Clinical Edge Journal Scan

Key clinical point: Apremilast reduced inflammation in the joints and entheses of patients with psoriatic arthritis (PsA), as assessed by magnetic resonance imaging.

Major finding: Apremilast improved the composite inflammation score of bone marrow edema, synovitis, and tenosynovitis in the hand, as assessed by the Psoriatic Arthritis Magnetic Resonance Imaging Scoring System at week 24 (least squares mean change [Δ], −2.32; 95% CI, −4.73 to 0.09) and week 48 (Δ, −2.91; 95% CI, −5.45 to −0.37). No new safety concerns were reported.

Study details: This phase 4 MOSAIC study included 122 adults with PsA treated with apremilast, each having at least three swollen and three tender joints involving the hands, along with at least 1 active enthesitis site.

Disclosures: This study was funded by Amgen. Six authors reported being employees of and owning stock in Amgen. Other authors declared having ties with various sources, including Amgen.

Source: Østergaard M, Boesen M, Maksymowych WP, et al. Effect of apremilast on hand and whole-body MRI assessments of inflammation in patients with psoriatic arthritis (MOSAIC): A phase 4, multicentre, single-arm, open-label study. Lancet Rheumatol. Published online October 30, 2024. Source

Key clinical point: Apremilast reduced inflammation in the joints and entheses of patients with psoriatic arthritis (PsA), as assessed by magnetic resonance imaging.

Major finding: Apremilast improved the composite inflammation score of bone marrow edema, synovitis, and tenosynovitis in the hand, as assessed by the Psoriatic Arthritis Magnetic Resonance Imaging Scoring System at week 24 (least squares mean change [Δ], −2.32; 95% CI, −4.73 to 0.09) and week 48 (Δ, −2.91; 95% CI, −5.45 to −0.37). No new safety concerns were reported.

Study details: This phase 4 MOSAIC study included 122 adults with PsA treated with apremilast, each having at least three swollen and three tender joints involving the hands, along with at least 1 active enthesitis site.

Disclosures: This study was funded by Amgen. Six authors reported being employees of and owning stock in Amgen. Other authors declared having ties with various sources, including Amgen.

Source: Østergaard M, Boesen M, Maksymowych WP, et al. Effect of apremilast on hand and whole-body MRI assessments of inflammation in patients with psoriatic arthritis (MOSAIC): A phase 4, multicentre, single-arm, open-label study. Lancet Rheumatol. Published online October 30, 2024. Source

Key clinical point: Apremilast reduced inflammation in the joints and entheses of patients with psoriatic arthritis (PsA), as assessed by magnetic resonance imaging.

Major finding: Apremilast improved the composite inflammation score of bone marrow edema, synovitis, and tenosynovitis in the hand, as assessed by the Psoriatic Arthritis Magnetic Resonance Imaging Scoring System at week 24 (least squares mean change [Δ], −2.32; 95% CI, −4.73 to 0.09) and week 48 (Δ, −2.91; 95% CI, −5.45 to −0.37). No new safety concerns were reported.

Study details: This phase 4 MOSAIC study included 122 adults with PsA treated with apremilast, each having at least three swollen and three tender joints involving the hands, along with at least 1 active enthesitis site.

Disclosures: This study was funded by Amgen. Six authors reported being employees of and owning stock in Amgen. Other authors declared having ties with various sources, including Amgen.

Source: Østergaard M, Boesen M, Maksymowych WP, et al. Effect of apremilast on hand and whole-body MRI assessments of inflammation in patients with psoriatic arthritis (MOSAIC): A phase 4, multicentre, single-arm, open-label study. Lancet Rheumatol. Published online October 30, 2024. Source

Key clinical point: Guselkumab led to sustained minimal or low disease activity (MDA/LDA) and remission across multiple disease domains over 1 year in patients with psoriatic arthritis (PsA) who had an inadequate response or intolerance to tumor necrosis factor inhibitors (TNFi-IR).

Major finding: At week 24, a greater proportion of patients receiving guselkumab vs placebo achieved MDA/LDA (14.8%-52.4% vs 3.1%-28.1%) and remission (3.7%-5.3% vs 0.0%-2.1%), according to composite indices. Most of the patients who achieved LDA/MDA or remission at week 24 (≥70%) maintained the response at week 48.

