Headache & Migraine

Key clinical point: Vitamin D supplementation may improve headache characteristics and disability levels in patients with episodic migraine, especially among those with aura, possibly through attenuation of calcitonin gene-related peptide level.

Major finding: After 12 weeks, the vitamin D vs placebo group had a significant improvement in mean headache days (4.71 vs 6.43 days/month; P = .031) and mean Migraine Disability Assessment Questionnaire score (21.49 vs 31.16; P = .016).  

Study details: A post hoc analysis of a double-blind study which included patients with episodic migraine randomly assigned to receive either vitamin D 2,000 IU/day (n = 40) or placebo (n = 40). 

Disclosures: This study was supported by the Tehran University of Medical Sciences & Health Services. The authors reported no competing interests.

Citation: Ghorbani Z et al. J Headache Pain. 2020 Feb 24. doi: 10.1186/s10194-020-01090-w. 

Key clinical point: Vitamin D supplementation may improve headache characteristics and disability levels in patients with episodic migraine, especially among those with aura, possibly through attenuation of calcitonin gene-related peptide level.

Major finding: After 12 weeks, the vitamin D vs placebo group had a significant improvement in mean headache days (4.71 vs 6.43 days/month; P = .031) and mean Migraine Disability Assessment Questionnaire score (21.49 vs 31.16; P = .016).  

Study details: A post hoc analysis of a double-blind study which included patients with episodic migraine randomly assigned to receive either vitamin D 2,000 IU/day (n = 40) or placebo (n = 40). 

Disclosures: This study was supported by the Tehran University of Medical Sciences & Health Services. The authors reported no competing interests.

Citation: Ghorbani Z et al. J Headache Pain. 2020 Feb 24. doi: 10.1186/s10194-020-01090-w. 

Key clinical point: Vitamin D supplementation may improve headache characteristics and disability levels in patients with episodic migraine, especially among those with aura, possibly through attenuation of calcitonin gene-related peptide level.

Major finding: After 12 weeks, the vitamin D vs placebo group had a significant improvement in mean headache days (4.71 vs 6.43 days/month; P = .031) and mean Migraine Disability Assessment Questionnaire score (21.49 vs 31.16; P = .016).  

Study details: A post hoc analysis of a double-blind study which included patients with episodic migraine randomly assigned to receive either vitamin D 2,000 IU/day (n = 40) or placebo (n = 40). 

Disclosures: This study was supported by the Tehran University of Medical Sciences & Health Services. The authors reported no competing interests.

Citation: Ghorbani Z et al. J Headache Pain. 2020 Feb 24. doi: 10.1186/s10194-020-01090-w. 

Key clinical point: Serotonin-norepinephrine reuptake inhibitors (SNRIs) are clinically safe and effective, and non-inferior to other active drugs for the prophylaxis of migraine and vestibular migraine (VM).

Major finding: Fewer migraine days were reported with SNRIs vs placebo (standardized mean difference [SMD] -0.38; P = .04). In patients with VM, venlafaxine had a significant advantage in decreasing the vertigo severity score (weighted mean difference (MD) -1.45; P less than .0001) and emotional domain score of dizziness handicap inventory (MD -2.64; P = .03) vs other active drugs. No significant difference was noted in withdrawal rates between the groups.

Study details: Meta-analysis of six randomized controlled trials including 418 participants.

Disclosures: This study was funded by the Natural Science Foundation of Liaoning Province. The authors declared no conflicts of interests.

Citation: Wang F et al. Reg Anesth Pain Med. 2020 March. doi: 10.1136/rapm-2019-101207

Key clinical point: Serotonin-norepinephrine reuptake inhibitors (SNRIs) are clinically safe and effective, and non-inferior to other active drugs for the prophylaxis of migraine and vestibular migraine (VM).

