Cephalalgia最新文献

{"title":"Distribution of intranasal lidocaine and its effect on electrically-evoked calcium signals in mouse trigeminal ganglion neurons.","authors":"Lisa Tiebl, Hans Jürgen Solinski, Sara Belejova, Sabrina Soares, Claudia Pitzer, Roland Palkovacs, Gernot Poschet, Martin Schmelz, Beatrice Oehler, Richard Carr","doi":"10.1177/03331024261453548","DOIUrl":"10.1177/03331024261453548","url":null,"abstract":"<p><p>BackgroundLidocaine applied intranasally has shown promise in treating post-dural puncture headache and has been explored as a potential treatment for cluster headache and migraine. However, the mechanisms underlying its analgesic effects remain unclear. This study aimed to determine the concentration of lidocaine that reaches target tissues after intranasal application and its impact on the excitability of trigeminal ganglion neurons.MethodsA mouse model was used to examine lidocaine (10%) distribution after intranasal administration, employing liquid chromatography-mass spectrometry (LC-MS). Fluorescence calcium imaging with electrical field stimulation on acutely cultured murine trigeminal ganglion cells was applied to determine the effects of the pre-determined lidocaine concentrations on their excitability.ResultsAfter intranasal application, lidocaine concentrations ranged from approximately 2.5 μM in plasma to 7 μM in trigeminal ganglia. Calcium imaging revealed that 100 μM lidocaine was required to decrease electrical responses in capsaicin-unresponsive trigeminal ganglion neurons. In capsaicin-responsive nociceptive neurons such an inhibition was already observed at 10 μM lidocaine and these neurons also displayed a sustained increase in calcium that failed to return to baseline levels.ConclusionsThese findings suggest that intracranial lidocaine concentrations after intranasal administration are sufficiently high to selectively affect depolarized trigeminal nociceptors with ongoing activity, providing a potential mechanism for the analgesic effects of intranasally applied lidocaine. These results have implications for the use of intranasal lidocaine as a treatment for headache.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"46 6","pages":"3331024261453548"},"PeriodicalIF":5.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148307191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world achievement of higher standards for migraine prevention with CGRP monoclonal antibodies.","authors":"Keisuke Suzuki, Shiho Suzuki, Saro Kobayashi, Mukuto Shioda, Hiroaki Fujita, Yasuo Haruyama, Ryotaro Hida, Koichi Hirata","doi":"10.1177/03331024261453284","DOIUrl":"10.1177/03331024261453284","url":null,"abstract":"<p><p>ObjectiveTo evaluate the achievement of the International Headache Society (IHS) higher standards for migraine prevention in patients treated with calcitonin gene-related peptide monoclonal antibodies (CGRP mAbs) in real-world practice.MethodsWe retrospectively analyzed 307 migraine patients treated with CGRP mAbs at a single center. Monthly migraine days (MMDs) were assessed at baseline and during follow-up (1-24 months). According to IHS recommendations, migraine control was categorized as optimal (<4 migraine days/month), modest (4-6 days/month), or insufficient (>6 days/month). Patients were further classified by the timing of achieving optimal control.ResultsThe percentage of patients achieving a ≥ 50% reduction in MMDs increased from 36.2% at month 1 to 71.0% at month 24; optimal control increased from 15.0% to 38.8%. Among patients with a ≥ 50% response, 38.7-55.7% achieved optimal control during follow-up. Migraine freedom remained relatively uncommon (1.6-10.1%). Patients who achieved optimal control early (≤3 months) had a lower baseline migraine burden, whereas nonachievers had a higher baseline disease burden and more prior preventive treatment failures.ConclusionsCGRP mAbs were associated with substantial reductions in migraine frequency; however, achieving optimal control and migraine freedom remains challenging in real-world practice, particularly in patients with a higher baseline burden.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"46 6","pages":"3331024261453284"},"PeriodicalIF":5.