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Migraine - Europe PMC

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Last Updated: 22 June 2022

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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.

Background The monoclonal antibody eptinezumab, which targets calcitonin gene-related peptide, has shown migraine avoidance starting the day after infusion and safe and tolerability in phase 3 studies, but not explored were the effects in patients with previous preventive treatment failures. Efficacy and effectiveness of eptinezumab for migraine relief in adults with migraine and two-to-four previous preventive treatment failures was investigated. From 96 research centers throughout Europe and the United States, We recruited adults with episodic or chronic migraine with at least four monthly migraine days and documented evidence of two-to-four failed prevention efforts within the last ten years. With eptinezumab 300 mg, -5u00b73 and a 0. 05 percent placebo, and -278 with placebo, the change from baseline to weeks 1-12 in mean monthly migraine days was -4u00b78. With eptinezumab 100 mg and eptinezumab 300 mg, the difference was significant from placebo in change in mean monthly migraine days from baseline. In 120 of 294 patients in the eptinezumab 300 mg group, 12 of 299 in the treatment-emergent adverse events occurred in 127 of 299 patients in the eptinezumab 300 mg group, and in 119 of 298 in the placebo group. Interpretation Themezumab drug was found to have significant migraine prevention in adults with migraine and two-to-four previous preventive treatment failures, as well as general safety and tolerability, suggesting that eptinezumab may be a safe treatment option for this patient population.

Source link: https://europepmc.org/article/MED/35716692


Lidocaine infusions for refractory chronic migraine: a retrospective analysis.

Introduction Patients with chronic migraine (refractory chronic migraine) have a low quality of life. Lidocaine infusions may be safe, but studies are lacking. Methods of study The results of 832 hospital admissions involving continuous multiday lidocaine infusions for migraine were reviewed. All patients met the criteria for refractory chronic migraine. Change in headache pain from baseline to hospital discharge was the key result. The post-discharge office visit revealed headache pain and the number of headache days, as well as the percentage of persistent responders. In total, 609 patient admissions met the criteria. At the time of hospitalization, the median pain rating fell from 7. 0 to 1. 0, with 87 percent of patients being acute responders. At the office visit 1, average pain stayed below baseline. At the post-discharge office visit, the headache days decreased from 23. 8 percent at baseline to 22. 5. 3 at baseline. In refractory persistent migraine, Lidocaine infusions may be related to short-term and medium-term pain relief.

Source link: https://europepmc.org/article/MED/35609890


Disparities in the emergency department management of pediatric migraine by race, ethnicity, and language preference.

According to their racial and ethnic origins, pain management for children presenting to the emergency department differs. It's not known if differences in the care of pediatric migraines are related to race, ethnicity, and care jargon. By REaL, we analyzed treatment methods and outcomes in our ED for acute migraine in pediatric patients. Patients who were Asian, Black, African American, and Hispanic, and Hispanic, had a much lower chance of receiving IV therapy, compared to those who were nHW and preferred English, although patients who were indigent or native English had a higher chance of receiving IV therapy. Patients with migraine who were Black, Asian, and Hispanic, or had a LOE, had a decreased chance of receiving IV therapies, but IV patients with nHW were more likely to receive IV medications, despite similar initial pain scores.

Source link: https://europepmc.org/article/MED/35726699


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

Introduction Greater occipital nerve block is a minimally invasive procedure commonly used in patients with persistent migraine; however, the quality of the evidence proving its use is currently uncertain. At a onetime point, the key findings used to determine effectiveness were the change from baseline in the frequency and frequency of headaches in the intervention group relative to placebo at a one-time point. Random effect models was used to perform a meta-analysis, and we analyzed random errors with trial sequential analysis. The severity of headaches at the end of the first month and the second month, as well as the frequency of headaches, was reduced by GONB. During the first month of therapy, Corcorosteroids did not show a significant decrease in the frequency of headaches. Conclusion The limited information available shows that GONB with local anaesthetics may reduce headache frequency and intensity compared to placebo, while adding corticosteroids did not bring additional benefits.

Source link: https://europepmc.org/article/MED/35726455


Machine-learning based approach to predict CGRP response in patients with migraine: multicenter Spanish study.

Among migraine patients, migraine patients' reaction to anti-CGRP receptor or ligand therapies can be predicted by machine learning based methods. Methods We conducted a multicenter review of a prospectively collected cohort of patients with migraine receiving anti-CGRP drugs. In the 30 to 50% range, or at least 50%-, or at least 50%-, or at least 70%-, there has been a 5 percent decrease in the number of headache days per month between 6, 9 and 12 months. With a F1 score range of 0. 97-0. 98, migraine days/month, and HIT-6 variables, the ML models used headache days/month, migraine days/month, and HIT-6 variables produced forecasts with a F1 score range of 0. 87-0. 98 and AUC's score range of 0. 87-0. 98. Conclusions According to our report, ML models can predict anti-CGRP responses at 6, 9, and 12 months.

