Headache最新文献

{"title":"Indomethacin-responsive refractory headache: Two case reports in children after hemispherectomy for Rasmussen's encephalitis.","authors":"Jessica Hauser Chatterjee, Priya A Monrad, Hannah E Goldstein, Dennis W Shaw, Jeffrey G Ojemann, Stephanie Carapetian Randle, Jason S Hauptman, Heidi K Blume","doi":"10.1111/head.14928","DOIUrl":"https://doi.org/10.1111/head.14928","url":null,"abstract":"<p><strong>Background: </strong>Indomethacin-responsive headaches occur in youth and include primary headache syndromes such as hemicrania continua and paroxysmal hemicrania. Both are trigeminal autonomic cephalalgias (TACs). In pediatrics TACs are rare. Moreover, they may differ in their phenotypes and response to indomethacin compared to adults. Secondary causes for side-locked headaches can have vascular, neoplastic, and inflammatory etiologies, emphasizing the importance of imaging in the evaluation of these headache types. Post-craniotomy indomethacin-responsive headaches have been described in adults, but not in children.</p><p><strong>Methods: </strong>Written consent was obtained from the patients' families and written assent from the two children for publication.</p><p><strong>Results: </strong>We report the course of two children, both with a history of Rasmussen's encephalitis treated with functional hemispherectomies, who subsequently developed debilitating, side-locked, medically refractory headaches several months after surgery. Headaches were on the same side of their encephalitis and surgery. In both instances, the headaches were exquisitely and rapidly responsive to indomethacin. Headache freedom was maintained on low doses of indomethacin (0.14-0.5 mg/kg/day).</p><p><strong>Conclusion: </strong>In cases of refractory side-locked headaches following a craniotomy or neuroinflammatory condition in children, one may consider indomethacin as a treatment option after evaluation for other secondary etiologies.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700255","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":"Impact of perilesional edema on severity of migraine in patients with calcified neurocysticercosis: A prospective evaluation.","authors":"Vishwesh Vishnu Naik, Ravi Uniyal, Ravindra Kumar Garg, Rajesh Verma, Vimal Kumar Paliwal, Hardeep Singh Malhotra, Praveen Kumar Sharma, Neeraj Kumar, Shweta Pandey, Imran Rizvi, Harish Nigam","doi":"10.1111/head.14929","DOIUrl":"https://doi.org/10.1111/head.14929","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;Recent research has sparked increasing interest in the role of neuroinflammation in the pathogenesis of migraine. We hypothesize that perilesional edema, an imaging marker of inflammation caused by an immune response in the brain parenchyma surrounding calcified neurocysticercosis (NCC), may influence migraine pathophysiology. This study was designed to explore the potential impact of perilesional edema on migraine severity and treatment response.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Cranial imaging of patients with primary headache may sometimes reveal calcified lesions indicative of calcified NCC. These lesions were once considered incidental and harmless findings. However, recent studies have shown that such calcifications are more frequently associated with headaches. Some research suggests that patients with calcified brain lesions experience more frequent and severe migraine compared to those without these lesions, though the pathophysiology underlying this association remains unclear.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This single-center, prospective cohort study was conducted at King George Medical University, India, from September 2022 to September 2024. A total of 80 patients with migraine with calcified NCC were enrolled. Cranial magnetic resonance imaging with contrast was used to detect perilesional edema. Patients were divided into two groups based on the presence (Group A) or absence (Group B) of perilesional edema. Both groups were assessed for migraine frequency, severity, and disability using standard scales. They were treated with standard migraine therapy and followed up for 3 months. Statistical analysis was performed to compare migraine characteristics, treatment responses, and disability between the two groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Perilesional edema was observed in six of the 80 patients (7.5%). At presentation, Group A (those with perilesional edema) experienced more frequent migraine, with a mean (standard deviation [SD]) of 22.5 (4.4) days/month, compared to Group B (those without perilesional edema), which averaged 8.2 (2.7) days/month. The headaches in Group A were also more severe, as indicated by higher median visual analog scale scores (median [interquartile range, IQR] in