Study details: This post hoc analysis of the phase 3b COSMOS trial included 285 patients with PsA who had TNFi-IR and were randomly assigned to receive 100 mg guselkumab (n = 189) or placebo (n = 96) with 51 patients switching to guselkumab at week 24.

Disclosures: This study was supported by Johnson & Johnson Innovative Medicine. Several authors declared having ties with various sources, including being employees and having stock options or bond ownership in Johnson & Johnson or its subsidiaries.

Source: Gossec L, Baraliakos X, Aletaha D, et al. Multi-domain effectiveness of guselkumab evaluated via composite indices through 1 year in patients with PsA and inadequate response to TNFi: Post hoc analysis of COSMOS. Rheumatology (Oxford). Published online October 22, 2024. Source

Key clinical point: Guselkumab led to sustained minimal or low disease activity (MDA/LDA) and remission across multiple disease domains over 1 year in patients with psoriatic arthritis (PsA) who had an inadequate response or intolerance to tumor necrosis factor inhibitors (TNFi-IR).

Major finding: At week 24, a greater proportion of patients receiving guselkumab vs placebo achieved MDA/LDA (14.8%-52.4% vs 3.1%-28.1%) and remission (3.7%-5.3% vs 0.0%-2.1%), according to composite indices. Most of the patients who achieved LDA/MDA or remission at week 24 (≥70%) maintained the response at week 48.

Study details: This post hoc analysis of the phase 3b COSMOS trial included 285 patients with PsA who had TNFi-IR and were randomly assigned to receive 100 mg guselkumab (n = 189) or placebo (n = 96) with 51 patients switching to guselkumab at week 24.

Disclosures: This study was supported by Johnson & Johnson Innovative Medicine. Several authors declared having ties with various sources, including being employees and having stock options or bond ownership in Johnson & Johnson or its subsidiaries.

Source: Gossec L, Baraliakos X, Aletaha D, et al. Multi-domain effectiveness of guselkumab evaluated via composite indices through 1 year in patients with PsA and inadequate response to TNFi: Post hoc analysis of COSMOS. Rheumatology (Oxford). Published online October 22, 2024. Source

Key clinical point: Guselkumab led to sustained minimal or low disease activity (MDA/LDA) and remission across multiple disease domains over 1 year in patients with psoriatic arthritis (PsA) who had an inadequate response or intolerance to tumor necrosis factor inhibitors (TNFi-IR).

Major finding: At week 24, a greater proportion of patients receiving guselkumab vs placebo achieved MDA/LDA (14.8%-52.4% vs 3.1%-28.1%) and remission (3.7%-5.3% vs 0.0%-2.1%), according to composite indices. Most of the patients who achieved LDA/MDA or remission at week 24 (≥70%) maintained the response at week 48.

Study details: This post hoc analysis of the phase 3b COSMOS trial included 285 patients with PsA who had TNFi-IR and were randomly assigned to receive 100 mg guselkumab (n = 189) or placebo (n = 96) with 51 patients switching to guselkumab at week 24.

Disclosures: This study was supported by Johnson & Johnson Innovative Medicine. Several authors declared having ties with various sources, including being employees and having stock options or bond ownership in Johnson & Johnson or its subsidiaries.

Source: Gossec L, Baraliakos X, Aletaha D, et al. Multi-domain effectiveness of guselkumab evaluated via composite indices through 1 year in patients with PsA and inadequate response to TNFi: Post hoc analysis of COSMOS. Rheumatology (Oxford). Published online October 22, 2024. Source

Key clinical point: Both erenumab and topiramate reduced migraine-induced disability; however, erenumab had a better safety profile for the prevention of chronic migraine.

Major findings: Migraine Disability Assessment (MIDAS) scores reduced after 3 months of treatment with both erenumab (15.17 at baseline to 5.79 at 3 months post-treatment) and topiramate (9.13 at baseline to 6.20 at 3 months post-treatment). A 50% reduction in the MIDAS score was achieved in patients receiving erenumab vs topiramate (≈79% vs 16%), with fewer discontinuations due to adverse events in patients receiving erenumab vs topiramate (3.8% vs 14.2%). 

Study details: This retrospective cohort study included adults with a 12-month history of episodic or chronic migraine who received erenumab once monthly (dose, 70 mg/month; n = 52) or topiramate twice daily (dose, 50-100 mg/day; n = 56).

