Chronic Migraine as a Primary Chronic Pain Syndrome and Recommended Prophylactic Therapeutic Options: A Literature Review

Article Food Science & Technology

OnabotulinumtoxinA Modulates Visual Cortical Excitability in Chronic Migraine: Effects of 12-Week Treatment

Angelo Torrente et al.

Summary: This study found that multisensory integration is modified in chronic migraine, and onabotulinumtoxinA is effective in preventing chronic migraine and restoring multisensory processing.

TOXINS (2023)

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Article Medicine, General & Internal

Neuropsychological and Neuropsychiatric Features of Chronic Migraine Patients during the Interictal Phase

Elena Lozano-Soto et al.

Summary: This study aimed to examine the presence of neuropsychological deficits in chronic migraine patients during a headache-free period and their relationship with clinical, pharmacological, and neuropsychiatric characteristics. The study found that more than half of the patients exhibited some degree of neuropsychological impairment, which may increase disability related to migraine and have a negative impact on quality of life and treatment adherence.

JOURNAL OF CLINICAL MEDICINE (2023)

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Review Clinical Neurology

Effectiveness and Safety of Chronic Migraine Preventive Treatments: A Systematic Literature Review

Andrew M. Blumenfeld et al.

Summary: This systematic review assesses the real-world evidence on the effectiveness and safety of preventive treatments for chronic migraine in adults. The study finds substantial evidence supporting the long-term effectiveness and safety of onabotulinumtoxinA, while data on other preventive treatments are currently limited and mainly short-term.

PAIN AND THERAPY (2023)

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Article Medicine, General & Internal

Assessment of the relative effectiveness of erenumab compared with onabotulinumtoxinA for the prevention of chronic migraine

Ronan Mahon et al.

Summary: By conducting indirect treatment comparisons, this study found potential benefits of erenumab compared to onabotulinumtoxinA for the preventive treatment of chronic migraine, although the results did not reach the threshold of statistical significance. These findings can inform healthcare stakeholders in treatment selection and optimization for patients with chronic migraine.

CURRENT MEDICAL RESEARCH AND OPINION (2023)

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Review Neurosciences

CGRP and CGRP-Receptor as Targets of Migraine Therapy: Brain Prize-2021

Janos Tajti et al.

Summary: This review summarizes the significant breakthroughs in migraine research made by headache scientists in the past 40 years, including the pathogenesis and treatment options for migraine. The theory of the trigeminovascular system has played a crucial role in this field, and the calcitonin gene-related peptide has become an important target for the treatment of migraine. The related studies have provided a solid foundation and treatment strategies in both preclinical and clinical settings.

CNS & NEUROLOGICAL DISORDERS-DRUG TARGETS (2022)

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Article Clinical Neurology

Long-Term Effectiveness of Three Anti-CGRP Monoclonal Antibodies in Resistant Chronic Migraine Patients Based on the MIDAS score

Luigi Francesco Iannone et al.

Summary: This study evaluated the effectiveness and safety of three monoclonal antibodies against the calcitonin gene-related peptide pathway (erenumab, galcanezumab, and fremanezumab) in patients with resistant chronic migraine. The results showed that all three anti-CGRP mAbs were effective and safe, with a high percentage of patients achieving a ≥ 50% reduction in Migraine Disability Assessment (MIDAS) score.

CNS DRUGS (2022)

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Article Clinical Neurology

Predictors of sustained response and effects of the discontinuation of anti-calcitonin gene related peptide antibodies and reinitiation in resistant chronic migraine

Luigi Francesco Iannone et al.

Summary: This study evaluated the effects of discontinuation and retreatment of anti-CGRP mAbs in resistant chronic migraine patients and found that most patients experienced worsening of symptoms during the 3-month discontinuation period, which was rapidly resolved by retreatment. However, a quarter of patients showed sustained benefit during discontinuation and did not require retreatment.

EUROPEAN JOURNAL OF NEUROLOGY (2022)

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Article Clinical Neurology

Does wearing off of efficacy occur in galcanezumab-treated patients at the end of the monthly treatment cycle? Post hoc analyses of four phase III randomized trials

Jessica Ailani et al.