Major finding: Fewer migraine days were reported with SNRIs vs placebo (standardized mean difference [SMD] -0.38; P = .04). In patients with VM, venlafaxine had a significant advantage in decreasing the vertigo severity score (weighted mean difference (MD) -1.45; P less than .0001) and emotional domain score of dizziness handicap inventory (MD -2.64; P = .03) vs other active drugs. No significant difference was noted in withdrawal rates between the groups.

Study details: Meta-analysis of six randomized controlled trials including 418 participants.

Disclosures: This study was funded by the Natural Science Foundation of Liaoning Province. The authors declared no conflicts of interests.

Citation: Wang F et al. Reg Anesth Pain Med. 2020 March. doi: 10.1136/rapm-2019-101207

Key clinical point: Serotonin-norepinephrine reuptake inhibitors (SNRIs) are clinically safe and effective, and non-inferior to other active drugs for the prophylaxis of migraine and vestibular migraine (VM).

Major finding: Fewer migraine days were reported with SNRIs vs placebo (standardized mean difference [SMD] -0.38; P = .04). In patients with VM, venlafaxine had a significant advantage in decreasing the vertigo severity score (weighted mean difference (MD) -1.45; P less than .0001) and emotional domain score of dizziness handicap inventory (MD -2.64; P = .03) vs other active drugs. No significant difference was noted in withdrawal rates between the groups.

Study details: Meta-analysis of six randomized controlled trials including 418 participants.

Disclosures: This study was funded by the Natural Science Foundation of Liaoning Province. The authors declared no conflicts of interests.

Citation: Wang F et al. Reg Anesth Pain Med. 2020 March. doi: 10.1136/rapm-2019-101207

Key clinical points: In episodic migraine, enhanced mindfulness-based stress reduction (MBSR+) is more effective than stress management for headache (SMH) in reducing headache and migraine days and headache related disability.

Major finding: At week 20, MBSR+ group vs. SHM group reported fewer headache days (4.6 vs. 6.0 headache days; P = .04) and had greater reduction in headache-related disability (59.6 to 54.6 vs 59.6 to 57.5; P =.02). Treatment response rate was higher in the MBSR+ group vs SMH group (52% vs. 23% reduction in headache days; P = .004). 

Study details: Patients with episodic migraine (aged, 18-65 years) were randomly assigned to receive either MBSR+ (n = 50) or SMH (n = 48).

Disclosures: This study was funded by the National Center for Complementary and Integrative Health and National Institutes of Health. The authors declared no conflicts of interest.

Citation: Seminowicz DA et al. Pain. 2020 Mar 13. doi: 10.1097/j.pain.0000000000001860.

Key clinical points: In episodic migraine, enhanced mindfulness-based stress reduction (MBSR+) is more effective than stress management for headache (SMH) in reducing headache and migraine days and headache related disability.

Major finding: At week 20, MBSR+ group vs. SHM group reported fewer headache days (4.6 vs. 6.0 headache days; P = .04) and had greater reduction in headache-related disability (59.6 to 54.6 vs 59.6 to 57.5; P =.02). Treatment response rate was higher in the MBSR+ group vs SMH group (52% vs. 23% reduction in headache days; P = .004). 

Study details: Patients with episodic migraine (aged, 18-65 years) were randomly assigned to receive either MBSR+ (n = 50) or SMH (n = 48).

Disclosures: This study was funded by the National Center for Complementary and Integrative Health and National Institutes of Health. The authors declared no conflicts of interest.

Citation: Seminowicz DA et al. Pain. 2020 Mar 13. doi: 10.1097/j.pain.0000000000001860.

Key clinical points: In episodic migraine, enhanced mindfulness-based stress reduction (MBSR+) is more effective than stress management for headache (SMH) in reducing headache and migraine days and headache related disability.

Major finding: At week 20, MBSR+ group vs. SHM group reported fewer headache days (4.6 vs. 6.0 headache days; P = .04) and had greater reduction in headache-related disability (59.6 to 54.6 vs 59.6 to 57.5; P =.02). Treatment response rate was higher in the MBSR+ group vs SMH group (52% vs. 23% reduction in headache days; P = .004). 