Disclosure: The study was funded by the Dubai Medical College for Girls. The authors declared no conflicts of interest.

Source: Nebrisi EE, Ruwayya ZSA, Alzayori DI, Alzayori RI, Chandran SB, Elshafei M. Efficacy and tolerability of erenumab and topiramate for prevention of chronic migraine: A retrospective cohort study. Medicina. Published online October 14, 2024. Source

Key clinical point: Both erenumab and topiramate reduced migraine-induced disability; however, erenumab had a better safety profile for the prevention of chronic migraine.

Major findings: Migraine Disability Assessment (MIDAS) scores reduced after 3 months of treatment with both erenumab (15.17 at baseline to 5.79 at 3 months post-treatment) and topiramate (9.13 at baseline to 6.20 at 3 months post-treatment). A 50% reduction in the MIDAS score was achieved in patients receiving erenumab vs topiramate (≈79% vs 16%), with fewer discontinuations due to adverse events in patients receiving erenumab vs topiramate (3.8% vs 14.2%). 

Study details: This retrospective cohort study included adults with a 12-month history of episodic or chronic migraine who received erenumab once monthly (dose, 70 mg/month; n = 52) or topiramate twice daily (dose, 50-100 mg/day; n = 56).

Disclosure: The study was funded by the Dubai Medical College for Girls. The authors declared no conflicts of interest.

Source: Nebrisi EE, Ruwayya ZSA, Alzayori DI, Alzayori RI, Chandran SB, Elshafei M. Efficacy and tolerability of erenumab and topiramate for prevention of chronic migraine: A retrospective cohort study. Medicina. Published online October 14, 2024. Source

Key clinical point: Both erenumab and topiramate reduced migraine-induced disability; however, erenumab had a better safety profile for the prevention of chronic migraine.

Major findings: Migraine Disability Assessment (MIDAS) scores reduced after 3 months of treatment with both erenumab (15.17 at baseline to 5.79 at 3 months post-treatment) and topiramate (9.13 at baseline to 6.20 at 3 months post-treatment). A 50% reduction in the MIDAS score was achieved in patients receiving erenumab vs topiramate (≈79% vs 16%), with fewer discontinuations due to adverse events in patients receiving erenumab vs topiramate (3.8% vs 14.2%). 

Study details: This retrospective cohort study included adults with a 12-month history of episodic or chronic migraine who received erenumab once monthly (dose, 70 mg/month; n = 52) or topiramate twice daily (dose, 50-100 mg/day; n = 56).

Disclosure: The study was funded by the Dubai Medical College for Girls. The authors declared no conflicts of interest.

Source: Nebrisi EE, Ruwayya ZSA, Alzayori DI, Alzayori RI, Chandran SB, Elshafei M. Efficacy and tolerability of erenumab and topiramate for prevention of chronic migraine: A retrospective cohort study. Medicina. Published online October 14, 2024. Source

Key clinical point: A higher polygenic risk score (PRS) was associated with an earlier migraine onset in both women and men; however, it was not associated with migraine chronification.

Major findings: A higher PRS was strongly associated with an earlier onset of migraine in both women (hazard ratios [HRs], 2.1 in DodoNA and 1.8 in GHI; P < .001 for both) and men (HRs, 2.5 in DodoNA; P < .001 and 1.6 in GHI; P = .027). However, PRS was not associated with migraine chronification (HR, 1.2; P = .424).

Study details: This retrospective clinical/genetic case-control study analyzed data from the DodoNA cohort (1653 individuals with migraine and 3460 control individuals without migraine) and the GHI cohort (2443 individuals with migraine and 8576 control individuals without migraine).

Disclosure: The study was funded by the Agency for Healthcare Research and Quality. Two authors declared having ties with various sources.

Source: Chase BA, Frigerio R, Rubin S, et al. An integrative migraine polygenic risk score is associated with age at onset but not with chronification. Published online October 29, 2024. Source

Key clinical point: A higher polygenic risk score (PRS) was associated with an earlier migraine onset in both women and men; however, it was not associated with migraine chronification.

Major findings: A higher PRS was strongly associated with an earlier onset of migraine in both women (hazard ratios [HRs], 2.1 in DodoNA and 1.8 in GHI; P < .001 for both) and men (HRs, 2.5 in DodoNA; P < .001 and 1.6 in GHI; P = .027). However, PRS was not associated with migraine chronification (HR, 1.2; P = .424).

