of follow-up in a real-world population of patients with difficult-to-treat chronic migraine.

Major finding: At 3 months follow-up, the median total and severe monthly migraine days reduced significantly from 28 to 20 and from 15 to 5, respectively (both P < .0001), with 39.8%, 22.3%, and 7.8% of patients achieving at least 30%, 50%, and 75% reductions in mean monthly headache days, respectively. Overall, 43% of patients reported ≥1 adverse event, with constipation being the most common adverse event.

Study details: The data come from a prospective clinical audit of a treatment-resistant population of 103 patients with chronic migraine, high prevalence of medication overuse, and high headache burden who received 140 mg erenumab monthly for 3 months.

Disclosures: This study did not receive any funding. Some authors declared serving on advisory boards or as principal investigators for clinical trials or receiving speaker honoraria, conference sponsorship, or grants from various sources.

Source: Lowe M et al. Efficacy of erenumab and factors predicting response after 3 months in treatment resistant chronic migraine: A clinical service evaluation. J Headache Pain. 2022;23:86 (Jul 22). Doi: 10.1186/s10194-022-01456-2

Key clinical point: Meta-analysis demonstrated lower general cognitive and language functions in patients with migraine, along with a significant association between migraine and risk for all-cause dementia.

Major finding: General cognitive (standard mean difference [SMD] −0.40; 95% CI −0.66 to −0.15) and language (SMD −0.14; 95% CI −0.27 to −0.00) functions were lower in the group of participants with vs without migraine, and no significant between-group differences were observed for visuospatial, attention, executive, and memory functions. Moreover, migraine was significantly associated with the risk for dementia (odds ratio/relative risk 1.30; 95% CI 1.11-1.52).

Study details: Findings are from a meta-analysis of 22 studies (including 3295 patients with migraine) that assessed cognitive function and 11 studies (including 12,871 patients with dementia, 56,365 participants without dementia, 47,942 patients with migraine, and 190,024 healthy controls) that assessed the association between migraine and risk for dementia.

Disclosures: This study was supported by the National Natural Science Foundation of China. The authors declared no conflicts of interest.

Source: Gu L et al. Association between migraine and cognitive impairment. J Headache Pain. 2022;23:88 (Jul 26). Doi: 10.1186/s10194-022-01462-4

Key clinical point: Meta-analysis demonstrated lower general cognitive and language functions in patients with migraine, along with a significant association between migraine and risk for all-cause dementia.

Major finding: General cognitive (standard mean difference [SMD] −0.40; 95% CI −0.66 to −0.15) and language (SMD −0.14; 95% CI −0.27 to −0.00) functions were lower in the group of participants with vs without migraine, and no significant between-group differences were observed for visuospatial, attention, executive, and memory functions. Moreover, migraine was significantly associated with the risk for dementia (odds ratio/relative risk 1.30; 95% CI 1.11-1.52).

Study details: Findings are from a meta-analysis of 22 studies (including 3295 patients with migraine) that assessed cognitive function and 11 studies (including 12,871 patients with dementia, 56,365 participants without dementia, 47,942 patients with migraine, and 190,024 healthy controls) that assessed the association between migraine and risk for dementia.

Disclosures: This study was supported by the National Natural Science Foundation of China. The authors declared no conflicts of interest.

Source: Gu L et al. Association between migraine and cognitive impairment. J Headache Pain. 2022;23:88 (Jul 26). Doi: 10.1186/s10194-022-01462-4

Key clinical point: Meta-analysis demonstrated lower general cognitive and language functions in patients with migraine, along with a significant association between migraine and risk for all-cause dementia.

Major finding: General cognitive (standard mean difference [SMD] −0.40; 95% CI −0.66 to −0.15) and language (SMD −0.14; 95% CI −0.27 to −0.00) functions were lower in the group of participants with vs without migraine, and no significant between-group differences were observed for visuospatial, attention, executive, and memory functions. Moreover, migraine was significantly associated with the risk for dementia (odds ratio/relative risk 1.30; 95% CI 1.11-1.52).

Study details: Findings are from a meta-analysis of 22 studies (including 3295 patients with migraine) that assessed cognitive function and 11 studies (including 12,871 patients with dementia, 56,365 participants without dementia, 47,942 patients with migraine, and 190,024 healthy controls) that assessed the association between migraine and risk for dementia.

Disclosures: This study was supported by the National Natural Science Foundation of China. The authors declared no conflicts of interest.