Study details: Patients with episodic migraine (aged, 18-65 years) were randomly assigned to receive either MBSR+ (n = 50) or SMH (n = 48).

Disclosures: This study was funded by the National Center for Complementary and Integrative Health and National Institutes of Health. The authors declared no conflicts of interest.

Citation: Seminowicz DA et al. Pain. 2020 Mar 13. doi: 10.1097/j.pain.0000000000001860.

Key clinical points: Galcanezumab significantly reduces monthly headache frequency in patients with migraine and episodic cluster headache; 120 mg is superior to 240 mg for treatment of migraine and 300 mg is effective for episodic cluster headache with no increased risk for adverse events.

Major finding: Subcutaneous injections of galcanezumab 120 mg and 240 mg were associated with a significantly increased 50% response rate vs placebo for the treatment of migraine (120 mg: relative risk [RR], 1.51; 240 mg: RR, 1.58; P less than .001 for both). Galcanezumab 120 mg vs 240 mg had similar efficacy (50% response: RR, 1.06; 75% response: RR, 1.07; 100% response: RR, 1.06; migraine headache days: RR, -0.08) and lower risk for adverse effects (120 mg: RR, 1.06; 240 mg: RR, 1.17). Galcanezumab 300 mg dose was effective in reducing episodic cluster headache (RR, 1.36; P = .048).

Study details: Meta-analysis of 6 randomized controlled trials (n=3,889) evaluating the efficacy and safety of galcanezumab across different doses.

Disclosure: This study was supported by the Suzhou Health Talents Training Project. The authors declared no conflicts of interest.

Citation: Yang Y et al. J Headache Pain. 2020 Feb 11. doi: 10.1186/s10194-020-1085-x.

Key clinical points: Galcanezumab significantly reduces monthly headache frequency in patients with migraine and episodic cluster headache; 120 mg is superior to 240 mg for treatment of migraine and 300 mg is effective for episodic cluster headache with no increased risk for adverse events.

Major finding: Subcutaneous injections of galcanezumab 120 mg and 240 mg were associated with a significantly increased 50% response rate vs placebo for the treatment of migraine (120 mg: relative risk [RR], 1.51; 240 mg: RR, 1.58; P less than .001 for both). Galcanezumab 120 mg vs 240 mg had similar efficacy (50% response: RR, 1.06; 75% response: RR, 1.07; 100% response: RR, 1.06; migraine headache days: RR, -0.08) and lower risk for adverse effects (120 mg: RR, 1.06; 240 mg: RR, 1.17). Galcanezumab 300 mg dose was effective in reducing episodic cluster headache (RR, 1.36; P = .048).

Study details: Meta-analysis of 6 randomized controlled trials (n=3,889) evaluating the efficacy and safety of galcanezumab across different doses.

Disclosure: This study was supported by the Suzhou Health Talents Training Project. The authors declared no conflicts of interest.

Citation: Yang Y et al. J Headache Pain. 2020 Feb 11. doi: 10.1186/s10194-020-1085-x.

Key clinical points: Galcanezumab significantly reduces monthly headache frequency in patients with migraine and episodic cluster headache; 120 mg is superior to 240 mg for treatment of migraine and 300 mg is effective for episodic cluster headache with no increased risk for adverse events.

Major finding: Subcutaneous injections of galcanezumab 120 mg and 240 mg were associated with a significantly increased 50% response rate vs placebo for the treatment of migraine (120 mg: relative risk [RR], 1.51; 240 mg: RR, 1.58; P less than .001 for both). Galcanezumab 120 mg vs 240 mg had similar efficacy (50% response: RR, 1.06; 75% response: RR, 1.07; 100% response: RR, 1.06; migraine headache days: RR, -0.08) and lower risk for adverse effects (120 mg: RR, 1.06; 240 mg: RR, 1.17). Galcanezumab 300 mg dose was effective in reducing episodic cluster headache (RR, 1.36; P = .048).