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148136813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smoking and medication-overuse headache: Exploring the potential link between nicotine dependence and analgesic overuse.","authors":"Mona Hussein, Amr Hassan, Rehab Magdy, Ahmed Dahshan, Osama Yacoub, Mohamed Abdelghaffar, Nourhan Abdelmohsen Taha, Ahmed Essmat, May M Fayez, Nahla Merghany, Anas Elgenidi, Ramez Reda Moustafa, Anter Mothenna Abdullah Nasser, Alaa Elmazny","doi":"10.1177/03331024261453544","DOIUrl":"10.1177/03331024261453544","url":null,"abstract":"<p><p>BackgroundDespite consistent epidemiological evidence identifying smoking as a risk factor for medication-overuse headache (MOH), the mechanisms underlying this association remain incompletely elucidated. The aim of this work was to explore the relationship between the severity of analgesic dependence, headache-related disability, nicotine dependence, psychological distress, and addiction-related personality traits in patients with MOH.MethodsThis multicenter cross-sectional study was conducted on 442 patients with primary headache disorders. Participants underwent structured face-to-face interviews and were asked to fill out the following questionnaires: Headache Impact Test-6 (HIT-6), Severity of Dependence Scale (SDS), Depression Anxiety Stress Scales-12 (DASS-12), and Substance Use Risk Profile Scale (SURPS). Smoking status was documented for all participants. Current smokers were asked to complete Fagerström Test for Nicotine Dependence questionnaire (FTND).ResultsThis study included 442 patients with primary headache disorders, of whom 150 had MOH and 292 did not. Patients with MOH (n = 150) reported significantly higher monthly headache days (MHD), acute medication days (AMD), HIT-6, DASS-12, and SURPS scores than those without MOH (n = 292) (all P-values < 0.001). Smoking prevalence and FTND scores were significantly higher among MOH patients than those without MOH (all P-values < 0.001). Smokers demonstrated higher MHD, AMD, prevalence of MOH, DASS-12, and SURPS scores than non-smokers (all P-values < 0.05). Among smokers, FTND correlated positively with MHD, AMD, HIT-6, DASS-12, and SURPS (all P-values < 0.001). In patients with MOH, SDS scores showed positive correlations with AMD, HIT-6, DASS-12, and SURPS (all P-values < 0.05).ConclusionSeverity of dependence on analgesics in patients with MOH is strongly associated with headache burden, nicotine dependence, psychological distress, and addiction-related personality traits.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"46 6","pages":"3331024261453544"},"PeriodicalIF":5.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148142766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond headache: Cognitive improvement in patients with migraine responding to anti-CGRP monoclonal antibodies or botulinum toxin.","authors":"Isabel Pavão Martins, Mariana Costa Taveira, Maria Couto, Sofia Velasco, Rita Rato, Andreia Costa, Bárbara Martins, Filipa Dourado Sotero","doi":"10.1177/03331024261458424","DOIUrl":"10.1177/03331024261458424","url":null,"abstract":"<p><p>BackgroundCognitive functioning worsens during migraine attacks and in the interictal period, especially in chronic migraine. This study aims to evaluate whether preventive treatment with anti-CGRP monoclonal antibodies (mAbs) or botulinum toxin (BoNT) improves interictal cognitive performance in migraine patients, and to compare cognitive changes between treatment responders and non-responders, controlling for treatment type.MethodsA two-center prospective longitudinal comparative study of patients with Episodic (EM) or Chronic (CM) migraine receiving either mAbs or BoNT. Participants underwent two comprehensive cognitive evaluations targeting attention/processing speed, executive functions, episodic memory, and language, at baseline (visit 1) and after three to six months of treatment (visit 2). The primary end point was the degree of improvement measured by the z scores of each cognitive domain (adjusted for age and education), from baseline to follow-up, assessed using repeated-measures analysis with time as the within-subject factor and treatment response as the between-subject factor, controlling for treatment group. Treatment response was defined as a decrease in monthly moderate-to-severe headache days of ≥30% in CM or ≥50% in EM at follow-up.ResultsOne hundred patients were included, and 90 completed the study (median age = 42 years, 96.7% women, 58 (64.4%) with CM, 64 (71.1%) treated with mAbs, and 26 (28.8%) with BoNT. Forty-seven (52.2%) were responders (59.4% in the mAbs group and 34.6% in the BoNT group) after a mean follow-up time of 4.5 months. Improvement in a measure of executive functions (comprising tests of working memory, alternating attention, and phonological fluency) was significantly higher in responders than in non-responders, independently of treatment group. No significant differences between responders and non-responders were observed in episodic memory, language, or processing speed. Among responders, the change in executive function score was not associated with the reduction in monthly moderate-severe headache days or the final number of monthly headache-free days.ConclusionsPerformance on measures of executive capacities, may improve in migraine patients after a few months of effective migraine treatment with mAbs or BoNT, regardless of the treatment group. Further research is needed to determine whether this effect augments over time, is associated to the reduction of pre-ictal and post-ictal days and /or to brain networks reorganization.