Histological categories do not help in predicting treatment response in eosinophilic esophagitis

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Key clinical point: Budesonide orodispersible tablet (BOT) induces clinicohistological remission irrespective of the distribution of esophageal eosinophilia. Histological categories are not predictors of treatment response in patients with eosinophilic esophagitis (EoE).

Major finding: Histological categories were not found to be significantly associated with treatment outcome (mid: adjusted odds ratio [aOR] 1.75; 95% CI 0.588-5.25; distal: aOR 1.42; 95% CI 0.535-3.60; diffuse: aOR 0.910; 95% CI 0.358-2.19).

Study details: This post hoc analysis of the phase 3 EOS-1 and EOS-2 trials included 263 patients with EoE having either proximal, mid, or distal esophagus predominant disease or diffuse disease who received a 6-week induction treatment with BOT.

Disclosures: This study was supported by the Swiss National Science Foundation and others. Some authors declared serving as consultants for or receiving speaker or consulting fees or travel grants from various sources.

Source: Godat A et al on behalf of the EoE eosinophil distribution research group. Eosinophil distribution in eosinophilic esophagitis and its impact on disease activity and response to treatment. Clin Gastroenterol Hepatol. 2023 (Dec 15). doi: 10.1016/j.cgh.2023.12.003

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Key clinical point: Budesonide orodispersible tablet (BOT) induces clinicohistological remission irrespective of the distribution of esophageal eosinophilia. Histological categories are not predictors of treatment response in patients with eosinophilic esophagitis (EoE).

Major finding: Histological categories were not found to be significantly associated with treatment outcome (mid: adjusted odds ratio [aOR] 1.75; 95% CI 0.588-5.25; distal: aOR 1.42; 95% CI 0.535-3.60; diffuse: aOR 0.910; 95% CI 0.358-2.19).

Study details: This post hoc analysis of the phase 3 EOS-1 and EOS-2 trials included 263 patients with EoE having either proximal, mid, or distal esophagus predominant disease or diffuse disease who received a 6-week induction treatment with BOT.

Disclosures: This study was supported by the Swiss National Science Foundation and others. Some authors declared serving as consultants for or receiving speaker or consulting fees or travel grants from various sources.

Source: Godat A et al on behalf of the EoE eosinophil distribution research group. Eosinophil distribution in eosinophilic esophagitis and its impact on disease activity and response to treatment. Clin Gastroenterol Hepatol. 2023 (Dec 15). doi: 10.1016/j.cgh.2023.12.003

Key clinical point: Budesonide orodispersible tablet (BOT) induces clinicohistological remission irrespective of the distribution of esophageal eosinophilia. Histological categories are not predictors of treatment response in patients with eosinophilic esophagitis (EoE).

Major finding: Histological categories were not found to be significantly associated with treatment outcome (mid: adjusted odds ratio [aOR] 1.75; 95% CI 0.588-5.25; distal: aOR 1.42; 95% CI 0.535-3.60; diffuse: aOR 0.910; 95% CI 0.358-2.19).

Study details: This post hoc analysis of the phase 3 EOS-1 and EOS-2 trials included 263 patients with EoE having either proximal, mid, or distal esophagus predominant disease or diffuse disease who received a 6-week induction treatment with BOT.

Disclosures: This study was supported by the Swiss National Science Foundation and others. Some authors declared serving as consultants for or receiving speaker or consulting fees or travel grants from various sources.

Source: Godat A et al on behalf of the EoE eosinophil distribution research group. Eosinophil distribution in eosinophilic esophagitis and its impact on disease activity and response to treatment. Clin Gastroenterol Hepatol. 2023 (Dec 15). doi: 10.1016/j.cgh.2023.12.003

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Eosinophil-derived neurotoxin can help diagnose eosinophilic esophagitis in exclusive distal eosinophilia

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Key clinical point: The levels of eosinophil-derived neurotoxin (EDN) may be used to track disease activity in patients with eosinophilic esophagitis (EoE) patients and may aid the diagnosis of EoE in patients with challenging conditions, such as distal eosinophilia.

Major finding: The average endoscopic reference score (EREFS; 3.4 vs 0.4; P < .001) and EDN concentrations (135.8 µg/mL vs 3.2 µg/mL; P < .001) were significantly higher in patients with active EoE vs control individuals. In patients with exclusive distant eosinophilia, positive (≥10 µg/mL) vs negative EDN concentrations correlated with significantly higher EREFS (3.33 vs 1.35, P < .001), which indicated a diagnosis of EoE.