Study details: Meta-analysis of 6 randomized controlled trials (n=3,889) evaluating the efficacy and safety of galcanezumab across different doses.

Disclosure: This study was supported by the Suzhou Health Talents Training Project. The authors declared no conflicts of interest.

Citation: Yang Y et al. J Headache Pain. 2020 Feb 11. doi: 10.1186/s10194-020-1085-x.

Key clinical point: Ubrogepant as an acute treatment for episodic migraine in adults is associated with an increased rate of achieving freedom from pain and absence of the most bothersome symptoms at 2 hours post-dose.

Major finding: At 2 hours post-dose, ubrogepant vs placebo use was associated with a significantly higher percentage of patients with pain freedom (20.80% vs 12.60%; relative risk [RR], 1.65) and absence of the most bothersome migraine-associated symptoms (37.34% vs 27.58%; RR, 1.35) (P less than .001 for both). No significant difference was observed in treatment-related adverse events within 48 hours or 30 days between the two groups.

Study details: Meta-analysis of 3 randomized clinical trials including 3,326 participants.

Disclosures: This study was supported by the Suzhou Health Talents Training Project. The authors declared no conflicts of interest.

Citation: Yang Y et al. CNS Drugs. 2020 Mar 19. doi: 10.1007/s40263-020-00715-7.

Key clinical point: Ubrogepant as an acute treatment for episodic migraine in adults is associated with an increased rate of achieving freedom from pain and absence of the most bothersome symptoms at 2 hours post-dose.

Major finding: At 2 hours post-dose, ubrogepant vs placebo use was associated with a significantly higher percentage of patients with pain freedom (20.80% vs 12.60%; relative risk [RR], 1.65) and absence of the most bothersome migraine-associated symptoms (37.34% vs 27.58%; RR, 1.35) (P less than .001 for both). No significant difference was observed in treatment-related adverse events within 48 hours or 30 days between the two groups.

Study details: Meta-analysis of 3 randomized clinical trials including 3,326 participants.

Disclosures: This study was supported by the Suzhou Health Talents Training Project. The authors declared no conflicts of interest.

Citation: Yang Y et al. CNS Drugs. 2020 Mar 19. doi: 10.1007/s40263-020-00715-7.

Key clinical point: Ubrogepant as an acute treatment for episodic migraine in adults is associated with an increased rate of achieving freedom from pain and absence of the most bothersome symptoms at 2 hours post-dose.

Major finding: At 2 hours post-dose, ubrogepant vs placebo use was associated with a significantly higher percentage of patients with pain freedom (20.80% vs 12.60%; relative risk [RR], 1.65) and absence of the most bothersome migraine-associated symptoms (37.34% vs 27.58%; RR, 1.35) (P less than .001 for both). No significant difference was observed in treatment-related adverse events within 48 hours or 30 days between the two groups.

Study details: Meta-analysis of 3 randomized clinical trials including 3,326 participants.

Disclosures: This study was supported by the Suzhou Health Talents Training Project. The authors declared no conflicts of interest.

Citation: Yang Y et al. CNS Drugs. 2020 Mar 19. doi: 10.1007/s40263-020-00715-7.

Key clinical points: Migraine and non-migraine headache show no association with all-cause mortality; however, the risk of cardiovascular mortality is higher in women experiencing from migraine with aura.

Major finding: All-cause mortality did not differ among individuals experiencing any migraine (hazard ratio [HR], 0.96; 95% confidence interval, 0.89-1.04) or non-migraine headache (HR, 1.01; 95% confidence interval, 0.93-1.10). Women experiencing migraine with aura had a higher risk of cardiovascular mortality vs. those with no history of migraine or headache (HR, 1.64; 95% confidence interval, 1.06-2.54).

Study details: The data come from an analysis of 27,844 Women’s Health Study participants, (aged ≥ 45 years) who were followed up for a median of 22.7 years.