Group A of 10.0 [8.5-10.0] and 7 [7.0-8.0] in Group B, p &lt; 0.001). Disability scores were significantly higher in Group A, with higher median scores on the Migraine Disability Assessment Scale (median [IQR] score in Group A of 43 [40.5-48.5] and 21.5 [17.0-26.3] in Group B, p &lt; 0.001) and six-item Headache Impact Test (median [IQR] score in Group A of 66 [64.25-71.23] and 57 [54.8-62.0] in Group B, p &lt; 0.001) scales. Although both groups showed improvement over 3 months of treatment, Group A continued to experience greater migraine severity. In Group A, the mean (SD) headache frequency was 22.5 (4.4) at presentation, 14.0 (1.6) at 30 days, 10.7 (1.6) at 60 days, and 9.2 (2.0) at 90 days (p &lt; 0.001). Similarly","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692023","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":"Correction to \"Facial variant of epicrania fugax secondary to a cerebellopontine angle meningioma\".","authors":"","doi":"10.1111/head.14938","DOIUrl":"https://doi.org/10.1111/head.14938","url":null,"abstract":"","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692019","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":"From adolescence to adulthood: The role of dietary quality in headache and temporomandibular disorder risks.","authors":"Daniela A Godoi Gonçalves","doi":"10.1111/head.14933","DOIUrl":"https://doi.org/10.1111/head.14933","url":null,"abstract":"","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656940","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":"Migraine and sleep apnea, insomnia, and sleep patterns in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).","authors":"Angeliki Vgontzas, Murray A Mittleman, Cecilia Castro-Diehl, Carmen R Isasi, Richard B Lipton, Sanjay R Patel, Alberto Ramos, Daniela Sotres-Alvarez, Christian Agudelo, Martha L Daviglus, Phyllis C Zee, Susan Redline, Suzanne M Bertisch","doi":"10.1111/head.14926","DOIUrl":"https://doi.org/10.1111/head.14926","url":null,"abstract":"<p><strong>Objective: </strong>To quantify the prevalence of migraine and examine its association with sleep disorders, patterns, and symptoms in adults in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). We hypothesized that migraine would be associated with insomnia but not sleep apnea.</p><p><strong>Background: </strong>Sparse research has examined migraine prevalence and sleep comorbidities in underrepresented racial and ethnic groups in the United States. Hispanic/Latino adults in the United States may be at risk for worse health outcomes due to disparities in health-care access and socioeconomic stressors.</p><p><strong>Methods: </strong>We analyzed data collected during the baseline examination (March 2008-June 2011) from the HCHS/SOL, a community-based cohort study of self-identified Hispanic/Latino adults in the United States. The exposure was self-reported medical diagnosis of migraine, and primary outcomes were obstructive sleep apnea (apnea-hypopnea index ≥ 15 events/h from at-home sleep testing) and insomnia (≥ 9 on the Women's Health Initiative Insomnia Rating Scale). Exploratory outcomes included self-reported sleep duration, timing, sleeping pill use, and naps. We compared weighted differences in outcomes by migraine status, adjusting for age and sex in all reported models.</p><p><strong>Results: </strong>Our analytical sample included HCHS/SOL participants who completed questionnaires on sleep and migraine (16,325). The mean age (standard deviation) was 41.1 (31.7) years, 52.2% identified as female, and 39.5% had a body mass index ≥ 30 kg/m². Lifetime prevalence of migraine was 15.9% (95% confidence interval [CI]: 15.0, 16.8; 23.6% [95% CI: 22.2, 25.0] of females and 7.5% [95% CI:6.6, 8.5] of males). Those with migraine were more likely to be unemployed (50.8% vs. 36.2%) and to have a household yearly income of < $20,000 (50.9% vs. 45.5%). There was no association between migraine and obstructive sleep apnea (odds ratio [OR] 0.98 [95% CI: 0.76, 1.26]) or napping (OR 0.92 [95% CI: 0.81, 1.06]). Compared to individuals without migraine, those with migraine were more likely to have insomnia (OR = 1.87; 95% CI: 1.62, 2.15) and to use sleeping pills (OR = 2.16; 95% CI: 1.80, 2.60) in sex- and age-adjusted models. Individuals with migraine also had shorter mean sleep duration (7.88 ± 2.5 h vs. 8.00 ± 2.1 h, β = -0.20; 95% CI: -0.30, -0.09) and later bedtimes (11:28 p.m. ± 5.1 h vs. 11:17 p.m. ± 4.2 h, β = 16.85; 95% CI: 3.58, 30.13; weekdays) in sex- and age-adjusted models.</p><p><strong>Conclusion: </strong>Self-reported medical diagnosis of migraine is common in Hispanic/Latino adults, especially females. Migraine is not associated with obstructive sleep apnea. Consistent with non-Hispanic/Latino populations, migraine is associated with insomnia in the HCHS/SOL.