Study details: Findings are from a retrospective study that included children and young adults who underwent routine endoscopy with biopsy and EDN esophageal epithelial brushings, of whom 140 had EoE and 91 were control individuals without EoE.

Disclosures: This study did not receive any external funding. The authors declared no conflicts of interest.

Source: Thomas J et al. Addressing diagnostic dilemmas in eosinophilic esophagitis using esophageal epithelial eosinophil-derived neurotoxin. J Pediatr Gastroenterol Nutr. 2023 (Dec 27). doi: 10.1002/jpn3.12054

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Key clinical point: The levels of eosinophil-derived neurotoxin (EDN) may be used to track disease activity in patients with eosinophilic esophagitis (EoE) patients and may aid the diagnosis of EoE in patients with challenging conditions, such as distal eosinophilia.

Major finding: The average endoscopic reference score (EREFS; 3.4 vs 0.4; P < .001) and EDN concentrations (135.8 µg/mL vs 3.2 µg/mL; P < .001) were significantly higher in patients with active EoE vs control individuals. In patients with exclusive distant eosinophilia, positive (≥10 µg/mL) vs negative EDN concentrations correlated with significantly higher EREFS (3.33 vs 1.35, P < .001), which indicated a diagnosis of EoE.

Study details: Findings are from a retrospective study that included children and young adults who underwent routine endoscopy with biopsy and EDN esophageal epithelial brushings, of whom 140 had EoE and 91 were control individuals without EoE.

Disclosures: This study did not receive any external funding. The authors declared no conflicts of interest.

Source: Thomas J et al. Addressing diagnostic dilemmas in eosinophilic esophagitis using esophageal epithelial eosinophil-derived neurotoxin. J Pediatr Gastroenterol Nutr. 2023 (Dec 27). doi: 10.1002/jpn3.12054

Key clinical point: The levels of eosinophil-derived neurotoxin (EDN) may be used to track disease activity in patients with eosinophilic esophagitis (EoE) patients and may aid the diagnosis of EoE in patients with challenging conditions, such as distal eosinophilia.

Major finding: The average endoscopic reference score (EREFS; 3.4 vs 0.4; P < .001) and EDN concentrations (135.8 µg/mL vs 3.2 µg/mL; P < .001) were significantly higher in patients with active EoE vs control individuals. In patients with exclusive distant eosinophilia, positive (≥10 µg/mL) vs negative EDN concentrations correlated with significantly higher EREFS (3.33 vs 1.35, P < .001), which indicated a diagnosis of EoE.

Study details: Findings are from a retrospective study that included children and young adults who underwent routine endoscopy with biopsy and EDN esophageal epithelial brushings, of whom 140 had EoE and 91 were control individuals without EoE.

Disclosures: This study did not receive any external funding. The authors declared no conflicts of interest.

Source: Thomas J et al. Addressing diagnostic dilemmas in eosinophilic esophagitis using esophageal epithelial eosinophil-derived neurotoxin. J Pediatr Gastroenterol Nutr. 2023 (Dec 27). doi: 10.1002/jpn3.12054

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Eosinophil levels may predict concomitant non-EoE diseases in patients with EoE

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Key clinical point: Patients with eosinophilic esophagitis (EoE) may also present with non-EoE eosinophilic gastrointestinal diseases (EGID) with esophageal involvement (EI; EGID + EI) if they have high levels of peripheral blood eosinophils.

Major finding: Patients with EGID + EI vs EoE were more likely to have eczema (P = .003), food allergy (P < .001), abdominal pain (60.9% vs 45.0%; P = .002), and higher peripheral blood eosinophil levels (0.44 × 103/µL vs 0.38 × 103/µL; P = .027).

Study details: Findings are from an observational cohort study including 592 patients with isolated EoE and 190 patients with EGID + EI.

Disclosures: This study was supported by a grant from the US National Institutes of Health. ME Rothenberg and corresponding author T Shoda declared serving as a consultant or being inventors or co-inventors of patents.