Disclosures: Tobias Kurth reported receiving honoraria from Novartis and Daiichi-Sankyo for lectures on neuroepidemiology and research methods, from Lilly, Newsenselab, and Total for providing methodological advice, and from The BMJ for editorial services. The Women’s Health Study was funded by grants from the National Institutes of Health.

Citation: Rohmann JL et al. J Headache Pain. 2020 Mar 17. doi: 10.1186/s10194-020-01091-9. 

Key clinical points: Migraine and non-migraine headache show no association with all-cause mortality; however, the risk of cardiovascular mortality is higher in women experiencing from migraine with aura.

Major finding: All-cause mortality did not differ among individuals experiencing any migraine (hazard ratio [HR], 0.96; 95% confidence interval, 0.89-1.04) or non-migraine headache (HR, 1.01; 95% confidence interval, 0.93-1.10). Women experiencing migraine with aura had a higher risk of cardiovascular mortality vs. those with no history of migraine or headache (HR, 1.64; 95% confidence interval, 1.06-2.54).

Study details: The data come from an analysis of 27,844 Women’s Health Study participants, (aged ≥ 45 years) who were followed up for a median of 22.7 years.

Disclosures: Tobias Kurth reported receiving honoraria from Novartis and Daiichi-Sankyo for lectures on neuroepidemiology and research methods, from Lilly, Newsenselab, and Total for providing methodological advice, and from The BMJ for editorial services. The Women’s Health Study was funded by grants from the National Institutes of Health.

Citation: Rohmann JL et al. J Headache Pain. 2020 Mar 17. doi: 10.1186/s10194-020-01091-9. 

Key clinical points: Migraine and non-migraine headache show no association with all-cause mortality; however, the risk of cardiovascular mortality is higher in women experiencing from migraine with aura.

Major finding: All-cause mortality did not differ among individuals experiencing any migraine (hazard ratio [HR], 0.96; 95% confidence interval, 0.89-1.04) or non-migraine headache (HR, 1.01; 95% confidence interval, 0.93-1.10). Women experiencing migraine with aura had a higher risk of cardiovascular mortality vs. those with no history of migraine or headache (HR, 1.64; 95% confidence interval, 1.06-2.54).

Study details: The data come from an analysis of 27,844 Women’s Health Study participants, (aged ≥ 45 years) who were followed up for a median of 22.7 years.

Disclosures: Tobias Kurth reported receiving honoraria from Novartis and Daiichi-Sankyo for lectures on neuroepidemiology and research methods, from Lilly, Newsenselab, and Total for providing methodological advice, and from The BMJ for editorial services. The Women’s Health Study was funded by grants from the National Institutes of Health.

Citation: Rohmann JL et al. J Headache Pain. 2020 Mar 17. doi: 10.1186/s10194-020-01091-9. 

Key clinical point: After 10 years, a high proportion of migraineurs improve. Reduction in headache frequency, medical follow-up, and nonsmoking are independent factors associated with improvement.

Major finding: After 10 years, 48.2% of patients did not receive a medical follow-up for their migraine. Moreover, 47.4% (180/380) of patients had a decrease of 50% or higher in frequency (defined as improvement), which increased the proportion of episodic migraine (73.7% vs. 87.4%). Factors independently associated with improvement included a baseline frequency of greater than 10 headache days/month (odds ratio [OR], 3.04), having a medical follow-up (OR, 2.45), and nonsmoking (OR, 2.13).

Study details: A 10-year longitudinal study included 1,109 patients with migraine who answered an initial survey (380 completed the survey) and compared initial (2008) and final (2018) data, focusing on baseline prognostic factors of improvement (50% or higher frequency reduction) and no improvement (less than 50% frequency reduction).

Disclosures: No study sponsor was identified. The presenting author had no disclosures. Two coauthors received honoraria from pharmaceutical companies. 