Summary: The study aims to determine if migraine patients experience a decrease in the efficacy of galcanezumab at the end of a treatment cycle. The results showed that there were no significant differences in the percentage of patients experiencing wearing off between galcanezumab and placebo treatment groups at the individual patient-level.

HEADACHE (2022)

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Article Clinical Neurology

Early response to eptinezumab indicates high likelihood of continued response in patients with chronic migraine

Dawn C. Buse et al.

Summary: This study analyzed the consistency and predictive power of treatment response in the first month on later response in patients with chronic migraine. The results showed that more patients in the eptinezumab-treated group achieved a high level of response compared to the placebo group, and a significant proportion of early responders maintained a high level of response for the entire treatment period.

JOURNAL OF HEADACHE AND PAIN (2022)

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Article Clinical Neurology

Chronic migraine evolution after 3 months from erenumab suspension: real-world-evidence-life data

Simona Guerzoni et al.

Summary: Patients affected by CM and MOH showed a significant worsening of headaches in terms of increased migraine days per month, higher painkiller consumption, and greater migraine-related disability after discontinuing erenumab. Factors such as high body mass index and presence of aura were positively correlated with the relapse of CM and MOH.

NEUROLOGICAL SCIENCES (2022)

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Article Clinical Neurology

Real-World Evidence for the Safety and Efficacy of CGRP Monoclonal Antibody Therapy Added to OnabotulinumtoxinA Treatment for Migraine Prevention in Adult Patients With Chronic Migraine

Laszlo Mechtler et al.

Summary: This study aimed to assess the safety and effectiveness of combining onabotulinumtoxinA with CGRP mAbs for the preventive treatment of chronic migraine. The results showed that the combination treatment was effective in reducing monthly headache days and was safe and well-tolerated. Lack of insurance coverage was the most common reason for discontinuation of the treatment.

FRONTIERS IN NEUROLOGY (2022)

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Article Medicine, General & Internal

Migraine

Michel D. Ferrari et al.

Summary: This paper summarizes the epidemiology, pathophysiology, diagnosis and treatment of migraine, and discusses quality of life issues faced by patients with migraine and future research avenues. It provides an overview of the etiology of migraine, various treatment options, and the emergence of new treatment targets and therapies.

NATURE REVIEWS DISEASE PRIMERS (2022)

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Article Clinical Neurology

Eptinezumab for migraine prevention in patients 50 years or older

Vincent Martin et al.

Summary: This study evaluated the efficacy and safety of eptinezumab in patients aged 50 and above with episodic or chronic migraine. The results showed that eptinezumab significantly reduced the number of migraine days and had a good safety profile.

ACTA NEUROLOGICA SCANDINAVICA (2022)

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Article Clinical Neurology

Safety and tolerability of fremanezumab in patients with episodic and chronic migraine: a pooled analysis of phase 3 studies

Hans Christoph Diener et al.

Summary: Fremanezumab demonstrated a favorable overall and cardio- and cerebrovascular safety profile in more than 2800 patients with episodic migraine or chronic migraine, regardless of cardio- and cerebrovascular medical history, CVRFs, or medication use.

CEPHALALGIA (2022)

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Article Clinical Neurology

Efficacy and safety of eptinezumab in patients with migraine and self-reported aura: Post hoc analysis of PROMISE-1 and PROMISE-2

Messoud Ashina et al.

Summary: This subgroup analysis evaluated the efficacy and safety of eptinezumab for migraine prevention in patients with self-reported aura. The results showed that eptinezumab had comparable preventive efficacy for both episodic and chronic migraine patients with aura, with a similarly favorable safety and tolerability profile as the overall study populations.

CEPHALALGIA (2022)

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Article Clinical Neurology

Reduction in migraine-associated burden after eptinezumab treatment in patients with chronic migraine

Peter McAllister et al.

Summary: This study aimed to investigate the changes in occurrence, severity, and symptoms of headache episodes in patients with chronic migraine following eptinezumab treatment. The results showed that patients treated with eptinezumab experienced a significant reduction in monthly headache days and episodes compared to placebo. The proportion of migraine attacks among headache episodes also decreased, indicating a decrease in headache severity after eptinezumab treatment.

