Episodic Migraine Comorbidities: Avoiding Pitfalls and Taking Therapeutic Opportunities

Klenofsky, Britany; Pace, Anna; Natbony, Lauren R.; Sheikh, Huma U.

doi:10.1007/s11916-019-0742-8

Cited by 20 publications

(17 citation statements)

References 46 publications

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“…Insomnia is the most common sleep complaint among migraine patients since it has been observed in 40% of episodic migraine patients and almost 70% of chronic migraine patients, half of which also reporting snoring during sleep [65]. It has been suggested that sleep disorders may predispose individuals to migraine attacks and play a role in migraine chronification [66] and, on the other hand, management of insomnia may reverse chronic in episodic migraine or prevent migraine chronification [67]. Therefore, as sleep disorders could be involved in the onset and resolution of symptoms, they should be carefully considered when discussing migraine management.…”

Section: Discussionmentioning

confidence: 99%

Multidimensional assessment of the effects of erenumab in chronic migraine patients with previous unsuccessful preventive treatments: a comprehensive real-world experience

et al. 2020

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Background: erenumab was safe and effective in clinical trials for the prevention of migraine. However, real-life data are still lacking. Here we report the clinical experience from an Italian real-world setting using erenumab in patients with chronic migraine experiencing previous unsuccessful preventive treatments. Methods: Seventy patients with chronic migraine and failure to ≥4 migraine preventive medication classes initially received monthly erenumab 70 mg s.c. Patients without a clinically meaningful improvement, considered as a > 30% reduction in headache days per month, after ≥3 months of therapy switched to monthly erenumab 140 mg. At the first administration and after 3 and 6 months, patients underwent extensive interviews to assess clinical parameters of disease severity and migraine-related disability and impact, and validated questionnaires to explore depression/ anxiety, sleep, and quality of life (QoL). Finally, the Pain Catastrophizing Scale, Allodynia Symptom Checklist-12 and MIGraine attacks-Subjective COGnitive impairments scale (MIG-SCOG) were administered. Results: 70% of patients were "responders" after the third administration of erenumab 70 mg, whereas 30% switched to erenumab 140 mg; 29% (6 pts) responded after the sixth administration. The headache-day frequency was reduced from 21.1 ± 0.7 to 11.4 ± 0.9 days after the third administration (p < 0.001) and to 8.9 ± 0.7 days after the sixth administration (p < 0.001). 53% and 70% of patients, respectively, showed a reduction of ≥50% of headache days/month after the third and the sixth administrations. Also improved were headache pain severity, migraine-related disability, and impact on daily living, QoL, pain catastrophizing and allodynia (all p < 0.001), quality of sleep, symptoms of depression or anxiety (p < 0.05) but not MIG-SCOG. There were no new adverse event signals.

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Section: Discussionmentioning

confidence: 99%

Multidimensional assessment of the effects of erenumab in chronic migraine patients with previous unsuccessful preventive treatments: a comprehensive real-world experience

et al. 2020

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“…66 In addition, effective management of anxiety, depression, and poor sleep may reduce migraine frequency and the progression to chronic migraine. 67 In some patients, triggers, such as certain food, caffeine intake, and alcohol, can be identified and avoided.…”

Section: Lifestyle and Other Therapiesmentioning

confidence: 99%

Migraine Aura: Pathophysiology, Mimics, and Treatment Options

et al. 2019

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Recent insights into the clinical presentation and pathophysiology of migraine aura have paved the way for new treatments for this common but frequently debilitating condition. Marked efflux of cellular potassium and glutamate contributes to the cortical spreading depression that forms the electrophysiological basis of migraine aura phenomena. Secondary vascular perturbations also contribute to the various symptoms of a migraine attack. Calcitonin gene-related peptide (CGRP) plays a key role in many of these steps, and a growing class of CGRP-antagonists have emerged as a novel, efficacious preventative therapy. It is still not fully understood why a preponderance of migraine aura symptoms is visual, and this issue is an active area of research. In addition, the pathophysiological changes responsible for visual snow syndrome are under investigation. Before diagnosing a patient with migraine aura, it is important to consider the differential diagnosis of transient visual phenomena, with attention to clinical features that may suggest conditions such as retinal disorders, transient ischemic attack, or occipital epilepsy.

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“…Comorbidity is the greater than coincidental association of two conditions in the same individual 3 . The most widely considered comorbidities of migraine include anxiety, panic disorder, depression, bipolar disorder, asthma, sleep disorders, arthritis and chronic nonheadache pain, fatigue, obesity, gastrointestinal disorders, epilepsy, and cardiovascular conditions [4][5][6][7][8][9] .…”

Section: Introductionmentioning

confidence: 99%

“…An estimated 70% of female and 73% of male migraine patients in the US have at least one cardiovascular risk factor 11 . People with migraine have an increased risk of cardiovascular disease 12 , including almost a two times increased risk of ischemic stroke 8 . In one study, 11.42% of patients with episodic migraine had circulation problems, 6.34% had heart disease or angina, and 2.21% had stroke 13 .…”

Section: Introductionmentioning

confidence: 99%

Lasmiditan in patients with common migraine comorbidities: apost hocefficacy and safety analysis of two phase 3 randomized clinical trials

Clemow

Baygani

Hauck

et al. 2020

Current Medical Research and Opinion

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Objective: Determine whether common migraine comorbidities affect the efficacy and safety of lasmiditan, a 5-HT 1F receptor agonist approved in the United States for the acute treatment of migraine. Methods: In SPARTAN and SAMURAI (double-blind Phase 3 clinical trials), patients with migraine were randomized to oral lasmiditan 50 mg (SPARTAN only), 100mg, 200 mg, or placebo. Lasmiditan increased the proportion of pain-free and most bothersome symptom (MBS)-free patients at 2 h after dose compared with placebo. Most common treatment-emergent adverse events (TEAEs) were dizziness, paraesthesia, somnolence, fatigue, nausea, muscular weakness, and hypoesthesia. Based upon literature review of common migraine comorbidities,

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Episodic Migraine Comorbidities: Avoiding Pitfalls and Taking Therapeutic Opportunities

Cited by 20 publications

References 46 publications

Multidimensional assessment of the effects of erenumab in chronic migraine patients with previous unsuccessful preventive treatments: a comprehensive real-world experience

Multidimensional assessment of the effects of erenumab in chronic migraine patients with previous unsuccessful preventive treatments: a comprehensive real-world experience

Migraine Aura: Pathophysiology, Mimics, and Treatment Options

Lasmiditan in patients with common migraine comorbidities: apost hocefficacy and safety analysis of two phase 3 randomized clinical trials

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