Citation: Caronna E et al. Headache. 2020 Feb 18. doi: 10.1111/head.13774. 

Key clinical point: After 10 years, a high proportion of migraineurs improve. Reduction in headache frequency, medical follow-up, and nonsmoking are independent factors associated with improvement.

Major finding: After 10 years, 48.2% of patients did not receive a medical follow-up for their migraine. Moreover, 47.4% (180/380) of patients had a decrease of 50% or higher in frequency (defined as improvement), which increased the proportion of episodic migraine (73.7% vs. 87.4%). Factors independently associated with improvement included a baseline frequency of greater than 10 headache days/month (odds ratio [OR], 3.04), having a medical follow-up (OR, 2.45), and nonsmoking (OR, 2.13).

Study details: A 10-year longitudinal study included 1,109 patients with migraine who answered an initial survey (380 completed the survey) and compared initial (2008) and final (2018) data, focusing on baseline prognostic factors of improvement (50% or higher frequency reduction) and no improvement (less than 50% frequency reduction).

Disclosures: No study sponsor was identified. The presenting author had no disclosures. Two coauthors received honoraria from pharmaceutical companies. 

Citation: Caronna E et al. Headache. 2020 Feb 18. doi: 10.1111/head.13774. 

Key clinical point: After 10 years, a high proportion of migraineurs improve. Reduction in headache frequency, medical follow-up, and nonsmoking are independent factors associated with improvement.

Major finding: After 10 years, 48.2% of patients did not receive a medical follow-up for their migraine. Moreover, 47.4% (180/380) of patients had a decrease of 50% or higher in frequency (defined as improvement), which increased the proportion of episodic migraine (73.7% vs. 87.4%). Factors independently associated with improvement included a baseline frequency of greater than 10 headache days/month (odds ratio [OR], 3.04), having a medical follow-up (OR, 2.45), and nonsmoking (OR, 2.13).

Study details: A 10-year longitudinal study included 1,109 patients with migraine who answered an initial survey (380 completed the survey) and compared initial (2008) and final (2018) data, focusing on baseline prognostic factors of improvement (50% or higher frequency reduction) and no improvement (less than 50% frequency reduction).

Disclosures: No study sponsor was identified. The presenting author had no disclosures. Two coauthors received honoraria from pharmaceutical companies. 

Citation: Caronna E et al. Headache. 2020 Feb 18. doi: 10.1111/head.13774. 

Key clinical point: Calcitonin gene-related peptide-binding monoclonal antibody (CGRP mAb) is an effective and safe preventive treatment for episodic migraine.

Major finding: CGRP mAb therapy was associated with a significant reduction in monthly migraine days (weighted mean difference [WMD], −1.44; P less than .00001) and acute migraine-specific medication days (WMD, −1.28; P less than .00001), with an improvement in 50% responder rate (RR, 1.51; 95% CI,  1.37-1.66) compared with placebo. Adverse events and treatment withdrawal rates did not differ between groups.

Study details: Meta-analysis of 11 randomized controlled trials including 4,402 patients.

Disclosures: This study was supported by the National Natural Science Foundation of China and the Wuhan science and technology plan project. The authors declared no conflicts of interest.

Citation: Deng H et al. BMC Neurol. 2020 Feb 15. doi: 10.1186/s12883-020-01633-3. 

Key clinical point: Calcitonin gene-related peptide-binding monoclonal antibody (CGRP mAb) is an effective and safe preventive treatment for episodic migraine.

Major finding: CGRP mAb therapy was associated with a significant reduction in monthly migraine days (weighted mean difference [WMD], −1.44; P less than .00001) and acute migraine-specific medication days (WMD, −1.28; P less than .00001), with an improvement in 50% responder rate (RR, 1.51; 95% CI,  1.37-1.66) compared with placebo. Adverse events and treatment withdrawal rates did not differ between groups.

Study details: Meta-analysis of 11 randomized controlled trials including 4,402 patients.