Source: Sato H et al. Eosinophil involvement outside the esophagus in eosinophilic esophagitis. Clin Gastroenterol Hepatol. 2023 (Dec 14). doi: 10.1016/j.cgh.2023.12.004

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Key clinical point: Patients with eosinophilic esophagitis (EoE) may also present with non-EoE eosinophilic gastrointestinal diseases (EGID) with esophageal involvement (EI; EGID + EI) if they have high levels of peripheral blood eosinophils.

Major finding: Patients with EGID + EI vs EoE were more likely to have eczema (P = .003), food allergy (P < .001), abdominal pain (60.9% vs 45.0%; P = .002), and higher peripheral blood eosinophil levels (0.44 × 103/µL vs 0.38 × 103/µL; P = .027).

Study details: Findings are from an observational cohort study including 592 patients with isolated EoE and 190 patients with EGID + EI.

Disclosures: This study was supported by a grant from the US National Institutes of Health. ME Rothenberg and corresponding author T Shoda declared serving as a consultant or being inventors or co-inventors of patents.

Source: Sato H et al. Eosinophil involvement outside the esophagus in eosinophilic esophagitis. Clin Gastroenterol Hepatol. 2023 (Dec 14). doi: 10.1016/j.cgh.2023.12.004

Key clinical point: Patients with eosinophilic esophagitis (EoE) may also present with non-EoE eosinophilic gastrointestinal diseases (EGID) with esophageal involvement (EI; EGID + EI) if they have high levels of peripheral blood eosinophils.

Major finding: Patients with EGID + EI vs EoE were more likely to have eczema (P = .003), food allergy (P < .001), abdominal pain (60.9% vs 45.0%; P = .002), and higher peripheral blood eosinophil levels (0.44 × 103/µL vs 0.38 × 103/µL; P = .027).

Study details: Findings are from an observational cohort study including 592 patients with isolated EoE and 190 patients with EGID + EI.

Disclosures: This study was supported by a grant from the US National Institutes of Health. ME Rothenberg and corresponding author T Shoda declared serving as a consultant or being inventors or co-inventors of patents.

Source: Sato H et al. Eosinophil involvement outside the esophagus in eosinophilic esophagitis. Clin Gastroenterol Hepatol. 2023 (Dec 14). doi: 10.1016/j.cgh.2023.12.004

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Real-world comparison of treatment pattern of CGRP antibodies in migraine

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Key clinical point: Patients with migraine initiating calcitonin gene-related peptide (CGRP) monoclonal antibody treatment with galcanezumab showed higher treatment persistence, lower treatment discontinuation, and similar adherence compared with those initiating fremanezumab or erenumab.

Major finding: Compared with fremanezumab, galcanezumab initiators showed higher rates of treatment persistence (P = .001) and lower treatment discontinuation (P = .005). Compared with erenumab, galcanezumab initiators had lower treatment discontinuation (P = .040). Patient adherence was similar among those who initiated galcanezumab vs fremanezumab or erenumab.

 

Study details: This retrospective real-world study included patients with migraine initiating galcanezumab treatment who were matched with those initiating fremanezumab (n = 2674) or erenumab (n = 3503) treatment using propensity score matching.

Disclosures: This study was funded by Eli Lilly and Company. The authors declared no conflicts of interest.

Source: Varnado OJ et al. Comparison of treatment patterns in patients with migraine initiating calcitonin gene-related peptide monoclonal antibodies: A Retrospective Real-World US Study. Patient Preference and Adherence. 2024;18:69-88 (Jan 9). doi: 10.2147/PPA.S437396

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Key clinical point: Patients with migraine initiating calcitonin gene-related peptide (CGRP) monoclonal antibody treatment with galcanezumab showed higher treatment persistence, lower treatment discontinuation, and similar adherence compared with those initiating fremanezumab or erenumab.

Major finding: Compared with fremanezumab, galcanezumab initiators showed higher rates of treatment persistence (P = .001) and lower treatment discontinuation (P = .005). Compared with erenumab, galcanezumab initiators had lower treatment discontinuation (P = .040). Patient adherence was similar among those who initiated galcanezumab vs fremanezumab or erenumab.

 

Study details: This retrospective real-world study included patients with migraine initiating galcanezumab treatment who were matched with those initiating fremanezumab (n = 2674) or erenumab (n = 3503) treatment using propensity score matching.

Disclosures: This study was funded by Eli Lilly and Company. The authors declared no conflicts of interest.