Source: Gu L et al. Association between migraine and cognitive impairment. J Headache Pain. 2022;23:88 (Jul 26). Doi: 10.1186/s10194-022-01462-4

Key clinical point: Increased dietary niacin intake may have a beneficial effect on migraine outcomes in adults with inadequate niacin consumption and the effect seems to peak in patients with adequate niacin intake, with the threshold level being approximately 21.0 mg/day.

Major finding: The risk for migraine was lower among adults in the higher (18.4-26.2 mg/day: odds ratio [OR] 0.78; P  =  .004, and ≥26.3 mg/day: OR 0.74; P  =  .006) vs lower (≤12.3 mg/day) quartile of daily niacin intake, with the risk of developing migraine reducing by 2.5% with every 1 mg increase in daily dietary niacin consumption (OR 0.975; P  =  .011) in those with dietary niacin intake of <21 mg/day, but no such association was observed in those with dietary niacin intake of ≥21 mg/day.

Study details: This was a cross-sectional study including 10,246 participants aged ≥20 years, of whom 20.1% experienced migraine.

Disclosures: This study was supported by the National Natural Science Foundation of China. The authors declared no conflicts of interest.

Source: Liu H et al. Association between dietary niacin intake and migraine among american adults: National Health and Nutrition Examination Survey. Nutrients. 2022;14(15):3052 (Jul 25). Doi: 10.3390/nu14153052

Key clinical point: Increased dietary niacin intake may have a beneficial effect on migraine outcomes in adults with inadequate niacin consumption and the effect seems to peak in patients with adequate niacin intake, with the threshold level being approximately 21.0 mg/day.

Major finding: The risk for migraine was lower among adults in the higher (18.4-26.2 mg/day: odds ratio [OR] 0.78; P  =  .004, and ≥26.3 mg/day: OR 0.74; P  =  .006) vs lower (≤12.3 mg/day) quartile of daily niacin intake, with the risk of developing migraine reducing by 2.5% with every 1 mg increase in daily dietary niacin consumption (OR 0.975; P  =  .011) in those with dietary niacin intake of <21 mg/day, but no such association was observed in those with dietary niacin intake of ≥21 mg/day.

Study details: This was a cross-sectional study including 10,246 participants aged ≥20 years, of whom 20.1% experienced migraine.

Disclosures: This study was supported by the National Natural Science Foundation of China. The authors declared no conflicts of interest.

Source: Liu H et al. Association between dietary niacin intake and migraine among american adults: National Health and Nutrition Examination Survey. Nutrients. 2022;14(15):3052 (Jul 25). Doi: 10.3390/nu14153052

Key clinical point: Increased dietary niacin intake may have a beneficial effect on migraine outcomes in adults with inadequate niacin consumption and the effect seems to peak in patients with adequate niacin intake, with the threshold level being approximately 21.0 mg/day.

Major finding: The risk for migraine was lower among adults in the higher (18.4-26.2 mg/day: odds ratio [OR] 0.78; P  =  .004, and ≥26.3 mg/day: OR 0.74; P  =  .006) vs lower (≤12.3 mg/day) quartile of daily niacin intake, with the risk of developing migraine reducing by 2.5% with every 1 mg increase in daily dietary niacin consumption (OR 0.975; P  =  .011) in those with dietary niacin intake of <21 mg/day, but no such association was observed in those with dietary niacin intake of ≥21 mg/day.

Study details: This was a cross-sectional study including 10,246 participants aged ≥20 years, of whom 20.1% experienced migraine.

Disclosures: This study was supported by the National Natural Science Foundation of China. The authors declared no conflicts of interest.

Source: Liu H et al. Association between dietary niacin intake and migraine among american adults: National Health and Nutrition Examination Survey. Nutrients. 2022;14(15):3052 (Jul 25). Doi: 10.3390/nu14153052

Key clinical point: Soy isoflavones significantly reduced the frequency and duration of migraine attacks, clinical indices, and calcitonin gene-related peptide (CGRP) levels and improved the quality of life in women with migraine.

Major finding: At 8 weeks, soy isoflavones vs placebo significantly reduced migraine frequency (mean change [MC] −2.36 vs −0.43; P < .001) and duration of attacks (MC −2.50 vs −0.02; P < .001), Migraine Headache Index score (MC −10.46 vs −1.47; P < .001), and CGRP levels (MC −12.18 vs −8.62 ng/L; P  =  .002) and significantly improved migraine-specific quality-of-life score (MC 16.76 vs 2.52; P < .001). No adverse effects were reported.