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"46 6","pages":"3331024261458424"},"PeriodicalIF":5.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148249520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Achieving International Headache Society-aspired optimal migraine control in fremanezumab-treated patients: A post-hoc analysis of a real-world, prospective study from the GRASP study group.","authors":"Andreas A Argyriou, Emmanouil V Dermitzakis, Dimitrios Rikos, Maria Chondrogianni, Aikaterini Foska, Panagiotis Soldatos, Eleni Mavraki, Georgia Xiromerisiou, Pantelis Litsardopoulos, Georgios Tsivgoulis, Michail Vikelis","doi":"10.1177/03331024261456247","DOIUrl":"10.1177/03331024261456247","url":null,"abstract":"<p><p>ObjectiveTo evaluate whether the conventional ≥50% reduction in monthly migraine days (MMDs) accurately reflects clinically meaningful benefit compared with IHS-aspired migraine control definitions in difficult-to-treat high-frequency episodic migraine (HFEM).MethodsIn this post-hoc analysis of a prospective, real-world registry, conducted by the Greek Research Alliance for the Study of Headache and Pain (GRASP), 114 HFEM patients who had failed ≥3 preventive therapies and achieved a sustained ≥50% reduction in MMDs with monthly fremanezumab over 24 months, were included. Treatment response (≥50% and ≥75% MMD reduction) and IHS-defined control states (freedom, optimal, modest, insufficient control) were assessed using headache diaries at baseline (T0), month 12 (T1), and month 24 (T2). Secondary outcomes included headache intensity, analgesic use, and migraine-related disability.ResultsAt T1, fremanezumab significantly improved all efficacy and disability outcomes (p < 0.001), with mean MMDs reduced from 11.9 at baseline to 5.1 at T1. While 78.1% achieved ≥50% MMD reduction, only 19.3% reached optimal control (<4 MMDs), highlighting a mismatch between relative response and true disease control. At T2, MMDs further declined to 4.3, while optimal control increased to 29.8% and insufficient control declined to 7.8%. Overall, most patients remained moderately controlled (60.6%) with residual 4-6 MMDs. Non-prior exposure to other anti-CGRP therapies emerged as the only independent predictor of optimal long-term control (OR:2.1; p = 0.03).ConclusionAchieving a ≥ 50% MMD reduction with CGRP-targeted therapies may not always correspond to clinically-meaningful benefit. More ambitious outcome measures are essential for more accurately evaluating treatment effectiveness and achieving clinically-meaningful reduction of migraine's disability.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"46 6","pages":"3331024261456247"},"PeriodicalIF":4.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148154891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methodological limitations of anxiety screening tools used in migraine studies -a narrative review.","authors":"Monica Yen Hoang Pham, Jasmin Asheer, Fatima Ali, Rikke Hilker, Poul Videbech, Henrik Winther Schytz","doi":"10.1177/03331024261453541","DOIUrl":"10.1177/03331024261453541","url":null,"abstract":"<p><p>BackgroundAnxiety is commonly reported among patients with migraine, and anxiety questionnaires are frequently used to assess anxiety symptoms. This narrative review examines how common anxiety screening tools are applied in migraine studies and whether they are applied and interpreted appropriately.MethodA PubMed search included studies using the Hospital Anxiety Depression Scale (HADS), Generalized Anxiety Disorder 7-Items (GAD-7) or Beck Anxiety Inventory (BAI). The search also included studies using the Hamilton Anxiety Rating Scale (HAM-A) or State Anxiety Inventory (STAI). Eligible patients were diagnosed with migraine according to the International Classification of Headache Disorders (ICHD-2 or ICHD-3).ResultsNinety-eight studies met the inclusion criteria. In 42 studies (41%), an anxiety score above the cut-off was interpreted as an anxiety diagnosis. This approach was used in 52%, 44%, 41%, 29% and 38% of studies using HADS-A, GAD-7, BAI, HAM-A and STAI. Only three studies confirmed the diagnosis through a structured clinical interview. Data presentation and interpretation across the studies were heterogeneous. Only a few of the scales are validated in a population of migraine patients.ConclusionThis study shows that anxiety screening tools are commonly used in migraine studies but with considerable variation in cut-off scores and interpretation. Such methodological differences and limited validation of these tools may make it difficult to determine the true prevalence of anxiety in migraine studies. Further studies are needed to validate these instruments and to establish clear guidelines for their use in migraine research.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"46 6","pages":"3331024261453541"},"PeriodicalIF":5.