Source: Varnado OJ et al. Comparison of treatment patterns in patients with migraine initiating calcitonin gene-related peptide monoclonal antibodies: A Retrospective Real-World US Study. Patient Preference and Adherence. 2024;18:69-88 (Jan 9). doi: 10.2147/PPA.S437396

Key clinical point: Patients with migraine initiating calcitonin gene-related peptide (CGRP) monoclonal antibody treatment with galcanezumab showed higher treatment persistence, lower treatment discontinuation, and similar adherence compared with those initiating fremanezumab or erenumab.

Major finding: Compared with fremanezumab, galcanezumab initiators showed higher rates of treatment persistence (P = .001) and lower treatment discontinuation (P = .005). Compared with erenumab, galcanezumab initiators had lower treatment discontinuation (P = .040). Patient adherence was similar among those who initiated galcanezumab vs fremanezumab or erenumab.

 

Study details: This retrospective real-world study included patients with migraine initiating galcanezumab treatment who were matched with those initiating fremanezumab (n = 2674) or erenumab (n = 3503) treatment using propensity score matching.

Disclosures: This study was funded by Eli Lilly and Company. The authors declared no conflicts of interest.

Source: Varnado OJ et al. Comparison of treatment patterns in patients with migraine initiating calcitonin gene-related peptide monoclonal antibodies: A Retrospective Real-World US Study. Patient Preference and Adherence. 2024;18:69-88 (Jan 9). doi: 10.2147/PPA.S437396

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Higher delayed discounting rate among patients with episodic migraine without aura

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Key clinical point: Patients with episodic migraine without aura (EMoA) presented a higher delayed discounting rate, which was positively associated with the migraine history.

Major finding: Patients with EMoA vs control individuals showed a significantly higher subjective discount rate (F = 4.74; P = .032), which was positively correlated with migraine history (r = 0.742; P < .001). The resting-state functional connectivity between the left ventral striatum and middle occipital gyrus was significantly associated with migraine history (r′ = 0.294; P = .036) and subjective discount rate (r′ = 0.380; P = .006).

 

Study details: This study included 51 patients with EMoA and 45 control individuals who underwent task-based and multi-model magnetic resonance imaging.

Disclosures: This study was supported by the National Natural Science Foundation of China, Foundation for the Cultivation of Doctoral Research Talents, and the 2021 Youth Foundation Training Program of the First Affiliated Hospital of Anhui Medical University. The authors declared no conflicts of interest.

Source: Wang L et al. Patients with episodic migraine without aura have an increased rate of delayed discounting. Brain Behav. 2024;14(1):e3367 (Jan 2). doi: 10.1002/brb3.3367

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Key clinical point: Patients with episodic migraine without aura (EMoA) presented a higher delayed discounting rate, which was positively associated with the migraine history.

Major finding: Patients with EMoA vs control individuals showed a significantly higher subjective discount rate (F = 4.74; P = .032), which was positively correlated with migraine history (r = 0.742; P < .001). The resting-state functional connectivity between the left ventral striatum and middle occipital gyrus was significantly associated with migraine history (r′ = 0.294; P = .036) and subjective discount rate (r′ = 0.380; P = .006).

 

Study details: This study included 51 patients with EMoA and 45 control individuals who underwent task-based and multi-model magnetic resonance imaging.

Disclosures: This study was supported by the National Natural Science Foundation of China, Foundation for the Cultivation of Doctoral Research Talents, and the 2021 Youth Foundation Training Program of the First Affiliated Hospital of Anhui Medical University. The authors declared no conflicts of interest.

Source: Wang L et al. Patients with episodic migraine without aura have an increased rate of delayed discounting. Brain Behav. 2024;14(1):e3367 (Jan 2). doi: 10.1002/brb3.3367

Key clinical point: Patients with episodic migraine without aura (EMoA) presented a higher delayed discounting rate, which was positively associated with the migraine history.

Major finding: Patients with EMoA vs control individuals showed a significantly higher subjective discount rate (F = 4.74; P = .032), which was positively correlated with migraine history (r = 0.742; P < .001). The resting-state functional connectivity between the left ventral striatum and middle occipital gyrus was significantly associated with migraine history (r′ = 0.294; P = .036) and subjective discount rate (r′ = 0.380; P = .006).