Study details: Findings are from a phase 3 trial including 88 adult women with migraine who had not reached menopausal/perimenopausal age and were randomly assigned to receive 50 mg/day soy isoflavones or placebo supplementation for 8 weeks.

Disclosures: This study was supported by Isfahan University of Medical Sciences, Iran. The authors declared no conflicts of interest.

Source: Babapour M et al. Effect of soy isoflavones supplementation on migraine characteristics, mental status and calcitonin gene-related peptide (CGRP) levels in women with migraine: results of randomised controlled trial. Nutr J. 2022;21:50 (Jul 30). Doi: 10.1186/s12937-022-00802-z

Key clinical point: Soy isoflavones significantly reduced the frequency and duration of migraine attacks, clinical indices, and calcitonin gene-related peptide (CGRP) levels and improved the quality of life in women with migraine.

Major finding: At 8 weeks, soy isoflavones vs placebo significantly reduced migraine frequency (mean change [MC] −2.36 vs −0.43; P < .001) and duration of attacks (MC −2.50 vs −0.02; P < .001), Migraine Headache Index score (MC −10.46 vs −1.47; P < .001), and CGRP levels (MC −12.18 vs −8.62 ng/L; P  =  .002) and significantly improved migraine-specific quality-of-life score (MC 16.76 vs 2.52; P < .001). No adverse effects were reported.

Study details: Findings are from a phase 3 trial including 88 adult women with migraine who had not reached menopausal/perimenopausal age and were randomly assigned to receive 50 mg/day soy isoflavones or placebo supplementation for 8 weeks.

Disclosures: This study was supported by Isfahan University of Medical Sciences, Iran. The authors declared no conflicts of interest.

Source: Babapour M et al. Effect of soy isoflavones supplementation on migraine characteristics, mental status and calcitonin gene-related peptide (CGRP) levels in women with migraine: results of randomised controlled trial. Nutr J. 2022;21:50 (Jul 30). Doi: 10.1186/s12937-022-00802-z

Key clinical point: Soy isoflavones significantly reduced the frequency and duration of migraine attacks, clinical indices, and calcitonin gene-related peptide (CGRP) levels and improved the quality of life in women with migraine.

Major finding: At 8 weeks, soy isoflavones vs placebo significantly reduced migraine frequency (mean change [MC] −2.36 vs −0.43; P < .001) and duration of attacks (MC −2.50 vs −0.02; P < .001), Migraine Headache Index score (MC −10.46 vs −1.47; P < .001), and CGRP levels (MC −12.18 vs −8.62 ng/L; P  =  .002) and significantly improved migraine-specific quality-of-life score (MC 16.76 vs 2.52; P < .001). No adverse effects were reported.

Study details: Findings are from a phase 3 trial including 88 adult women with migraine who had not reached menopausal/perimenopausal age and were randomly assigned to receive 50 mg/day soy isoflavones or placebo supplementation for 8 weeks.

Disclosures: This study was supported by Isfahan University of Medical Sciences, Iran. The authors declared no conflicts of interest.

Source: Babapour M et al. Effect of soy isoflavones supplementation on migraine characteristics, mental status and calcitonin gene-related peptide (CGRP) levels in women with migraine: results of randomised controlled trial. Nutr J. 2022;21:50 (Jul 30). Doi: 10.1186/s12937-022-00802-z

Key clinical point: Patients with diabetes who were screened for diabetic retinopathy (DR) had a lower risk of having migraine; however, DR was not a protective marker of incident migraine.

Major finding: The prevalence of migraine was 17% lower in patients with vs without diabetes (odds ratio [OR] 0.83; 95% CI 0.81-0.85), with the risk being lower in patients with vs without DR (OR 0.69; 95% CI 0.65-0.72). The risk of developing migraine was significantly lower in patients with diabetes and DR level ranging between 1 and 4 compared with matched individuals without diabetes (hazard ratio [HR] 0.66; 95% CI 0.55-0.80), but the risk was independent of the presence of DR.

Study details: The data come from a cross-sectional study including patients with diabetes who attended DR screening (n = 205,970) and age- and sex-matched patients without diabetes (n = 1,003,170).

Disclosures: This study was funded by the The Velux Foundation, Denmark. The authors declared no competing interests.

Source: Vergmann AS et al. Investigation of the correlation between diabetic retinopathy and prevalent and incident migraine in a national cohort study. Sci Rep. 2022;12:12443 (Jul 20). Doi: 10.1038/s41598-022-16793-0

Key clinical point: Patients with diabetes who were screened for diabetic retinopathy (DR) had a lower risk of having migraine; however, DR was not a protective marker of incident migraine.