CEPHALALGIA (2022)

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Article Medicine, General & Internal

Long-term treatment with galcanezumab in patients with chronic migraine: results from the open-label extension of the REGAIN study

Patricia Pozo-Rosich et al.

Summary: Galcanezumab showed safety, effectiveness, and good tolerability in the preventive treatment of chronic migraine, with high adherence, for up to 12 months.

CURRENT MEDICAL RESEARCH AND OPINION (2022)

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Article Clinical Neurology

Evaluating the clinical utility of the patient-identified most bothersome symptom measure from PROMISE-2 for research in migraine prevention

Richard B. Lipton et al.

Summary: This study assessed the utility of patient-identified most bothersome symptom (PI-MBS) measure in the preventive treatment of chronic migraine. It found that improvement in PI-MBS was associated with improvement in other patient-reported outcome measures.

HEADACHE (2022)

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Article Clinical Neurology

Measuring dose-related efficacy of eptinezumab for migraine prevention: post hoc analysis of PROMISE-1 and PROMISE-2

Rami Apelian et al.

Summary: In the PROMISE-1 and PROMISE-2 studies, there were no meaningful differences in the likelihood of achieving >= 50% migraine responder rate between the eptinezumab dose levels in the majority of patient subgroups. However, small but potentially meaningful differences were observed in a few subgroups.

JOURNAL OF HEADACHE AND PAIN (2022)

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Article Clinical Neurology

Real-world long-term efficacy and safety of erenumab in adults with chronic migraine: a 52-week, single-center, prospective, observational study

Christopher Kjaer Cullum et al.

Summary: This study assessed the real-world efficacy and safety of erenumab in patients with chronic migraine. The results showed that erenumab was effective and well-tolerated in reducing the frequency of migraine attacks in patients with chronic migraine.

JOURNAL OF HEADACHE AND PAIN (2022)

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Article Clinical Neurology

Real-world effectiveness after initiating fremanezumab treatment in US patients with episodic and chronic migraine or difficult-to-treat migraine

Maurice T. Driessen et al.

Summary: This study assessed the effectiveness of fremanezumab for different types of migraines in a real-world clinical setting. The results showed that fremanezumab is effective for the treatment of migraines regardless of the type or other contributing factors.

JOURNAL OF HEADACHE AND PAIN (2022)

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Article Clinical Neurology

Fremanezumab in the prevention of high-frequency episodic and chronic migraine: a 12-week, multicenter, real-life, cohort study (the FRIEND study)

Piero Barbanti et al.

Summary: This study investigated the effectiveness, safety, and tolerability of fremanezumab in a real-life population of high-frequency episodic or chronic migraine patients. The results showed that fremanezumab was effective in reducing migraine days, headache days, analgesic intake, and improving quality of life in both types of migraine. Younger age emerged as a potential predictor for positive treatment response.

JOURNAL OF HEADACHE AND PAIN (2022)

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Review Anesthesiology

Different routes of administration in chronic migraine prevention lead to different placebo responses: a meta-analysis

Diego Belandrino Swerts et al.

Summary: Placebo response is a significant determinant of health outcomes in various disorders. This study examines how different administration routes affect the placebo response in chronic migraine patients. The results show that head injection has the strongest placebo response, while oral and subcutaneous administration have lower effects.

PAIN (2022)

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Article Economics

Annual indirect cost savings in patients with episodic or chronic migraine: post-hoc analyses from multiple galcanezumab clinical trials

Joshua Tobin et al.

Summary: Galcanezumab (GMB) treatment resulted in annual indirect cost savings in patients with episodic migraine (EM) or chronic migraine (CM).

JOURNAL OF MEDICAL ECONOMICS (2022)

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Article Clinical Neurology

Two-year effectiveness of erenumab in resistant chronic migraine: a prospective real-world analysis

Anna P. Andreou et al.

Summary: This study analyzed the long-term sustained effectiveness of erenumab in treating resistant chronic migraine. The findings revealed that only a minority of patients maintained good efficacy over a period of two years. However, erenumab can still provide relief in terms of reducing migraine load and related disability in some patients.