 

Study details: This study included 51 patients with EMoA and 45 control individuals who underwent task-based and multi-model magnetic resonance imaging.

Disclosures: This study was supported by the National Natural Science Foundation of China, Foundation for the Cultivation of Doctoral Research Talents, and the 2021 Youth Foundation Training Program of the First Affiliated Hospital of Anhui Medical University. The authors declared no conflicts of interest.

Source: Wang L et al. Patients with episodic migraine without aura have an increased rate of delayed discounting. Brain Behav. 2024;14(1):e3367 (Jan 2). doi: 10.1002/brb3.3367

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Patients with migraine face an elevated risk for Parkinson's disease

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Key clinical point: Patients with migraine have increased risk for incident Parkinson's disease (PD), with younger age and underlying dyslipidemia aggravating the risk for PD among women and men with migraine, respectively.

Major finding: The risk of incident PD was 1.35-fold (adjusted hazard ratio 1.35; 95% CI 1.29-1.41) higher in patients with vs without migraine, with the risk of PD being significantly higher among younger vs older women (age < 65 years vs ≥ 65 years; P = .038) and men with vs without dyslipidemia (P = .012).

 

Study details: This retrospective, nationwide, population-based cohort study included 214,193 individuals with migraine and 5,879,711 individuals without migraine, of whom 1973 (0.92%) and 30,664 (0.52%) individuals with and without migraine, respectively, were diagnosed with PD.

Disclosures: This research was supported by a grant from the National Research Foundation, Technology Development Program, and Technology Innovation Program. Korea. The authors declared no conflicts of interest.

Source: Ha WS et al. The association between migraine and Parkinson's disease: A nationwide cohort study. Epidemiol Health. 2023 (Dec 18). doi: 10.4178/epih.e2024010

 

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Key clinical point: Patients with migraine have increased risk for incident Parkinson's disease (PD), with younger age and underlying dyslipidemia aggravating the risk for PD among women and men with migraine, respectively.

Major finding: The risk of incident PD was 1.35-fold (adjusted hazard ratio 1.35; 95% CI 1.29-1.41) higher in patients with vs without migraine, with the risk of PD being significantly higher among younger vs older women (age < 65 years vs ≥ 65 years; P = .038) and men with vs without dyslipidemia (P = .012).

 

Study details: This retrospective, nationwide, population-based cohort study included 214,193 individuals with migraine and 5,879,711 individuals without migraine, of whom 1973 (0.92%) and 30,664 (0.52%) individuals with and without migraine, respectively, were diagnosed with PD.

Disclosures: This research was supported by a grant from the National Research Foundation, Technology Development Program, and Technology Innovation Program. Korea. The authors declared no conflicts of interest.

Source: Ha WS et al. The association between migraine and Parkinson's disease: A nationwide cohort study. Epidemiol Health. 2023 (Dec 18). doi: 10.4178/epih.e2024010

 

Key clinical point: Patients with migraine have increased risk for incident Parkinson's disease (PD), with younger age and underlying dyslipidemia aggravating the risk for PD among women and men with migraine, respectively.

Major finding: The risk of incident PD was 1.35-fold (adjusted hazard ratio 1.35; 95% CI 1.29-1.41) higher in patients with vs without migraine, with the risk of PD being significantly higher among younger vs older women (age < 65 years vs ≥ 65 years; P = .038) and men with vs without dyslipidemia (P = .012).

 

Study details: This retrospective, nationwide, population-based cohort study included 214,193 individuals with migraine and 5,879,711 individuals without migraine, of whom 1973 (0.92%) and 30,664 (0.52%) individuals with and without migraine, respectively, were diagnosed with PD.

Disclosures: This research was supported by a grant from the National Research Foundation, Technology Development Program, and Technology Innovation Program. Korea. The authors declared no conflicts of interest.

Source: Ha WS et al. The association between migraine and Parkinson's disease: A nationwide cohort study. Epidemiol Health. 2023 (Dec 18). doi: 10.4178/epih.e2024010

 

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Meta-analysis shows comorbid association between migraine and epilepsy

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Key clinical point: In this meta-analysis, migraine was more frequent among patients with vs without epilepsy and epilepsy was more frequent among patients with vs without migraine, highlighting a co-morbid association between migraine and epilepsy.