Study details: This retrospective clinical/genetic case-control study analyzed data from the DodoNA cohort (1653 individuals with migraine and 3460 control individuals without migraine) and the GHI cohort (2443 individuals with migraine and 8576 control individuals without migraine).

Disclosure: The study was funded by the Agency for Healthcare Research and Quality. Two authors declared having ties with various sources.

Source: Chase BA, Frigerio R, Rubin S, et al. An integrative migraine polygenic risk score is associated with age at onset but not with chronification. Published online October 29, 2024. Source

Key clinical point: A higher polygenic risk score (PRS) was associated with an earlier migraine onset in both women and men; however, it was not associated with migraine chronification.

Major findings: A higher PRS was strongly associated with an earlier onset of migraine in both women (hazard ratios [HRs], 2.1 in DodoNA and 1.8 in GHI; P < .001 for both) and men (HRs, 2.5 in DodoNA; P < .001 and 1.6 in GHI; P = .027). However, PRS was not associated with migraine chronification (HR, 1.2; P = .424).

Study details: This retrospective clinical/genetic case-control study analyzed data from the DodoNA cohort (1653 individuals with migraine and 3460 control individuals without migraine) and the GHI cohort (2443 individuals with migraine and 8576 control individuals without migraine).

Disclosure: The study was funded by the Agency for Healthcare Research and Quality. Two authors declared having ties with various sources.

Source: Chase BA, Frigerio R, Rubin S, et al. An integrative migraine polygenic risk score is associated with age at onset but not with chronification. Published online October 29, 2024. Source

Key clinical point: Atogepant was an effective and safe treatment option for the prevention of episodic migraine. 

Major findings: Atogepant (10 mg, 30 mg, and 60 mg) vs placebo led to a significant reduction in monthly migraine days (MMDs; P < .001, P < .001, and P = .0009, respectively), monthly headache days (all P < .001), acute medication use (all P < .001), as well as increase in the proportion of patients achieving a ≥50% reduction in MMDs (P = .007, P = .02, and P = .003, respectively). No significant difference was observed in serious adverse events between the atogepant and placebo groups.

Study details: This meta-analysis of six randomized controlled trials included 4569 patients with episodic migraine who were randomly assigned to receive atogepant (10 mg, 30 mg, or 60 mg) or placebo.

Disclosure: The study did not receive funding from any sources. The authors declared no conflicts of interest. 

Source: Alrasheed AS, Almaqboul TM, Alshamrani RA, AlMohish NM, Alabdali MM. Safety and efficacy of atogepant for the preventive treatment of migraines in adults: A systematic review and meta-analysis. J Clin Med. Published online November 08, 2024. Source

Key clinical point: Atogepant was an effective and safe treatment option for the prevention of episodic migraine. 

Major findings: Atogepant (10 mg, 30 mg, and 60 mg) vs placebo led to a significant reduction in monthly migraine days (MMDs; P < .001, P < .001, and P = .0009, respectively), monthly headache days (all P < .001), acute medication use (all P < .001), as well as increase in the proportion of patients achieving a ≥50% reduction in MMDs (P = .007, P = .02, and P = .003, respectively). No significant difference was observed in serious adverse events between the atogepant and placebo groups.

Study details: This meta-analysis of six randomized controlled trials included 4569 patients with episodic migraine who were randomly assigned to receive atogepant (10 mg, 30 mg, or 60 mg) or placebo.

Disclosure: The study did not receive funding from any sources. The authors declared no conflicts of interest. 

Source: Alrasheed AS, Almaqboul TM, Alshamrani RA, AlMohish NM, Alabdali MM. Safety and efficacy of atogepant for the preventive treatment of migraines in adults: A systematic review and meta-analysis. J Clin Med. Published online November 08, 2024. Source

Key clinical point: Atogepant was an effective and safe treatment option for the prevention of episodic migraine. 

Major findings: Atogepant (10 mg, 30 mg, and 60 mg) vs placebo led to a significant reduction in monthly migraine days (MMDs; P < .001, P < .001, and P = .0009, respectively), monthly headache days (all P < .001), acute medication use (all P < .001), as well as increase in the proportion of patients achieving a ≥50% reduction in MMDs (P = .007, P = .02, and P = .003, respectively). No significant difference was observed in serious adverse events between the atogepant and placebo groups.