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148263516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A retrospective cohort study comparing treatment persistence between rimegepant and lasmiditan for the acute treatment of migraine in the US.","authors":"Stewart J Tepper, Aaron Jenkins, Simon Dagenais, Carl Henriksen, Lucy Abraham, Feng Dai, Karin Hygge Blakeman, Astrid Gendolla","doi":"10.1177/03331024261447187","DOIUrl":"10.1177/03331024261447187","url":null,"abstract":"<p><p>BackgroundThis study compared treatment persistence of individuals newly initiating treatment with rimegepant or lasmiditan for the acute treatment of migraine.MethodsA retrospective cohort analysis was conducted on individuals from MarketScan (commercial and managed Medicare) newly initiating treatment with rimegepant or lasmiditan between March 2020 and December 2022. Treatment persistence was defined as the proportion of individuals with ≥1 medication refill within 12 months of the index prescription. Subgroups included individuals with chronic migraine, index lasmiditan dose (50 and 100 mg) and individuals with a history of two or more uses of controlled substances (prior repeated use of controlled substances [PRUCS] defined here as opioids, butalbital, nausea medications with central nervous system action). Treatment persistence was compared between inverse probability of treatment weighting (IPTW)-adjusted cohorts using odds ratios (ORs) and 95% confidence intervals (CIs).ResultsThe primary analysis included 16,603 rimegepant and 716 lasmiditan users. A significantly higher proportion of individuals in the rimegepant cohort were treatment persistent compared with the lasmiditan cohort (OR 3.79 [95% CI 3.23-4.41]). This finding remained consistent across lasmiditan dosages (50 mg: 5.05 [3.87-6.60]; 100 mg: 3.33 [2.78-4.00]), chronic migraine diagnosis (3.89 [3.21-4.71]), or PRUCS (ORs ranged from 2.78 to 4.63; all statistically significant).ConclusionRimegepant users demonstrated higher treatment persistence over 12 months compared to lasmiditan users, which could reflect better real-world treatment satisfaction.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"46 6","pages":"3331024261447187"},"PeriodicalIF":5.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148216825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond ICHD-3 criteria: Diagnostic challenges in headache in pediatric age.","authors":"Laura Papetti, Alessandro Borrelli, Carmen Granata, Gabriele Monte, Fabiana Ursitti, Giorgia Sforza, Massimiliano Valeriani","doi":"10.1177/03331024261447378","DOIUrl":"10.1177/03331024261447378","url":null,"abstract":"<p><p>BackgroundDiagnosing headache in children and adolescents is challenging because clinical features vary with age, primary and secondary forms may overlap and the use of investigations is often inconsistent.MethodsWe conducted a scoping review following PRISMA guidelines. PubMed, Ovid MEDLINE, Scopus and the Cochrane Library were searched for studies on headache diagnosis in individuals aged 1-18 years (2018-2025). Of 126 records identified, 36 met eligibility criteria and were included.ResultsSeveral studies indicate that ICHD-3 criteria, developed mainly in adults, may not fully reflect paediatric presentations, contributing to diagnostic uncertainty. Evidence clarifies the value of some red flags while challenging others. Neuroimaging demonstrates low diagnostic yield except in selected cases. Common pitfalls include overdiagnosis of sinusitis, inappropriate EEG use and unnecessary ophthalmologic or allergologic testing.ConclusionsAccurate diagnosis relies on careful history taking, recognition of age-specific patterns and judicious use of investigations. Paediatric-focused diagnostic pathways are needed. Emerging digital tools and biomarkers may support earlier and more precise diagnosis.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"46 6","pages":"3331024261447378"},"PeriodicalIF":5.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148257520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient reported trigger, not the speed of transition to continuous headache, is associated with headache-related disability in children: Results of a cross-sectional clinic-based study.","authors":"Rachel Sehgal, Christina L Szperka, Andrew D Hershey, Carlyn Patterson Gentile","doi":"10.1177/03331024261446961","DOIUrl":"10.1177/03331024261446961","url":null,"abstract":"<p><p>ObjectiveTo investigate the relationship between the evolution of continuous headache and headache-related disability in children.MethodsThis was a single site cross-sectional study using patient-entered questionnaires from children aged 6-17 who presented to neurology clinic between November 2022-May 2024 with continuous headache. Participants were categorized as sudden onset (no evolution), rapidly evolved (< 3 months), or gradually evolved (≥ 3 months) continuous headache. Analysis examined the relationship between the pattern of headache evolution and