Major finding: The lifetime prevalence of migraine was 80% higher in patients with epilepsy compared with those without epilepsy (odds ratio [OR]/relative risk [RR] 1.80; P < .001). Similarly, the lifetime prevalence of epilepsy was 80% higher in patients with migraine compared with those without migraine (OR/RR 1.80; P < .001).

 

Study details: The data come from a meta-analysis of 13 studies that evaluated the association between migraine and epilepsy.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Wu X and Zhuang J. Association between migraine and epilepsy: A meta-analysis. Front Neurol. 2024;14:1276663 (Jan 5). doi: 10.3389/fneur.2023.1276663

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Key clinical point: In this meta-analysis, migraine was more frequent among patients with vs without epilepsy and epilepsy was more frequent among patients with vs without migraine, highlighting a co-morbid association between migraine and epilepsy.

Major finding: The lifetime prevalence of migraine was 80% higher in patients with epilepsy compared with those without epilepsy (odds ratio [OR]/relative risk [RR] 1.80; P < .001). Similarly, the lifetime prevalence of epilepsy was 80% higher in patients with migraine compared with those without migraine (OR/RR 1.80; P < .001).

 

Study details: The data come from a meta-analysis of 13 studies that evaluated the association between migraine and epilepsy.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Wu X and Zhuang J. Association between migraine and epilepsy: A meta-analysis. Front Neurol. 2024;14:1276663 (Jan 5). doi: 10.3389/fneur.2023.1276663

Key clinical point: In this meta-analysis, migraine was more frequent among patients with vs without epilepsy and epilepsy was more frequent among patients with vs without migraine, highlighting a co-morbid association between migraine and epilepsy.

Major finding: The lifetime prevalence of migraine was 80% higher in patients with epilepsy compared with those without epilepsy (odds ratio [OR]/relative risk [RR] 1.80; P < .001). Similarly, the lifetime prevalence of epilepsy was 80% higher in patients with migraine compared with those without migraine (OR/RR 1.80; P < .001).

 

Study details: The data come from a meta-analysis of 13 studies that evaluated the association between migraine and epilepsy.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Wu X and Zhuang J. Association between migraine and epilepsy: A meta-analysis. Front Neurol. 2024;14:1276663 (Jan 5). doi: 10.3389/fneur.2023.1276663

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Erenumab demonstrates more favorable efficacy than rimegepant for migraine prevention

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Key clinical point: Erenumab demonstrated a more favorable efficacy profile than rimegepant for the prevention of episodic and chronic migraine.

Major finding: Compared with 75 mg rimegepant, 70 mg erenumab significantly reduced monthly migraine days (MMD) by 0.90 days at 3 months (P = .042) and 140 mg erenumab significantly reduced MMD by 0.94 (P = .014) and 1.28 (P = .005) days at 1 month and 3 months, respectively. Erenumab showed advantages over rimegepant in improving Migraine-Specific Quality-of-life role function-restrictive domain and Migraine Disability Assessment scores (MIDAS) at 3 months.

 

Study details: This study performed anchored matching-adjusted indirect comparison of the relative efficacy of two erenumab regimens (70 mg and 140 mg) with rimegepant (75 mg) for migraine prevention using data from two phase 2/3 trials for erenumab (295 and STRIVE) and a phase 2/3 trial for rimegepant.

Disclosures: This study was funded by Novartis Healthcare Pvt. Ltd. Several authors declared being employees of and holding stocks or stock options in Novartis.

Source: Mahon R et al. Comparative effectiveness of erenumab versus rimegepant for migraine prevention using matching-adjusted indirect comparison. J Comp Eff Res. 2024 (Jan 4). doi: 10.57264/cer-2023-0122

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]

Key clinical point: Erenumab demonstrated a more favorable efficacy profile than rimegepant for the prevention of episodic and chronic migraine.

Major finding: Compared with 75 mg rimegepant, 70 mg erenumab significantly reduced monthly migraine days (MMD) by 0.90 days at 3 months (P = .042) and 140 mg erenumab significantly reduced MMD by 0.94 (P = .014) and 1.28 (P = .005) days at 1 month and 3 months, respectively. Erenumab showed advantages over rimegepant in improving Migraine-Specific Quality-of-life role function-restrictive domain and Migraine Disability Assessment scores (MIDAS) at 3 months.