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656942","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":"Assessing blood pressure changes and hypertension-related outcomes in patients with migraine treated with erenumab: A systematic review and meta-analysis.","authors":"Luana Miyahira Makita, Rafael de Freitas de Kleimmann, Rafael Reis de Oliveira, Henrique Alexsander Ferreira Neves, Angela Maria Sandini Corso, Vinícius Salles Alves, Giovana Schlichta Adriano Kojima, Aishwarya Koppanatham, Pedro André Kowacs, Elcio Juliato Piovesan","doi":"10.1111/head.14921","DOIUrl":"https://doi.org/10.1111/head.14921","url":null,"abstract":"<p><strong>Objectives/background: </strong>We aimed to systematically review and summarize evidence on the effects of erenumab on systemic blood pressure (BP) in patients with migraine (International Prospective Register of Systematic Reviews ID: CRD42024571056). US Prescribing Information for erenumab was updated to include the potential risk of hypertension, although randomized trials did not link it previously. The association of this monoclonal antibody with an elevated vascular risk remains uncertain.</p><p><strong>Methods: </strong>Embase, PubMed, and the Cochrane databases were searched up to June 18, 2024 for studies examining the impact of erenumab on BP in patients with migraine. I² statistics and prediction intervals (PIs) were applied to assess heterogeneity, and sensitivity and subgroup analyses were used to explore it. Data were collected using mean difference (MD) or proportion of events. The risk of bias of the included studies was assessed with the Cochrane Risk of Bias tool.</p><p><strong>Results: </strong>Systolic (MD = 0.86, 95% confidence interval [CI] = -1.02 to 2.73, p = 0.370, I² = 63%) and diastolic (MD = 1.33, 95% CI = -0.05 to 2.72, p = 0.060, I² = 69%) BP measures did not significantly differ between after and before erenumab treatment. This lack of significant difference persisted at 3 and 12 months. The leave-one-out technique did not change heterogeneity. The proportion of participants presenting worsening BP appears to be 22.04% (95% CI = 11.12-38.98, PI = 0.54-93.60), with 56.40% corresponding to nonhypertensive individuals at baseline. The incidence of patients starting antihypertensive medications during the study was 3.96% (95% CI = 1.30-11.42, PI = 0.02-90.04), of which 62.88% corresponded to nonhypertensive patients at baseline.</p><p><strong>Conclusion: </strong>We did not find an association of erenumab with significant increases in systemic BP. There is a considerable degree of fragility in the current evidence available. The decision to prescribe erenumab, especially for patients with multiple comorbidities and risk factors for hypertension, must be made weighing the risks and benefits. Further studies are needed to confirm these findings.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624395","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":"Efficacy of an educational website on headaches in schoolchildren: A cluster-randomized controlled trial.","authors":"Henrike Goldstein, Lisa-Marie Rau, Clarissa Humberg, Verena Bachhausen, Lorin Stahlschmidt, Julia Wager","doi":"10.1111/head.14923","DOIUrl":"https://doi.org/10.1111/head.14923","url":null,"abstract":"<p><strong>Objective: </strong>In this cluster-randomized controlled trial, we developed an educational website on tension-type headache and migraine for children and adolescents and evaluated its effectiveness in a school setting.</p><p><strong>Background: </strong>Primary headaches are a widespread issue in children and adolescents, often persisting into adulthood and associated with considerable disabilities, costs, and reduced quality of life. Effective management of primary headaches may prevent chronicity and its associated consequences.</p><p><strong>Design: </strong>Guided by a workbook, N = 814 fifth and sixth grade students explored the website during class. Data were collected before the headache education and at three further assessments, each 4 weeks apart, between November 2021 and April 2022. Participants were randomly assigned by class to either the intervention group, which received the website-based educational intervention after the first data collection, or a control group, which accessed the website after the last data collection.</p><p><strong>Results: </strong>The intervention significantly increased children's headache-related knowledge (time × group interaction: β = 0.35, 95% confidence interval [CI] = [0.30; 0.41], p ≤ 0.001) and resulted in fewer passive pain coping strategies (time × group interaction: β = -0.06, 95% CI = [-0.12; 0.00], p = 0.044). However, the intervention did not significantly reduce the number of days with headaches, use of headache medication, or school absences due to headaches.