JOURNAL OF HEADACHE AND PAIN (2022)

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Review Clinical Neurology

Greater occipital nerve block for chronic migraine patients: A meta-analysis

Victor Velasquez-Rimachi et al.

Summary: This study aimed to evaluate the efficacy of greater occipital nerve block in patients with chronic migraine. Results showed that GONB combined with local anesthetics could reduce headache frequency and intensity, while adding corticosteroids did not provide additional benefits. Adverse event rates were similar, but due to the low quality of evidence, further large-scale studies are needed to confirm the results.

ACTA NEUROLOGICA SCANDINAVICA (2022)

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Article Clinical Neurology

Long-term reductions in disease impact in patients with chronic migraine following preventive treatment with eptinezumab

Andrew Blumenfeld et al.

Summary: Long-term treatment with eptinezumab in patients with chronic migraine resulted in sustained reductions in disability as evaluated by MIDAS, consistent with the sustained reductions in headache frequency and pain severity.

BMC NEUROLOGY (2022)

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Article Clinical Neurology

Effectiveness of anti-CGRP monoclonal antibodies on central symptoms of migraine

Luigi Francesco Iannone et al.

Summary: Anti-calcitonin gene-related peptide antibodies appear to have a significant impact on the prodromal and accompanying symptoms of migraine, reducing the frequency and intensity of migraine attacks.

CEPHALALGIA (2022)

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Review Pharmacology & Pharmacy

Efficacy and safety of eptinezumab as preventive treatment for episodic/chronic migraine: A systematic review and meta-analysis

Yusak Mangara Tua Siahaan et al.

Summary: This study analyzed the efficacy and safety of eptinezumab, a CGRP-monoclonal antibody, as a preventive treatment for episodic/chronic migraine. The results showed that eptinezumab was effective in reducing monthly migraine days and improving migraine responder rate, with comparable safety to placebo.

CLINICAL AND EXPERIMENTAL PHARMACOLOGY AND PHYSIOLOGY (2022)

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Review Clinical Neurology

European Headache Federation guideline on the use of monoclonal antibodies targeting the calcitonin gene related peptide pathway for migraine prevention-2022 update

Simona Sacco et al.

Summary: This guideline evaluated the effectiveness and safety of monoclonal antibodies targeting the CGRP pathway for migraine prevention through systematic review and literature analysis, and provided updated treatment recommendations.

JOURNAL OF HEADACHE AND PAIN (2022)

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Article Clinical Neurology

Single-Pulse Transcranial Magnetic Stimulation for the preventive treatment of difficult-to-treat migraine: a 12-month prospective analysis

J. O. Lloyd et al.

Summary: This open label analysis suggests that sTMS may be an effective and well-tolerated treatment option for long-term prevention of difficult-to-treat migraines.

JOURNAL OF HEADACHE AND PAIN (2022)

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Article Clinical Neurology

Conversion from chronic to episodic migraine in patients treated with galcanezumab in real life in Italy: the 12-month observational, longitudinal, cohort multicenter GARLIT experience

Claudia Altamura et al.

Summary: The study found that more than half of patients with chronic migraine who received galcanezumab treatment in real-life settings persistently converted to episodic migraine during a one-year period.

JOURNAL OF NEUROLOGY (2022)

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Article Clinical Neurology

Safety and efficacy of eptinezumab for migraine prevention in patients with two-to-four previous preventive treatment failures (DELIVER): a multi-arm, randomised, double-blind, placebo-controlled, phase 3b trial

Messoud Ashina et al.

Summary: This study investigated the safety and efficacy of eptinezumab for patients with migraine and two-to-four previous preventive treatment failures, showing significant migraine preventive effects compared to placebo.

LANCET NEUROLOGY (2022)

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Article Clinical Neurology

Effects on pain and cognition of transcranial direct current stimulation over the dorsolateral prefrontal cortex in women with chronic migraine

Renata Emanuela Lyra de Brito Aranha et al.

Summary: This study compared the effects of different frequencies of transcranial direct current stimulation on chronic migraine patients and found that a once-daily session can significantly decrease migraine-related disability, while a twice-daily session did not show better results.