 

Study details: This study performed anchored matching-adjusted indirect comparison of the relative efficacy of two erenumab regimens (70 mg and 140 mg) with rimegepant (75 mg) for migraine prevention using data from two phase 2/3 trials for erenumab (295 and STRIVE) and a phase 2/3 trial for rimegepant.

Disclosures: This study was funded by Novartis Healthcare Pvt. Ltd. Several authors declared being employees of and holding stocks or stock options in Novartis.

Source: Mahon R et al. Comparative effectiveness of erenumab versus rimegepant for migraine prevention using matching-adjusted indirect comparison. J Comp Eff Res. 2024 (Jan 4). doi: 10.57264/cer-2023-0122

Key clinical point: Erenumab demonstrated a more favorable efficacy profile than rimegepant for the prevention of episodic and chronic migraine.

Major finding: Compared with 75 mg rimegepant, 70 mg erenumab significantly reduced monthly migraine days (MMD) by 0.90 days at 3 months (P = .042) and 140 mg erenumab significantly reduced MMD by 0.94 (P = .014) and 1.28 (P = .005) days at 1 month and 3 months, respectively. Erenumab showed advantages over rimegepant in improving Migraine-Specific Quality-of-life role function-restrictive domain and Migraine Disability Assessment scores (MIDAS) at 3 months.

 

Study details: This study performed anchored matching-adjusted indirect comparison of the relative efficacy of two erenumab regimens (70 mg and 140 mg) with rimegepant (75 mg) for migraine prevention using data from two phase 2/3 trials for erenumab (295 and STRIVE) and a phase 2/3 trial for rimegepant.

Disclosures: This study was funded by Novartis Healthcare Pvt. Ltd. Several authors declared being employees of and holding stocks or stock options in Novartis.

Source: Mahon R et al. Comparative effectiveness of erenumab versus rimegepant for migraine prevention using matching-adjusted indirect comparison. J Comp Eff Res. 2024 (Jan 4). doi: 10.57264/cer-2023-0122

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Genetic factors influence response to anti-CGRP antibodies in migraine

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Key clinical point: Monoclonal antibodies targeting the anti-calcitonin gene-related peptide (CGRP) showed persistent and comparable outcomes within a real-world cohort of patients with migraine leading to a reduction in migraine days per month (MDM) among responders with large effect sizes; however, the response was influenced by genetic factors.

Major finding: Patients responding to anti-CGRP monoclonal antibodies demonstrated persistent reduction in MDM (usually ≥50% reduction from baseline) at first (η2 = 0.26) and second (η2 = 0.22) follow-up, with all treatments showing similar effects and large effect sizes. Non-responders vs responders had a lower mean genetic risk score (P = .041) without any difference in polygenic risk score.

 

Study details: This retrospective clinical and genetic study included 481 patients with migraine who were prescribed preventive erenumab (n = 166), galcanezumab (n = 164), or fremanezumab (n = 151).

Disclosures: This study was funded by the US Agency for Healthcare Research and Quality. S Meyers declared serving on the speakers’ bureau for Biohaven Pharmaceuticals and Allergan.

Source: Chase BA et al. Characteristics associated with response to subcutaneously administered anti-CGRP monoclonal antibody medications in a real-world community cohort of persons living with migraine: A retrospective clinical and genetic study. Headache. 2023 (Dec 10). doi:

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Key clinical point: Monoclonal antibodies targeting the anti-calcitonin gene-related peptide (CGRP) showed persistent and comparable outcomes within a real-world cohort of patients with migraine leading to a reduction in migraine days per month (MDM) among responders with large effect sizes; however, the response was influenced by genetic factors.

Major finding: Patients responding to anti-CGRP monoclonal antibodies demonstrated persistent reduction in MDM (usually ≥50% reduction from baseline) at first (η2 = 0.26) and second (η2 = 0.22) follow-up, with all treatments showing similar effects and large effect sizes. Non-responders vs responders had a lower mean genetic risk score (P = .041) without any difference in polygenic risk score.

 

Study details: This retrospective clinical and genetic study included 481 patients with migraine who were prescribed preventive erenumab (n = 166), galcanezumab (n = 164), or fremanezumab (n = 151).

Disclosures: This study was funded by the US Agency for Healthcare Research and Quality. S Meyers declared serving on the speakers’ bureau for Biohaven Pharmaceuticals and Allergan.