Study details: This meta-analysis of six randomized controlled trials included 4569 patients with episodic migraine who were randomly assigned to receive atogepant (10 mg, 30 mg, or 60 mg) or placebo.

Disclosure: The study did not receive funding from any sources. The authors declared no conflicts of interest. 

Source: Alrasheed AS, Almaqboul TM, Alshamrani RA, AlMohish NM, Alabdali MM. Safety and efficacy of atogepant for the preventive treatment of migraines in adults: A systematic review and meta-analysis. J Clin Med. Published online November 08, 2024. Source

Key clinical point: Pregnant women with migraine with aura had a significantly increased risk for both acute ischemic stroke and hemorrhagic stroke.

Major findings: Pregnant women with vs without migraine had a higher incidence of acute ischemic stroke (0.1% vs 0.0%) and hemorrhagic stroke (0.3% vs 0.1%). The risk for acute ischemic stroke was highest in those with aura (odds ratio [OR], 23.26; 95% CI, 18.46-29.31), followed by those without aura (OR, 8.15; 95% CI, 4.79-13.88) and those with unspecified migraine (OR, 5.43; 95% CI, 4.72-6.25). 

Study details: This population-based study utilized the Healthcare Cost and Utilization Project's National Inpatient Sample database and involved 19,825,525 pregnant women, of whom 1.1% had migraine.

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

Source: Reddy M, Vazquez S, Nolan B, et al. Migraine and its association with stroke in pregnancy: A national examination. J Womens Health. 2024;33:1476-1481. Source

Key clinical point: Pregnant women with migraine with aura had a significantly increased risk for both acute ischemic stroke and hemorrhagic stroke.

Major findings: Pregnant women with vs without migraine had a higher incidence of acute ischemic stroke (0.1% vs 0.0%) and hemorrhagic stroke (0.3% vs 0.1%). The risk for acute ischemic stroke was highest in those with aura (odds ratio [OR], 23.26; 95% CI, 18.46-29.31), followed by those without aura (OR, 8.15; 95% CI, 4.79-13.88) and those with unspecified migraine (OR, 5.43; 95% CI, 4.72-6.25). 

Study details: This population-based study utilized the Healthcare Cost and Utilization Project's National Inpatient Sample database and involved 19,825,525 pregnant women, of whom 1.1% had migraine.

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

Source: Reddy M, Vazquez S, Nolan B, et al. Migraine and its association with stroke in pregnancy: A national examination. J Womens Health. 2024;33:1476-1481. Source

Key clinical point: Pregnant women with migraine with aura had a significantly increased risk for both acute ischemic stroke and hemorrhagic stroke.

Major findings: Pregnant women with vs without migraine had a higher incidence of acute ischemic stroke (0.1% vs 0.0%) and hemorrhagic stroke (0.3% vs 0.1%). The risk for acute ischemic stroke was highest in those with aura (odds ratio [OR], 23.26; 95% CI, 18.46-29.31), followed by those without aura (OR, 8.15; 95% CI, 4.79-13.88) and those with unspecified migraine (OR, 5.43; 95% CI, 4.72-6.25). 

Study details: This population-based study utilized the Healthcare Cost and Utilization Project's National Inpatient Sample database and involved 19,825,525 pregnant women, of whom 1.1% had migraine.

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

Source: Reddy M, Vazquez S, Nolan B, et al. Migraine and its association with stroke in pregnancy: A national examination. J Womens Health. 2024;33:1476-1481. Source

Key clinical point: Increased cardiovascular (CV) risk, as assessed by the Systematic Coronary Risk Evaluation 2 system, was associated with a lower risk for prevalent and incident migraine, notably in women.

Major findings: Compared with individuals with the lowest CV risk scores (< 1%), those with CV risk scores of 1% to < 2.5% had a higher risk for prevalent migraine (odds ratio [OR], 0.93; 95% CI, 0.90-0.96) and incident migraine (OR, 0.63; 95% CI, 0.57-0.69), whereas individuals with CV risk scores ≥ 10% had a lower risk for prevalent migraine (OR, 0.43; 95% CI, 0.39-0.48) and incident migraine (OR, 0.17; 95% CI, 0.10-0.27). The association between migraine and CV risk was stronger in women than in men within the same CV risk categories.