Major finding: The prevalence of migraine was 17% lower in patients with vs without diabetes (odds ratio [OR] 0.83; 95% CI 0.81-0.85), with the risk being lower in patients with vs without DR (OR 0.69; 95% CI 0.65-0.72). The risk of developing migraine was significantly lower in patients with diabetes and DR level ranging between 1 and 4 compared with matched individuals without diabetes (hazard ratio [HR] 0.66; 95% CI 0.55-0.80), but the risk was independent of the presence of DR.

Study details: The data come from a cross-sectional study including patients with diabetes who attended DR screening (n = 205,970) and age- and sex-matched patients without diabetes (n = 1,003,170).

Disclosures: This study was funded by the The Velux Foundation, Denmark. The authors declared no competing interests.

Source: Vergmann AS et al. Investigation of the correlation between diabetic retinopathy and prevalent and incident migraine in a national cohort study. Sci Rep. 2022;12:12443 (Jul 20). Doi: 10.1038/s41598-022-16793-0

Key clinical point: Patients with diabetes who were screened for diabetic retinopathy (DR) had a lower risk of having migraine; however, DR was not a protective marker of incident migraine.

Major finding: The prevalence of migraine was 17% lower in patients with vs without diabetes (odds ratio [OR] 0.83; 95% CI 0.81-0.85), with the risk being lower in patients with vs without DR (OR 0.69; 95% CI 0.65-0.72). The risk of developing migraine was significantly lower in patients with diabetes and DR level ranging between 1 and 4 compared with matched individuals without diabetes (hazard ratio [HR] 0.66; 95% CI 0.55-0.80), but the risk was independent of the presence of DR.

Study details: The data come from a cross-sectional study including patients with diabetes who attended DR screening (n = 205,970) and age- and sex-matched patients without diabetes (n = 1,003,170).

Disclosures: This study was funded by the The Velux Foundation, Denmark. The authors declared no competing interests.

Source: Vergmann AS et al. Investigation of the correlation between diabetic retinopathy and prevalent and incident migraine in a national cohort study. Sci Rep. 2022;12:12443 (Jul 20). Doi: 10.1038/s41598-022-16793-0

Key clinical point: Bariatric surgery significantly reduced the frequency of migraine attacks, headache severity, and improved the quality of life and disability in patients with chronic migraine and severe obesity.

Major finding: After a mean period of 7.5 ± 2.3 months, there was a significant reduction in the number of migraine attacks (20.9 to 8.3 days; P < .001), headache severity score (7.7 to 4.8; P < .001), Migraine-Specific Quality-of-Life score (44.6 to 26.8; P < .001), and Migraine Disability Assessment Scale score (64.4 to 25.5; P < .001) in patients with chronic migraine who underwent bariatric surgery.

Study details: Findings are from a prospective study including 60 patients with chronic migraine and severe obesity who were referred for bariatric surgery.

Disclosures: This study was supported by Isfahan University of Medical Sciences, Iran, and others. The authors declared no conflicts of interest.

Source: Etefagh HH et al. Bariatric surgery in migraine patients: CGRP level and weight loss. Obes Surg. 2022 (Aug 3). Doi: 10.1007/s11695-022-06218-2

Key clinical point: Bariatric surgery significantly reduced the frequency of migraine attacks, headache severity, and improved the quality of life and disability in patients with chronic migraine and severe obesity.

Major finding: After a mean period of 7.5 ± 2.3 months, there was a significant reduction in the number of migraine attacks (20.9 to 8.3 days; P < .001), headache severity score (7.7 to 4.8; P < .001), Migraine-Specific Quality-of-Life score (44.6 to 26.8; P < .001), and Migraine Disability Assessment Scale score (64.4 to 25.5; P < .001) in patients with chronic migraine who underwent bariatric surgery.

Study details: Findings are from a prospective study including 60 patients with chronic migraine and severe obesity who were referred for bariatric surgery.

Disclosures: This study was supported by Isfahan University of Medical Sciences, Iran, and others. The authors declared no conflicts of interest.

Source: Etefagh HH et al. Bariatric surgery in migraine patients: CGRP level and weight loss. Obes Surg. 2022 (Aug 3). Doi: 10.1007/s11695-022-06218-2

Key clinical point: Bariatric surgery significantly reduced the frequency of migraine attacks, headache severity, and improved the quality of life and disability in patients with chronic migraine and severe obesity.