NEUROPHYSIOLOGIE CLINIQUE-CLINICAL NEUROPHYSIOLOGY (2022)

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Article Food Science & Technology

Pooled Analysis of Real-World Evidence Supports Anti-CGRP mAbs and OnabotulinumtoxinA Combined Trial in Chronic Migraine

Damiana Scuteri et al.

Summary: The combination therapy of anti-CGRP mAbs and onabotulinumtoxinA in chronic migraine shows promising results, with up to 58.8% of patients experiencing a reduction of >= 50% in monthly headache days. Compared to anti-CGRP mAbs and onabotulinumtoxinA alone, the combination therapy leads to a greater decrease in headache days, suggesting its potential efficacy. However, more well-designed studies are needed to further confirm the effectiveness and safety of this combination therapy. PROSPERO registration: CRD42022313640.

TOXINS (2022)

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Article Behavioral Sciences

Real-world evidence following a mandatory treatment break after a 1-year prophylactic treatment with calcitonin gene-related peptide (pathway) monoclonal antibodies

Michael Nsaka et al.

Summary: The study found that a mandatory break in CGRP (pathway) monoclonal antibody therapy had a negative short-term impact on migraine patients, leading to an increase in the number of migraine days and the use of acute medications.

BRAIN AND BEHAVIOR (2022)

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Article Economics

Reductions in acute medication use and healthcare resource utilization in patients with chronic migraine: a secondary analysis of a phase 3, randomized, double-blind, placebo-controlled study of galcanezumab with open-label extension (REGAIN)

Joshua A. Tobin et al.

Summary: Treatment with galcanezumab showed significant reductions in medication overuse and migraine days, with noticeable decreases in migraine-specific healthcare resource utilization for chronic migraine patients.

JOURNAL OF MEDICAL ECONOMICS (2022)

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Review Clinical Neurology

Effectiveness of onabotulinumtoxinA (BOTOX (R)) for the preventive treatment of chronic migraine: A meta-analysis on 10 years of real-world data

Michel Lanteri-Minet et al.

Summary: This meta-analysis evaluated the real-world effectiveness of BOTOX (R) in the preventive treatment of chronic migraine. The study found significant improvements in headache days, acute headache pain medication intake, Headache Impact Test-6 score, and Migraine-Specific Quality-of-Life score at 24 and 52 weeks with onabotulinumtoxinA. The analysis also highlighted the durability of onabotulinumtoxinA effectiveness in chronic migraine preventive treatment.

CEPHALALGIA (2022)

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Review Clinical Neurology

Pathophysiology of Chronic Migraine: Insights from Recent Neuroimaging Research

Yu-Kai Lin et al.

Summary: This narrative review summarizes neuroimaging studies to better understand the pathophysiology of chronic migraine (CM). The studies reveal abnormal energy metabolism and metabolic changes in CM patients, dysfunction in the thalamocortical pathway, and possible involvement of hypothalamic activity. There is ongoing debate whether the functional and structural alterations in brain regions cause migraine chronification or are a consequence of repeated attacks.

CURRENT PAIN AND HEADACHE REPORTS (2022)

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Review Clinical Neurology

A systematic review of economic evaluations of pharmacological treatments for adults with chronic migraine

Saval Khanal et al.

Summary: This study conducted an economic evaluation of pharmacological treatments for chronic migraine in adults and found that both Botox and Erenumab are cost-effective options. Although Erenumab had more incremental economic benefits compared to Botox, its cost-effectiveness ratios were above the most common willingness-to-pay thresholds.

JOURNAL OF HEADACHE AND PAIN (2022)

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Article Clinical Neurology

Quantity changes in acute headache medication use among patients with chronic migraine treated with eptinezumab: subanalysis of the PROMISE-2 study

Robert P. Cowan et al.

Summary: This post hoc analysis examines the relationship between headache frequency reductions and changes in acute headache medication (AHM) use in chronic migraine patients treated with eptinezumab. The results show that eptinezumab use is associated with greater decreases in days with headache and AHM use, especially triptan use, in patients with chronic migraine and medication-overuse headache (MOH).

JOURNAL OF HEADACHE AND PAIN (2022)

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Article Clinical Neurology

Predictors of response to anti-CGRP monoclonal antibodies: a 24-week, multicenter, prospective study on 864 migraine patients

Piero Barbanti et al.