Study details: This ~13-year prospective population-based study involved 140,915 adults (58.5% women), with 25,915 having prevalent migraine and 2224 having incident migraine.

Disclosure: The study was supported by the Dutch Research Council and others. Two authors reported receiving research grants, advisory board fees, or speaking fees from various sources.

Source: Al-Hassany L, MaassenVanDenBrink A, Kurth T. Cardiovascular risk scores and migraine status. JAMA Netw Open. Published online October 22, 2024. Source

Key clinical point: Increased cardiovascular (CV) risk, as assessed by the Systematic Coronary Risk Evaluation 2 system, was associated with a lower risk for prevalent and incident migraine, notably in women.

Major findings: Compared with individuals with the lowest CV risk scores (< 1%), those with CV risk scores of 1% to < 2.5% had a higher risk for prevalent migraine (odds ratio [OR], 0.93; 95% CI, 0.90-0.96) and incident migraine (OR, 0.63; 95% CI, 0.57-0.69), whereas individuals with CV risk scores ≥ 10% had a lower risk for prevalent migraine (OR, 0.43; 95% CI, 0.39-0.48) and incident migraine (OR, 0.17; 95% CI, 0.10-0.27). The association between migraine and CV risk was stronger in women than in men within the same CV risk categories.

Study details: This ~13-year prospective population-based study involved 140,915 adults (58.5% women), with 25,915 having prevalent migraine and 2224 having incident migraine.

Disclosure: The study was supported by the Dutch Research Council and others. Two authors reported receiving research grants, advisory board fees, or speaking fees from various sources.

Source: Al-Hassany L, MaassenVanDenBrink A, Kurth T. Cardiovascular risk scores and migraine status. JAMA Netw Open. Published online October 22, 2024. Source

Key clinical point: Increased cardiovascular (CV) risk, as assessed by the Systematic Coronary Risk Evaluation 2 system, was associated with a lower risk for prevalent and incident migraine, notably in women.

Major findings: Compared with individuals with the lowest CV risk scores (< 1%), those with CV risk scores of 1% to < 2.5% had a higher risk for prevalent migraine (odds ratio [OR], 0.93; 95% CI, 0.90-0.96) and incident migraine (OR, 0.63; 95% CI, 0.57-0.69), whereas individuals with CV risk scores ≥ 10% had a lower risk for prevalent migraine (OR, 0.43; 95% CI, 0.39-0.48) and incident migraine (OR, 0.17; 95% CI, 0.10-0.27). The association between migraine and CV risk was stronger in women than in men within the same CV risk categories.

Study details: This ~13-year prospective population-based study involved 140,915 adults (58.5% women), with 25,915 having prevalent migraine and 2224 having incident migraine.

Disclosure: The study was supported by the Dutch Research Council and others. Two authors reported receiving research grants, advisory board fees, or speaking fees from various sources.

Source: Al-Hassany L, MaassenVanDenBrink A, Kurth T. Cardiovascular risk scores and migraine status. JAMA Netw Open. Published online October 22, 2024. Source

Key clinical point: In patients with migraine and those with prior treatment failure and medication overuse (MO), eptinezumab significantly reduced acute headache medication (AHM), with sustained reductions for up to 18 months.

Major findings: Eptinezumab significantly reduced AHM compared with placebo in patients with migraine and those with MO (P < .001 for all). These reductions in AHM were sustained through the 18-month treatment period, with continued reductions in the extension period. 

Study details: This DELIVER trial post-hoc analysis of 890 patients, 49.2% had MO who failed 2-4 preventive treatments, among these 865 patients continued in the 48-week extension period. 

Disclosure: This study was funded by H. Lundbeck A/S. Two authors reported receiving speaking fees from various sources. Five authors declared being full-time employees of H. Lundbeck A/S. Other authors declared multiple ties with various sources.

Source: Gryglas-Dworak A, Schim J, Ettrup A, et al. Long-term reductions in acute headache medication use after eptinezumab treatment in patients with migraine and prior preventive treatment failures: Post hoc analysis of the DELIVER randomized trial. Headache. Published online November 5, 2024. Source

Key clinical point: In patients with migraine and those with prior treatment failure and medication overuse (MO), eptinezumab significantly reduced acute headache medication (AHM), with sustained reductions for up to 18 months.