</p><p><strong>Conclusion: </strong>While the website is an effective educational tool for imparting knowledge about headaches, even initiating small behavioral changes, it does not lead to substantial changes in behavior or headache characteristics. Educating children via this website may lay a solid foundation of knowledge, but the intervention should be expanded and supplemented with closer supervision to achieve more significant behavior changes and improved outcomes.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624396","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":"Headache characteristics in acromegaly: Only a secondary disorder?","authors":"Giada Giuliani, Denise Costa, Chiara Pellicano, Patrizia Gargiulo, Camilla Virili, Vittorio Di Piero, Marta Altieri","doi":"10.1111/head.14927","DOIUrl":"https://doi.org/10.1111/head.14927","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the characteristics and nature of headache in a population of patients with acromegaly.</p><p><strong>Background: </strong>Headache is frequently described by patients with pituitary adenomas. Although it is mainly considered a secondary disorder, it can persist despite effective therapy for pituitary disease. A proper description of headache according to the subtype of pituitary adenoma is not available in literature. In this light, we aimed to analyze headache characteristics in a population of patients with acromegaly.</p><p><strong>Methods: </strong>In this registry-based retrospective cohort study, headache features were collected through a structured telephone interview. The clinical picture of each patient was classified according to the third edition of the International Classification of Headache Disorders criteria. We carefully investigated the time course and the relationship of headache with acromegaly.</p><p><strong>Results: </strong>Out of 39 enrolled patients, 27 (69%) reported headache. Six patients (15%) fulfilled secondary headache criteria, with complete headache resolution after acromegaly treatment. In all, 21 patients (54%) met the criteria for a primary headache: fourteen had episodic migraine, four had chronic migraine, and three had tension-type headache. No trigeminal autonomic cephalalgias were observed. The presence of primary headache significantly reduced the time to diagnosis of acromegaly (mean [standard deviation] 2.1 [2.5] vs. 4.3 [3.5] years, p = 0.007). The occurrence of primary headache was similar in patients with macroadenoma compared to patients with microadenoma (14 [67%] vs. 7 [33%], χ² = 0.591, p = 0.400), while its course was not significantly influenced either by the acromegaly treatment (p = 0.670) or the achievement of biochemical control (p = 0.490).</p><p><strong>Conclusion: </strong>Secondary headache was found only in a small percentage of our patients. Most of them had a primary headache with a high prevalence of migraine, suggesting that acromegaly might act as a trigger for this disorder. Considering the potentially disabling nature, primary headaches in patients with acromegaly require careful evaluation and personalized management.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624397","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":"Serum levels of autotaxin reveal its role as a novel biomarker of migraine.","authors":"Alberto Ouro, Mónica Castro-Mosquera, Mariña Rodríguez-Arrizabalaga, Manuel Debasa-Mouce, Daniel Romaus-Sanjurjo, Marta Aramburu-Nuñez, Ramón Iglesias-Rey, Josefina Casas, Isabel Lema, José Castillo, Rogelio Leira, Tomás Sobrino","doi":"10.1111/head.14922","DOIUrl":"https://doi.org/10.1111/head.14922","url":null,"abstract":"<p><strong>Background: </strong>Migraine is the most common neurological disorder and the second most disabling human condition. Autotaxin (ATX) is a plasma enzyme that leads to the formation of lysophosphatidic acid (LPA), which is involved in different functions involved in migraine, such as vascular tone control, inflammation, neuronal excitation, endothelial dysfunction, and neuropathic pain, among others. Most patients with migraine are females and, interestingly, ATX is physiologically higher in the serum of females compared to males.</p><p><strong>Objective: </strong>As ATX may be a link between common mechanisms associated with migraine, we aimed to determine the potential role of ATX in migraine by studying its concentrations in serum between patients with episodic (EM) and chronic migraine (CM) compared to healthy controls, as well as the correlation of ATX with clinical outcomes, and other biomarkers described in migraine.