headache-related disability (PedMIDAS score), accounting for demographic, headache characteristic, and onset factors.ResultsOf 751 respondents, 42.5% reported sudden onset, 35.0% rapid evolution, and 22.5% gradual evolution to continuous headache. There was no significant difference in PedMIDAS score in children who reported sudden onset compared to children with rapid (6.9 [-2.7, 16.4], p = 0.159) or gradual evolution (10.3 [-0.8, 21.3], p = 0.068) of headache onset. Older age (3.3 per year [1.8, 4.8], p < 0.001) and patient reported trigger (17.1 [8.8, 25.5], p < 0.001) at the onset of continuous headache were both associated with greater headache-related disability, accounting for other covariates.ConclusionChildren transitioned to continuous headache quickly, consistent with prior studies. Older children and those who associated onset of continuous headache with a trigger reported higher rates of headache-related disability.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"46 5","pages":"3331024261446961"},"PeriodicalIF":5.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benefits of eptinezumab on patient-reported disease burden and health-related quality of life in adults with chronic migraine and medication-overuse headache: Results from the placebo-controlled RESOLUTION trial.","authors":"Stewart J Tepper, Henrik W Schytz, Rigmor H Jensen, Christofer Lundqvist, Gisela M Terwindt, Cristina Tassorelli, Fabrizio Vernieri, Michel Lantéri-Minet, Andrew Blumenfeld, Mette Krog Josiassen, Gary Jansson, Anders Ettrup, Aurélia Mittoux, Richard B Lipton","doi":"10.1177/03331024261449814","DOIUrl":"10.1177/03331024261449814","url":null,"abstract":"&lt;p&gt;&lt;p&gt;AimThe phase 4 RESOLUTION trial showed that, in comparison with placebo, adding eptinezumab-an anti-calcitonin gene-related peptide monoclonal antibody-to a brief educational intervention (BEI) reduced the monthly frequency of migraine, headache, and acute medication use in participants with chronic migraine (CM) and medication-overuse headache (MOH). Herein, we report data from multiple patient-reported outcomes (PROs) evaluating treatment impact on disease burden and health-related productivity and quality of life in the RESOLUTION trial.MethodsRESOLUTION was a multi-national (conducted at 76 sites across 11 countries), double-blind, randomized, placebo-controlled trial. The trial comprised a 4-week screening period; a 12-week, double-blind, placebo-controlled period; a 12-week, open-label, extension period; and an 8-week, safety follow-up period, with results of the placebo-controlled period presented in this paper. Adults diagnosed with CM and MOH received a BEI and were randomized 1:1 to intravenous infusion with either eptinezumab 100 mg or placebo. Several PROs were assessed at baseline, Week 4, and Week 12, including the six-item Headache Impact Test (HIT-6), modified Migraine Disability Assessment (mMIDAS), Migraine-specific Work Productivity and Activity Impairment questionnaire (WPAI:M), Patient Global Impression of Change (PGIC; assessed only at follow-up), patient-identified most bothersome symptom (PI-MBS; assessed only at follow-up), Migraine-Specific Quality-of-Life questionnaire version 2.1 (MSQ v2.1), EQ-5D-5L visual analogue scale, and nine-item Treatment Satisfaction Questionnaire for Medication (TSQM-9; assessed only at follow-up). &lt;i&gt;Post hoc&lt;/i&gt; analyses included responder rates for HIT-6 (i.e., participants with ≥5-point reduction from baseline), as well as for PGIC and PI-MBS (i.e., participants who reported \"much improved\" or \"very much improved\").ResultsOf 608 participants randomized, the full-analysis set included 302 participants in the eptinezumab arm and 300 in the placebo arm. Eptinezumab with BEI was associated with more favorable PRO scores compared to placebo with BEI, starting at Week 4 (&lt;i&gt;p&lt;/i&gt; &lt; 0.05 for all comparisons) and up to Week 12 (&lt;i&gt;p&lt;/i&gt; &lt; 0.01 for all comparisons except WPAI:M absenteeism). Responder rates for HIT-6, PGIC, and PI-MBS also favored eptinezumab versus placebo.ConclusionsIn participants with CM and MOH who also received patient education, eptinezumab treatment resulted in greater reductions in headache impact and migraine disability than placebo, with greater improvements in productivity, quality of life, overall disease status, and treatment satisfaction starting from Week 4 and sustained to Week 12. Eptinezumab in combination with patient education is an effective treatment for reducing disease burden and improving overall quality of life in people with CM and MOH.Trial registrationClinicalTrials.gov Identifier: NCT05452239 (https://clinicaltrials.gov/study/NCT05452239); Eudr","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"46 5","pages":"3331024261449814"},"PeriodicalIF":5.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147959810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}