Major findings: Eptinezumab significantly reduced AHM compared with placebo in patients with migraine and those with MO (P < .001 for all). These reductions in AHM were sustained through the 18-month treatment period, with continued reductions in the extension period. 

Study details: This DELIVER trial post-hoc analysis of 890 patients, 49.2% had MO who failed 2-4 preventive treatments, among these 865 patients continued in the 48-week extension period. 

Disclosure: This study was funded by H. Lundbeck A/S. Two authors reported receiving speaking fees from various sources. Five authors declared being full-time employees of H. Lundbeck A/S. Other authors declared multiple ties with various sources.

Source: Gryglas-Dworak A, Schim J, Ettrup A, et al. Long-term reductions in acute headache medication use after eptinezumab treatment in patients with migraine and prior preventive treatment failures: Post hoc analysis of the DELIVER randomized trial. Headache. Published online November 5, 2024. Source

Key clinical point: In patients with migraine and those with prior treatment failure and medication overuse (MO), eptinezumab significantly reduced acute headache medication (AHM), with sustained reductions for up to 18 months.

Major findings: Eptinezumab significantly reduced AHM compared with placebo in patients with migraine and those with MO (P < .001 for all). These reductions in AHM were sustained through the 18-month treatment period, with continued reductions in the extension period. 

Study details: This DELIVER trial post-hoc analysis of 890 patients, 49.2% had MO who failed 2-4 preventive treatments, among these 865 patients continued in the 48-week extension period. 

Disclosure: This study was funded by H. Lundbeck A/S. Two authors reported receiving speaking fees from various sources. Five authors declared being full-time employees of H. Lundbeck A/S. Other authors declared multiple ties with various sources.

Source: Gryglas-Dworak A, Schim J, Ettrup A, et al. Long-term reductions in acute headache medication use after eptinezumab treatment in patients with migraine and prior preventive treatment failures: Post hoc analysis of the DELIVER randomized trial. Headache. Published online November 5, 2024. Source

Key clinical point: Patients with migraine, particularly those with severe symptoms, were at a higher risk for occupational burnout than those without migraine.

Major findings: Patients with vs without migraine experienced increased occupational burnout (mean burnout score, 3.46 vs 2.82), had higher rates of depression (mean Depression, Anxiety and Stress Scale–21 score, 0.864 vs 0.664), worked longer hours (median weekly hours, 40.0 vs 36.0), and preferred remote work (20.3% vs 10.3%). Migraine severity, as measured by the Migraine Disability Assessment, was significantly associated with increased occupational burnout (P < .001).

Study details: This observational cohort study included 675 patients with migraine and 232 patients without migraine, matched according to age, gender, and primary clinic. 

Disclosure: The study was funded by Teva Pharmaceuticals. Gal Ifergane received consulting fees and honoraria from various sources, including Teva Pharmaceuticals, and others declared no conflicts of interest.

Source: Peles I, Sharvit S, Zlotnik Y, et al. Migraine and work — beyond absenteeism: Migraine severity and occupational burnout — A cohort study. Cephalalgia. Published online October 18, 2024. Source

Key clinical point: Patients with migraine, particularly those with severe symptoms, were at a higher risk for occupational burnout than those without migraine.

Major findings: Patients with vs without migraine experienced increased occupational burnout (mean burnout score, 3.46 vs 2.82), had higher rates of depression (mean Depression, Anxiety and Stress Scale–21 score, 0.864 vs 0.664), worked longer hours (median weekly hours, 40.0 vs 36.0), and preferred remote work (20.3% vs 10.3%). Migraine severity, as measured by the Migraine Disability Assessment, was significantly associated with increased occupational burnout (P < .001).

Study details: This observational cohort study included 675 patients with migraine and 232 patients without migraine, matched according to age, gender, and primary clinic. 

Disclosure: The study was funded by Teva Pharmaceuticals. Gal Ifergane received consulting fees and honoraria from various sources, including Teva Pharmaceuticals, and others declared no conflicts of interest.

Source: Peles I, Sharvit S, Zlotnik Y, et al. Migraine and work — beyond absenteeism: Migraine severity and occupational burnout — A cohort study. Cephalalgia. Published online October 18, 2024. Source

Key clinical point: Patients with migraine, particularly those with severe symptoms, were at a higher risk for occupational burnout than those without migraine.