Disclosures: This study was supported by the National Natural Science Foundation of China and the Wuhan science and technology plan project. The authors declared no conflicts of interest.

Citation: Deng H et al. BMC Neurol. 2020 Feb 15. doi: 10.1186/s12883-020-01633-3. 

Key clinical point: Calcitonin gene-related peptide-binding monoclonal antibody (CGRP mAb) is an effective and safe preventive treatment for episodic migraine.

Major finding: CGRP mAb therapy was associated with a significant reduction in monthly migraine days (weighted mean difference [WMD], −1.44; P less than .00001) and acute migraine-specific medication days (WMD, −1.28; P less than .00001), with an improvement in 50% responder rate (RR, 1.51; 95% CI,  1.37-1.66) compared with placebo. Adverse events and treatment withdrawal rates did not differ between groups.

Study details: Meta-analysis of 11 randomized controlled trials including 4,402 patients.

Disclosures: This study was supported by the National Natural Science Foundation of China and the Wuhan science and technology plan project. The authors declared no conflicts of interest.

Citation: Deng H et al. BMC Neurol. 2020 Feb 15. doi: 10.1186/s12883-020-01633-3. 

Key clinical point: Long-term treatment with lasmiditan is associated with progressive and clinically meaningful reductions in migraine-related disability, including fewer missed days of work and school.

Major finding: Total scores of Migraine Disability Assessment (MIDAS) scale significantly reduced from baseline to months 3, 6, 9, and 12 for both 100 and 200 mg doses of lasmiditan, with no significant differences between the dose groups. Work and/or school absenteeism and presenteeism, monthly headache days, and mean headache pain intensity improved significantly with lasmiditan for up to 1 year.

Study details: Patients in GLADIATOR trial were randomly assigned to lasmiditan 100 mg (n=974) or 200 mg (n=1063).

Disclosures: The GLADIATOR study was funded by Eli Lilly and Company. The presenting author had received consultant fees, honoraria, and/or research grants from various pharmaceutical companies, including Eli Lilly and Company. Five of the authors were employees and minor stockholders of Eli Lilly and Company and one was an employee of Syneos Health, Inc., under contract to Eli Lilly and Company.

Citation: Lipton RB et al. J Headache Pain. 2020 Feb 24. doi: 10.1186/s10194-020-01088-4. 

Key clinical point: Long-term treatment with lasmiditan is associated with progressive and clinically meaningful reductions in migraine-related disability, including fewer missed days of work and school.

Major finding: Total scores of Migraine Disability Assessment (MIDAS) scale significantly reduced from baseline to months 3, 6, 9, and 12 for both 100 and 200 mg doses of lasmiditan, with no significant differences between the dose groups. Work and/or school absenteeism and presenteeism, monthly headache days, and mean headache pain intensity improved significantly with lasmiditan for up to 1 year.

Study details: Patients in GLADIATOR trial were randomly assigned to lasmiditan 100 mg (n=974) or 200 mg (n=1063).

Disclosures: The GLADIATOR study was funded by Eli Lilly and Company. The presenting author had received consultant fees, honoraria, and/or research grants from various pharmaceutical companies, including Eli Lilly and Company. Five of the authors were employees and minor stockholders of Eli Lilly and Company and one was an employee of Syneos Health, Inc., under contract to Eli Lilly and Company.

Citation: Lipton RB et al. J Headache Pain. 2020 Feb 24. doi: 10.1186/s10194-020-01088-4. 

Key clinical point: Long-term treatment with lasmiditan is associated with progressive and clinically meaningful reductions in migraine-related disability, including fewer missed days of work and school.

Major finding: Total scores of Migraine Disability Assessment (MIDAS) scale significantly reduced from baseline to months 3, 6, 9, and 12 for both 100 and 200 mg doses of lasmiditan, with no significant differences between the dose groups. Work and/or school absenteeism and presenteeism, monthly headache days, and mean headache pain intensity improved significantly with lasmiditan for up to 1 year.