Summary: This study investigates the predictors of response to antiCGRP mAbs in patients with high-frequency episodic migraine (HFEM) and chronic migraine (CM). The results show that in HFEM, unilateral pain + unilateral cranial autonomic symptoms are positively associated with >= 50% response. In CM, allodynia + unilateral pain, unilateral cranial autonomic symptoms are positively associated with >= 50% response, while obesity is negatively associated with >= 50% response. This study is important for predicting the response of migraine patients to antiCGRP mAbs.

JOURNAL OF HEADACHE AND PAIN (2022)

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Article Clinical Neurology

Safety and tolerability of erenumab in individuals with episodic or chronic migraine across age groups: a pooled analysis of placebo-controlled trials

Christian Lampl et al.

Summary: This pooled analysis examined the safety of erenumab in different age groups, particularly in older populations. The results showed that erenumab exhibited a similar safety profile compared with placebo in individuals with episodic or chronic migraine, and it was well tolerated in older participants.

JOURNAL OF HEADACHE AND PAIN (2022)

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Article Clinical Neurology

Impact of fremanezumab on disability outcomes in patients with episodic and chronic migraine: a pooled analysis of phase 3 studies

Peter McAllister et al.

Summary: This pooled analysis showed that fremanezumab can clinically reduce the severity of migraine-related disability. The study demonstrated significant improvements in disability outcomes for patients with different levels of baseline severity.

JOURNAL OF HEADACHE AND PAIN (2022)

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Review Medicine, General & Internal

Management of chronic migraine

Alexandra Hovaguimian et al.

Summary: This article provides an overview of the epidemiology, diagnostic criteria, and risk factors of chronic migraine. It discusses the evidence-based drug and non-drug treatments, as well as the principles of patient-centered care. It evaluates international guidelines on drug treatment and explores non-drug treatments, and also covers the management of chronic migraine in special populations and future research in the field.

BMJ-BRITISH MEDICAL JOURNAL (2022)

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Article Environmental Sciences

A Preliminary Analysis on the Feasibility and Short-Term Efficacy of a Phase-III RCT on Mindfulness Added to Treatment as Usual for Patients with Chronic Migraine and Medication Overuse Headache

Licia Grazzi et al.

Summary: This preliminary analysis compares the feasibility and short-term efficacy of mindfulness as an add-on to treatment for chronic migraine and medication overuse headache. The results suggest that adding mindfulness therapy to the usual treatment leads to better outcomes in terms of headache frequency and medication intake.

INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH (2022)

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Review Food Science & Technology

Botulinum Toxin-A Current Place in the Treatment of Chronic Migraine and Other Primary Headaches

Katarzyna Kepczynska et al.

Summary: This article presents the common types of headaches and the effects of botulinum toxin in their treatment. Tension-type headache and migraine are the most common types of headaches, and botulinum toxin has shown significant benefits in treating chronic headaches. However, there is still a lack of evidence for its use in other types of headaches.

TOXINS (2022)

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Review Medicine, Research & Experimental

Treatment of resistant chronic migraine with anti-CGRP monoclonal antibodies: a systematic review

Hugo Sevivas et al.

Summary: This systematic review examines the effectiveness and safety of anti-calcitonin gene-related peptide (CGRP) monoclonal antibodies (mAb) in treating resistant chronic migraine. The findings suggest that anti-CGRP mAb demonstrate effectiveness in reducing monthly migraine days, acute medication use, and improving quality of life. There were no significant differences in adverse events between the anti-CGRP mAb and placebo groups.

EUROPEAN JOURNAL OF MEDICAL RESEARCH (2022)

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Article Clinical Neurology

Neuronavigation based 10 sessions of repetitive transcranial magnetic stimulation therapy in chronic migraine: an exploratory study

Anant Kumar et al.

Summary: In this study, fMRI-guided neuronavigation was used to target the left motor cortex, and significant reduction in pain ratings, headache frequency, and MIDAS questionnaire were observed in the real rTMS group, with effects maintained at one-month follow-up. Further studies are needed to confirm the long-term pain relief potential of fMRI-based rTMS over the left motor cortex in chronic migraine patients.