Major findings: Patients with vs without migraine experienced increased occupational burnout (mean burnout score, 3.46 vs 2.82), had higher rates of depression (mean Depression, Anxiety and Stress Scale–21 score, 0.864 vs 0.664), worked longer hours (median weekly hours, 40.0 vs 36.0), and preferred remote work (20.3% vs 10.3%). Migraine severity, as measured by the Migraine Disability Assessment, was significantly associated with increased occupational burnout (P < .001).

Study details: This observational cohort study included 675 patients with migraine and 232 patients without migraine, matched according to age, gender, and primary clinic. 

Disclosure: The study was funded by Teva Pharmaceuticals. Gal Ifergane received consulting fees and honoraria from various sources, including Teva Pharmaceuticals, and others declared no conflicts of interest.

Source: Peles I, Sharvit S, Zlotnik Y, et al. Migraine and work — beyond absenteeism: Migraine severity and occupational burnout — A cohort study. Cephalalgia. Published online October 18, 2024. Source

Key clinical point: Migraine, including migraine with aura (MWA) and migraine without aura (MWoA), was not a significant factor for stroke caused by cerebral small-vessel disease (CSVD) in adult patients hospitalized with first-ever ischemic stroke. 

Major findings: Patients with migraine (P = .003), those with MWA (P = .02), and those with MWoA (P = .04) were found to have a significantly lower prevalence of CSVD lesions than those without migraine. There was no significant association between CSVD lesions of any grade and migraine (P = .34), MWA (P = .60), and MWoA (P = .51).  

Study details: This retrospective case-control study included 646 patients who were hospitalized for their first-ever ischemic stroke, of whom 225 (34.82%) had migraine. Among those with migraine, 115 (17.8%) had MWA and 110 (17.02%) had MWoA. 

Disclosure: This study received no specific funding. One author declared receiving speaker fees from various pharmaceutical companies. 

Source: Cloet F, Gueyraud G, Lerebours F, Munio M, Larrue V, Gollion C. Stroke due to small-vessel disease and migraine: A case-control study of a young adult with ischemic stroke population. Cephalalgia. 2024;44:1-8. Source 

Key clinical point: Migraine, including migraine with aura (MWA) and migraine without aura (MWoA), was not a significant factor for stroke caused by cerebral small-vessel disease (CSVD) in adult patients hospitalized with first-ever ischemic stroke. 

Major findings: Patients with migraine (P = .003), those with MWA (P = .02), and those with MWoA (P = .04) were found to have a significantly lower prevalence of CSVD lesions than those without migraine. There was no significant association between CSVD lesions of any grade and migraine (P = .34), MWA (P = .60), and MWoA (P = .51).  

Study details: This retrospective case-control study included 646 patients who were hospitalized for their first-ever ischemic stroke, of whom 225 (34.82%) had migraine. Among those with migraine, 115 (17.8%) had MWA and 110 (17.02%) had MWoA. 

Disclosure: This study received no specific funding. One author declared receiving speaker fees from various pharmaceutical companies. 

Source: Cloet F, Gueyraud G, Lerebours F, Munio M, Larrue V, Gollion C. Stroke due to small-vessel disease and migraine: A case-control study of a young adult with ischemic stroke population. Cephalalgia. 2024;44:1-8. Source 

Key clinical point: Migraine, including migraine with aura (MWA) and migraine without aura (MWoA), was not a significant factor for stroke caused by cerebral small-vessel disease (CSVD) in adult patients hospitalized with first-ever ischemic stroke. 

Major findings: Patients with migraine (P = .003), those with MWA (P = .02), and those with MWoA (P = .04) were found to have a significantly lower prevalence of CSVD lesions than those without migraine. There was no significant association between CSVD lesions of any grade and migraine (P = .34), MWA (P = .60), and MWoA (P = .51).  

Study details: This retrospective case-control study included 646 patients who were hospitalized for their first-ever ischemic stroke, of whom 225 (34.82%) had migraine. Among those with migraine, 115 (17.8%) had MWA and 110 (17.02%) had MWoA. 

Disclosure: This study received no specific funding. One author declared receiving speaker fees from various pharmaceutical companies. 

Source: Cloet F, Gueyraud G, Lerebours F, Munio M, Larrue V, Gollion C. Stroke due to small-vessel disease and migraine: A case-control study of a young adult with ischemic stroke population. Cephalalgia. 2024;44:1-8. Source