Study details: Patients in GLADIATOR trial were randomly assigned to lasmiditan 100 mg (n=974) or 200 mg (n=1063).

Disclosures: The GLADIATOR study was funded by Eli Lilly and Company. The presenting author had received consultant fees, honoraria, and/or research grants from various pharmaceutical companies, including Eli Lilly and Company. Five of the authors were employees and minor stockholders of Eli Lilly and Company and one was an employee of Syneos Health, Inc., under contract to Eli Lilly and Company.

Citation: Lipton RB et al. J Headache Pain. 2020 Feb 24. doi: 10.1186/s10194-020-01088-4. 

Key clinical point: Increased subcutaneous abdominal fat is independently associated with cutaneous allodynia (CA), a marker of central sensitization in patients with migraine.

Major finding: Migraine patients with CA had a higher proportion of abdominal fat values than patients without CA (P = .04). The use of migraine prophylaxis (odds ratio [OR], 3.26), abdominal fat (OR, 1.13), and sleep disorders (OR, 1.13) were independent risk factors for the development of CA.

Study details: This prospective study investigated the association between CA and percentages of body fat and abdominal fat in 80 patients with migraine and 39 nonmigraine controls.

Disclosures: No study sponsor was identified. Allergan Inc. funded editorial assistance and statistical advice. María Rosario Luquin has received honoraria from TEVA, Zambon, AbbVie, and Bial for activities unrelated to the study. Pablo Irimia has received honoraria from Allergan, Novartis, Lilly, and Teva Pharmaceuticals as a consultant and speaker.

Citation: Mínguez-Olaondo A et al. J Headache Pain. 2020 Feb 4. doi: 10.1186/s10194-020-1082-0. 

Key clinical point: Increased subcutaneous abdominal fat is independently associated with cutaneous allodynia (CA), a marker of central sensitization in patients with migraine.

Major finding: Migraine patients with CA had a higher proportion of abdominal fat values than patients without CA (P = .04). The use of migraine prophylaxis (odds ratio [OR], 3.26), abdominal fat (OR, 1.13), and sleep disorders (OR, 1.13) were independent risk factors for the development of CA.

Study details: This prospective study investigated the association between CA and percentages of body fat and abdominal fat in 80 patients with migraine and 39 nonmigraine controls.

Disclosures: No study sponsor was identified. Allergan Inc. funded editorial assistance and statistical advice. María Rosario Luquin has received honoraria from TEVA, Zambon, AbbVie, and Bial for activities unrelated to the study. Pablo Irimia has received honoraria from Allergan, Novartis, Lilly, and Teva Pharmaceuticals as a consultant and speaker.

Citation: Mínguez-Olaondo A et al. J Headache Pain. 2020 Feb 4. doi: 10.1186/s10194-020-1082-0. 

Key clinical point: Increased subcutaneous abdominal fat is independently associated with cutaneous allodynia (CA), a marker of central sensitization in patients with migraine.

Major finding: Migraine patients with CA had a higher proportion of abdominal fat values than patients without CA (P = .04). The use of migraine prophylaxis (odds ratio [OR], 3.26), abdominal fat (OR, 1.13), and sleep disorders (OR, 1.13) were independent risk factors for the development of CA.

Study details: This prospective study investigated the association between CA and percentages of body fat and abdominal fat in 80 patients with migraine and 39 nonmigraine controls.

Disclosures: No study sponsor was identified. Allergan Inc. funded editorial assistance and statistical advice. María Rosario Luquin has received honoraria from TEVA, Zambon, AbbVie, and Bial for activities unrelated to the study. Pablo Irimia has received honoraria from Allergan, Novartis, Lilly, and Teva Pharmaceuticals as a consultant and speaker.

Citation: Mínguez-Olaondo A et al. J Headache Pain. 2020 Feb 4. doi: 10.1186/s10194-020-1082-0.