</p><p><strong>Methods: </strong>In this cross-sectional study, healthy controls (n = 62), and patients with EM (n = 45), and CM (n = 38) were studied. Clinical outcomes, such as migraine intensity as assessed on a visual analog scale (VAS), frequency of headaches (days/month), evolution time (months), and the duration of attacks (h) were investigated together with the serum biomarkers for inflammation (interleukin 6 [IL-6] and IL-10), trigeminovascular system activation (calcitonin gene-related peptide [CGRP]), endothelial dysfunction (pentraxin 3 [PTX3], cellular fibrinogen [cFN], soluble tumor necrosis factor-like weak inducer of apoptosis [sTWEAK]), and ATX. Additionally, the serum lipidomic biomarkers profile was also analyzed.</p><p><strong>Results: </strong>Serum ATX levels were found to be significantly elevated in both patients with EM (mean [standard deviation, SD] 310.7 [79.7] ng/mL) and CM (mean [SD] 336.7 [66.9] ng/mL) compared to controls (mean [SD] 212.3 [53.2] ng/mL) (p < 0.001). Elevated ATX levels were associated with migraine outcomes in CM, such as VAS score (Spearman's coefficient = 0.405, p < 0.05), frequency (Spearman's coefficient = 0.718, p < 0.001), and evolution time (Spearman's coefficient = 0.2257, p < 0.01). ATX was correlated with CGRP (Pearson's coefficient = 0.278, p < 0.001), PTX3 (Pearson's coefficient = 0.468, p < 0.001), sTWEAK (Pearson's coefficient = 0.242, p < 0.001), cFN (Pearson's coefficient = 0.252, p < 0.01), and IL-6 serum levels (Pearson's coefficient = 0.159, p < 0.001). A drastic decrease in serum lysophosphatidylcholine levels indicates high ATX activity in patients with migraine.</p><p><strong>Conclusions: </strong>Serum levels of ATX were significantly increased in patients with EM and CM. In addition, ATX correlates with clinical outcomes, as well as CGRP, endothelial dysfunction and inflammation biomarkers. Further studies are necessary to elucidate the potential role of ATX as a therapeutic target for migraine.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143541266","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":"Effect of erenumab versus other migraine preventive medications on cardiovascular and cerebrovascular outcomes: A United States claims database-based observational cohort study.","authors":"David W Dodick, Stewart J Tepper, Jessica Ailani, Ani C Khodavirdi, Nico Pannacciulli, Alan Fu, Shia T Kent, Karminder Gill, Robert Urman, Sam S Oh","doi":"10.1111/head.14912","DOIUrl":"https://doi.org/10.1111/head.14912","url":null,"abstract":"<p><strong>Objective: </strong>To estimate the real-world risk of cardiovascular events among patients with migraine treated with erenumab and other migraine preventive medications.</p><p><strong>Background: </strong>Migraine preventive treatment with calcitonin gene-related peptide (CGRP) pathway inhibitors, such as erenumab and others, may theoretically result in cardiovascular effects due to a lack of compensatory vasodilation with CGRP pathway inhibition.</p><p><strong>Methods: </strong>In this retrospective observational cohort study, we estimated the unadjusted cumulative risk (CR) of new-onset hypertension, acute myocardial infarction (MI), or stroke among patients with migraine newly treated with erenumab, other anti-CGRP pathway monoclonal antibodies (mAbs), standard oral preventive medications, and onabotulinumtoxinA using data from the MarketScan® Commercial and Medicare Supplemental medical claims database. Comparative analyses to assess the relative risk (RR) of vascular events were gated on the comparability of treatment groups with respect to baseline demographics and clinical characteristics. Potential bias due to unmeasured confounding was evaluated via negative control outcome (NCO) analyses. Confounding based on measured covariates and differential informative censoring were addressed with inverse probability weights.</p><p><strong>Results: </strong>A total of 108,019 new users of migraine preventive medications were included. Unadjusted CR (95% confidence interval [CI]) of hypertension at 12 months of treatment was: erenumab, 9.34% (8.79-9.89%); other anti-CGRP pathway mAbs, 9.42% (8.92-9.92%); standard oral preventive medications, 9.09% (8.77-9.41%); and onabotulinumtoxinA, 9.10% (8.39-9.81%). NCO analyses identified minimal concerns related to unmeasured confounding in erenumab versus other mAbs and erenumab versus onabotulinumtoxinA comparisons. Adjusted RRs (95% CIs) of acute MI and stroke, respectively, at 36 months of treatment were 1.02 (0.45-1.59) and 0.90 (0.56-1.25) for erenumab versus other mAbs and 0.87 (0.19-1.55) and 0.97 (0.42-1.52) for erenumab versus onabotulinumtoxinA.</p><p><strong>Conclusions: </strong>In this analysis of the MarketScan medical claims database, we found no difference in the risk of vascular events in patients treated with erenumab versus other anti-CGRP pathway mAbs or onabotulinumtoxinA.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143541255","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}