Source link: https://europepmc.org/article/MED/35726393


Advocacy for Migraine Relief: Strategic Planning to Eliminate the Burden.

Purpose of study The purpose of this essay is to highlight migraine advocacy as an essential step forward in headache therapy research. This summary includes the most recent advocacy efforts to promote migraine care, increase the field of headache research, and reduce the burden of migraines.

Source link: https://europepmc.org/article/MED/35716274


Single midline incision approach for decompression of greater, lesser and third occipital nerves in migraine surgery.

Background The common treatment for occipital migraine surgery in the posterior neck includes three separate surgical incisions to decompress the greater occipital nerves, reduced occipital nerves, and third occipital nerves. Results The GON and TON were found at 3. 5 and 6. 2 cm, respectively, inferior to a line bisecting the external auditory canal and 1. 5 cm lateral to the midline, respectively, during the midline's midline incision. Before the posterior border of the sternocleidomastoid was reached, the LON was identified as 6-cm inferior and 6. 5-cm medial to a line bisecting the EAC in the plane just above the investing layer of the deep cervical fascia. The LON had the most variation, but it was not recognizable lateral to the SCM's posterior border. Conclusions of migraine surgery A single midline incision technique allows for the successful identification and decompression of all six occipital nerves.

Source link: https://europepmc.org/article/MED/35715794


Efficacy and Safety of Lasmiditan as a Novel Acute Treatment in Chinese Patients with Migraine: A Subpopulation Analysis of the Randomized Controlled Phase 3 CENTURION Trial.

The CENTURION trial is a multi-country, placebo-controlled phase 3 study designed to determine the first attack sensitivity and lasmidation of lasmidon in acute migraine treatment. This is the first review focusing on lasmiditan's efficacy and safety in Chinese patients with migraine, and it wants to provide valid information for Chinese physicians. Patients were randomized 1:1:1 to one of three treatment groups for four attacks: lasmiditan 100 mg; lasmiditan 200 mg; or placebo group. In at least two out of three attacks, pain freedom was granted at 2 h and pain freedom at 2 h, with pain relief at 2 h and pain freedom at 2 h. Conclusions In total, 281 Chinese patients were treated for at least one migraine attack. At 2 h after the first attack, both doses of lasmiditan showed improvement compared to placebo for pain relief, with lasmiditan 200 mg showing minimal significance.

Source link: https://europepmc.org/article/MED/35713760


Recent advances in targeting calcitonin gene-related peptide for the treatment of menstrual migraine: A narrative review.

Abstract Menstrual migraine has a longer duration and greater drug resistance than non-perimenstrual migraines. The use of CGRP receptor antagonists and anti-CGRP monoclonal antibodies have shown continued effectiveness and tolerability in the prevention of chronic or episodic migraines, and have now been approved for clinical use. In MM therapy, we'll address the role of CGRP receptor antagonists and anti-CGRP mAbs. We also discuss the role of anti-CGRP mAbs and CGRP receptor antagonists in migraine therapy, as well as the medications that inhibit CGRP release. The anti-CGRP mAbs or CGRP receptor antagonists, as well as Altogether, provided superior efficacy and safety in the treatment of MM.

Source link: https://europepmc.org/article/MED/35713436


Microstructural white matter alterations associated with migraine headaches: a systematic review of diffusion tensor imaging studies.

The pathophysiology of migraine as a headache disorder is also uncertain. Diffusion tensor imaging has greatly enhanced our understanding of brain microstructure in this disorder. Here, we sought tosystematically review DTI studies in migraine and identify the sources of heterogeneity by investigating diffusion parameter changes related to clinical characteristics and migraine subtypes. In addition, migraine-associated with depressive/anxiety symptoms demonstrated significant changes in the corpus callosum, internal capsule, and superior longitudinal fasciculus. There were no significant WM microstructural differences between migraine patients with and without aura, but no significant WM microstructural differences were found among migraine patients with and without aura. Overall, inconsistent findings showed inconsistency among chronic and episodic migraines. These changes can reveal neuronal damage and neuronal plasticity mechanisms either as a result of migraine triggers or as a compensatory reaction to pain in chronic migraine. Longitudinal studies using novel modalities may shed new light on the underlying microstructural changes in migraine subtypes.

Source link: https://europepmc.org/article/MED/35710680

* Please keep in mind that all text is summarized by machine, we do not bear any responsibility, and you should always check original source before taking any actions

* Please keep in mind that all text is summarized by machine, we do not bear any responsibility, and you should always check original source before taking any actions