NEUROLOGICAL SCIENCES (2021)

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Review Clinical Neurology

Nerivio(R) remote electrical neuromodulation for acute treatment of chronic migraine

Hida Nierenburg et al.

Summary: Nerivio is a wearable Bluetooth device controlled by a smartphone app, approved by the US FDA for treating migraine in individuals aged 12 and older. Clinical trials and real-world studies have demonstrated the safety, tolerability, and efficacy of Nerivio as a nonmedication option for migraine treatment.

PAIN MANAGEMENT (2021)

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Article Clinical Neurology

Efficacy, tolerability, and safety of eptinezumab in patients with a dual diagnosis of chronic migraine and medication-overuse headache: Subgroup analysis of PROMISE-2

Hans-Christoph Diener et al.

Summary: The study evaluated the efficacy and tolerability of Eptinezumab in patients with dual diagnosis of CM and MOH, showing that Eptinezumab treatment led to greater reductions in monthly migraine days, higher responder rates, and fewer patients meeting CM and MOH criteria.

HEADACHE (2021)

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Review Clinical Neurology

Efficacy and safety of anti-calcitonin gene-related peptide monoclonal antibodies for treatment of chronic migraine: A systematic review and network meta-analysis

Prashant Soni et al.

Summary: This systematic review and network meta-analysis examined the effects of anti-calcitonin gene related peptide monoclonal antibodies on adult patients with chronic migraine. The results indicated that high doses of subcutaneous fremanezumab and intravenous eptinezumab showed numerical advantages in reducing migraine days. Additionally, anti-CGRP mAbs were found to have comparable safety and immunogenicity, with no significant differences observed.

CLINICAL NEUROLOGY AND NEUROSURGERY (2021)

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Article Clinical Neurology

Improvements in pain, medication use and quality of life in onabotulinumtoxinA-resistant chronic migraine patients following erenumab treatment - real world outcomes

J. Talbot et al.

Summary: This study presented the outcomes of erenumab treatment in chronic migraine patients who had previously shown unsatisfactory response to onabotulinumtoxinA. The results showed significant improvements in pain, medication use, and quality of life over the 9-month treatment period.

JOURNAL OF HEADACHE AND PAIN (2021)

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Article Clinical Neurology

Preventive migraine treatment with eptinezumab reduced acute headache medication and headache frequency to below diagnostic thresholds in patients with chronic migraine and medication-overuse headache

Michael J. Marmura et al.

Summary: In patients with chronic migraine and medication-overuse headache treated with eptinezumab in the PROMISE-2 study, there was a significant reduction in the use of acute headache medication and a substantial proportion of patients did not meet diagnostic thresholds for either CM or MOH throughout the entire treatment period.

HEADACHE (2021)

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Review Pharmacology & Pharmacy

Identifying New Antimigraine Targets: Lessons from Molecular Biology

Lars Edvinsson et al.

Summary: Primary headaches, with migraines being the most common type, are believed to be influenced by a mismatch in the trigeminovascular system, resulting in sensitization and the release of CGRP. The research focuses on how to modify this system for future treatments by understanding the distribution and expression of neuropeptides and ion channels.

TRENDS IN PHARMACOLOGICAL SCIENCES (2021)

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Article Clinical Neurology

Efficacy and safety of fremanezumab in clinical trial participants aged ≥60 years with episodic or chronic migraine: pooled results from 3 randomized, double-blind, placebo-controlled phase 3 studies

Stephanie J. Nahas et al.

Summary: This study evaluated the efficacy, safety, and tolerability of fremanezumab in patients aged >= 60 years with migraine, showing significant reductions in monthly migraine days over 12 weeks and improvements in quality of life, with low rates of adverse events.

JOURNAL OF HEADACHE AND PAIN (2021)

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Article Clinical Neurology

Comparative Effectiveness and Tolerability of the Pharmacology of Monoclonal Antibodies Targeting the Calcitonin Gene-Related Peptide and Its Receptor for the Prevention of Chronic Migraine: a Network Meta-analysis of Randomized Controlled Trials

Chun-Pai Yang et al.