Source: Chase BA et al. Characteristics associated with response to subcutaneously administered anti-CGRP monoclonal antibody medications in a real-world community cohort of persons living with migraine: A retrospective clinical and genetic study. Headache. 2023 (Dec 10). doi:

Key clinical point: Monoclonal antibodies targeting the anti-calcitonin gene-related peptide (CGRP) showed persistent and comparable outcomes within a real-world cohort of patients with migraine leading to a reduction in migraine days per month (MDM) among responders with large effect sizes; however, the response was influenced by genetic factors.

Major finding: Patients responding to anti-CGRP monoclonal antibodies demonstrated persistent reduction in MDM (usually ≥50% reduction from baseline) at first (η2 = 0.26) and second (η2 = 0.22) follow-up, with all treatments showing similar effects and large effect sizes. Non-responders vs responders had a lower mean genetic risk score (P = .041) without any difference in polygenic risk score.

 

Study details: This retrospective clinical and genetic study included 481 patients with migraine who were prescribed preventive erenumab (n = 166), galcanezumab (n = 164), or fremanezumab (n = 151).

Disclosures: This study was funded by the US Agency for Healthcare Research and Quality. S Meyers declared serving on the speakers’ bureau for Biohaven Pharmaceuticals and Allergan.

Source: Chase BA et al. Characteristics associated with response to subcutaneously administered anti-CGRP monoclonal antibody medications in a real-world community cohort of persons living with migraine: A retrospective clinical and genetic study. Headache. 2023 (Dec 10). doi:

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Agomelatine offers an effective preventive treatment for episodic migraine without aura

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Key clinical point: Agomelatine appeared to be an effective preventive treatment for episodic migraine without aura.

Major finding: After 3 months of treatment, patients receiving agomelatine vs placebo had significant reduction in headache frequency (4.8 vs 5.82; P = .009) and severity (4.1 vs 0.71; P < .001), mean monthly migraine days (8.86 vs 10.63; P = .025), and Migraine Disability Assessment Score (MIDAS; 1.06 vs 0.36; P < .001).

 

Study details: Findings are from a parallel randomized controlled trial that included 99 patients with episodic migraine without aura who were randomly assigned to receive either agomelatine (n = 49) or placebo (vitamin B1 tablets; n = 50).

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Farzin K et al. The effectiveness of agomelatine on headache severity and frequency in episodic migraine without aura; a parallel randomized controlled trial study. BMC Neurol. 2024;24:2 (Jan 2). doi: 10.1186/s12883-023-03516-9

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Key clinical point: Agomelatine appeared to be an effective preventive treatment for episodic migraine without aura.

Major finding: After 3 months of treatment, patients receiving agomelatine vs placebo had significant reduction in headache frequency (4.8 vs 5.82; P = .009) and severity (4.1 vs 0.71; P < .001), mean monthly migraine days (8.86 vs 10.63; P = .025), and Migraine Disability Assessment Score (MIDAS; 1.06 vs 0.36; P < .001).

 

Study details: Findings are from a parallel randomized controlled trial that included 99 patients with episodic migraine without aura who were randomly assigned to receive either agomelatine (n = 49) or placebo (vitamin B1 tablets; n = 50).

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Farzin K et al. The effectiveness of agomelatine on headache severity and frequency in episodic migraine without aura; a parallel randomized controlled trial study. BMC Neurol. 2024;24:2 (Jan 2). doi: 10.1186/s12883-023-03516-9

Key clinical point: Agomelatine appeared to be an effective preventive treatment for episodic migraine without aura.

Major finding: After 3 months of treatment, patients receiving agomelatine vs placebo had significant reduction in headache frequency (4.8 vs 5.82; P = .009) and severity (4.1 vs 0.71; P < .001), mean monthly migraine days (8.86 vs 10.63; P = .025), and Migraine Disability Assessment Score (MIDAS; 1.06 vs 0.36; P < .001).

 

Study details: Findings are from a parallel randomized controlled trial that included 99 patients with episodic migraine without aura who were randomly assigned to receive either agomelatine (n = 49) or placebo (vitamin B1 tablets; n = 50).

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Farzin K et al. The effectiveness of agomelatine on headache severity and frequency in episodic migraine without aura; a parallel randomized controlled trial study. BMC Neurol. 2024;24:2 (Jan 2). doi: 10.1186/s12883-023-03516-9

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