Major finding: After a mean period of 7.5 ± 2.3 months, there was a significant reduction in the number of migraine attacks (20.9 to 8.3 days; P < .001), headache severity score (7.7 to 4.8; P < .001), Migraine-Specific Quality-of-Life score (44.6 to 26.8; P < .001), and Migraine Disability Assessment Scale score (64.4 to 25.5; P < .001) in patients with chronic migraine who underwent bariatric surgery.

Study details: Findings are from a prospective study including 60 patients with chronic migraine and severe obesity who were referred for bariatric surgery.

Disclosures: This study was supported by Isfahan University of Medical Sciences, Iran, and others. The authors declared no conflicts of interest.

Source: Etefagh HH et al. Bariatric surgery in migraine patients: CGRP level and weight loss. Obes Surg. 2022 (Aug 3). Doi: 10.1007/s11695-022-06218-2

Key clinical point: Once-monthly 120 mg galcanezumab was more effective than placebo in reducing total pain burden (TPB) in patients with chronic or episodic migraine who previously did not benefit from 2-4 categories of migraine preventive medication.

Major finding: At 3 months, galcanezumab vs placebo led to a significantly higher overall percentage change in TPB in patients with chronic (mean difference [MD] −40.4%; P < .001) or episodic (MD −53.1%; P < .001) migraine and significant reductions in monthly number, duration, and severity of migraine headache days in the overall population (all P < .001).

Study details: Findings are from a post hoc analysis of a phase 3 trial, CONQUER, including 458 patients with chronic or episodic migraine who previously did not benefit from 2-4 categories of migraine preventive medication and were randomly assigned to receive galcanezumab or placebo.

Disclosures: This study was sponsored by Eli Lilly and Company. Four authors declared being current or former employees or stockholders of Eli Lilly. J Ailani reported ties with various sources, including Eli Lilly and Company.

Source: Ailani J et al. Effect of galcanezumab on total pain burden in patients who had previously not benefited from migraine preventive medication (CONQUER Trial): A post hoc analysis. Adv Ther. 2022 (Aug 5). Doi: 10.1007/s12325-022-02233-y

Key clinical point: Once-monthly 120 mg galcanezumab was more effective than placebo in reducing total pain burden (TPB) in patients with chronic or episodic migraine who previously did not benefit from 2-4 categories of migraine preventive medication.

Major finding: At 3 months, galcanezumab vs placebo led to a significantly higher overall percentage change in TPB in patients with chronic (mean difference [MD] −40.4%; P < .001) or episodic (MD −53.1%; P < .001) migraine and significant reductions in monthly number, duration, and severity of migraine headache days in the overall population (all P < .001).

Study details: Findings are from a post hoc analysis of a phase 3 trial, CONQUER, including 458 patients with chronic or episodic migraine who previously did not benefit from 2-4 categories of migraine preventive medication and were randomly assigned to receive galcanezumab or placebo.

Disclosures: This study was sponsored by Eli Lilly and Company. Four authors declared being current or former employees or stockholders of Eli Lilly. J Ailani reported ties with various sources, including Eli Lilly and Company.

Source: Ailani J et al. Effect of galcanezumab on total pain burden in patients who had previously not benefited from migraine preventive medication (CONQUER Trial): A post hoc analysis. Adv Ther. 2022 (Aug 5). Doi: 10.1007/s12325-022-02233-y

Key clinical point: Once-monthly 120 mg galcanezumab was more effective than placebo in reducing total pain burden (TPB) in patients with chronic or episodic migraine who previously did not benefit from 2-4 categories of migraine preventive medication.

Major finding: At 3 months, galcanezumab vs placebo led to a significantly higher overall percentage change in TPB in patients with chronic (mean difference [MD] −40.4%; P < .001) or episodic (MD −53.1%; P < .001) migraine and significant reductions in monthly number, duration, and severity of migraine headache days in the overall population (all P < .001).

Study details: Findings are from a post hoc analysis of a phase 3 trial, CONQUER, including 458 patients with chronic or episodic migraine who previously did not benefit from 2-4 categories of migraine preventive medication and were randomly assigned to receive galcanezumab or placebo.

Disclosures: This study was sponsored by Eli Lilly and Company. Four authors declared being current or former employees or stockholders of Eli Lilly. J Ailani reported ties with various sources, including Eli Lilly and Company.

Source: Ailani J et al. Effect of galcanezumab on total pain burden in patients who had previously not benefited from migraine preventive medication (CONQUER Trial): A post hoc analysis. Adv Ther. 2022 (Aug 5). Doi: 10.1007/s12325-022-02233-y