Summary: This study aimed to compare the efficacy and acceptability of CGRP mAbs with onabotulinumtoxinA or topiramate for chronic migraine. Results showed that a single 300 mg dose of eptinezumab was most effective in improving monthly migraine days, while a regimen of 675 mg fremanezumab in the first month followed by 225 mg showed the highest response rate.

NEUROTHERAPEUTICS (2021)

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Article Clinical Neurology

Long-term safety and tolerability of eptinezumab in patients with chronic migraine: a 2-year, open-label, phase 3 trial

David Kudrow et al.

Summary: In the PREVAIL study, eptinezumab demonstrated a favorable safety profile and improvements in patient-reported outcomes over 2 years in adults with chronic migraine. The study also showed limited long-term immunogenicity of eptinezumab.

BMC NEUROLOGY (2021)

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Article Clinical Neurology

Efficacy of erenumab in chronic migraine patients with and without ictal allodynia

Richard B. Lipton et al.

Summary: The study showed that erenumab was effective in reducing monthly migraine days and acute migraine-specific medication days for patients with chronic migraine, regardless of the presence of moderate-severe ictal allodynia. Both groups with no allodynia and moderate-severe allodynia benefited significantly from erenumab treatment in terms of migraine reduction.

CEPHALALGIA (2021)

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Article Clinical Neurology

Barriers to care in episodic and chronic migraine: Results from the Chronic Migraine Epidemiology and Outcomes Study

Dawn C. Buse et al.

Summary: This study assessed the rates and factors associated with barriers to good medical outcomes and pharmacologic care in individuals with migraine, finding that many patients did not successfully traverse these barriers. Efforts should focus on increasing consultation and diagnosis rates, improving the delivery of appropriate treatments, and avoiding medication overuse.

HEADACHE (2021)

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Article Clinical Neurology

Effects of fremanezumab in patients with chronic migraine and comorbid depression: Subgroup analysis of the randomized HALO CM study

Richard B. Lipton et al.

Summary: The study showed that Fremanezumab was effective in reducing the impact of headaches in patients with chronic migraine, especially those with comorbid depression.

HEADACHE (2021)

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Review Clinical Neurology

CGRP-antibodies, topiramate and botulinum toxin type A in episodic and chronic migraine: A systematic review and meta-analysis

Florian Frank et al.

Summary: The approval of monoclonal antibodies for the prevention of migraine has revolutionized treatment for patients, although oral preventative medications are still considered first-line treatments. This study aimed to compare the efficacy of three commonly prescribed migraine preventative medication classes, finding that topiramate, botulinum toxin type A, and monoclonal antibodies had higher odds ratios in achieving a 50% response rate compared to placebo. Topiramate had the greatest effect size but also the highest drop-out rate among the three.

CEPHALALGIA (2021)

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Article Clinical Neurology

Improvements in quality of life and work productivity with up to 6 months of fremanezumab treatment in patients with episodic and chronic migraine and documented inadequate response to 2 to 4 classes of migraine-preventive medications in the phase 3b FOCUS study

Egilius L. H. Spierings et al.

Summary: The study assessed the patient-reported outcomes (PROs) in terms of quality of life, depression, and work productivity during the treatment with fremanezumab in patients with migraine, showing progressive improvements in these aspects over a 6-month period.

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Article Clinical Neurology

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L. Edvinsson

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Summary: Erenumab, the first human monoclonal antibody approved for migraine prophylaxis in adults, has shown significant efficacy in improving the quality of life for Cypriot migraine patients. Patients experienced improvements in mental well-being, anxiety, depression levels, and almost all assessed migraine parameters after receiving erenumab treatment.

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BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE (2011)

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Cost of Health Care Among Patients With Chronic and Episodic Migraine in Canada and the USA: Results From the International Burden of Migraine Study (IBMS)

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OnabotulinumtoxinA for treatment of chronic migraine: Results from the double-blind, randomized, placebo-controlled phase of the PREEMPT 2 trial

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OnabotulinumtoxinA for Treatment of Chronic Migraine: Pooled Results From the Double-Blind, Randomized, Placebo-Controlled Phases of the PREEMPT Clinical Program

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Sociodemographic and comorbidity profiles of chronic migraine and episodic migraine sufferers

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