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Is it time to rethink chronic migraine classification?

Leading US migraine specialists are questioning the 15 headache days/month threshold for differentiating episodic and chronic migraine following an analysis showing that it does not adequately capture the burden of illness or reflect treatment needs. Migraine patients who participated in the American Registry for Migraine Research between February 2016 and March 2020 were divided into …

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Head-to-head study shows CGRP MAb therapy superior to standard of care in migraine prevention

Data from the first randomised controlled trial of MAb therapy versus standard of care in migraine prevention have shown a higher responder rate with erenumab compared with topiramate and fewer treatment discontinuations. During the 24-week double blind, double dummy phase of the HER-MES study of 777 patients with more than four migraine days per month, …

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Clinicians urged to document bridge therapies used to address CGRP MAb wearing-off

Clinicians are being encouraged to document the use and benefit of bridge therapies for patients who experience CGRP MAb wearing off during migraine treatment. This follows a retrospective chart review of patients attending a US headache centre which showed wearing-off in 20% of patients, equivalent to approximately 25% of the anticipated duration of monthly CGRP …

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Sustained efficacy of atogepant reported up to 1 year

Once daily atogepant administered over 52 weeks reduced monthly migraine days (MMDs), moderate/severe headache days, and acute medication use days in patients with episodic migraine, with MMD response rates rising during the study. These were the key efficacy data from an open label study (NCT03700320) which randomised 744 patients to atogepant 60 mg once daily …

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Growing evidence for benefits of CGRP MAb/onabotulinumtoxinA combination in chronic migraine

Further evidence supports the efficacy and safety of combining anti-CGRP therapy with onabotulinumtoxinA. A retrospective, longitudinal chart review was carried out for 149 adult patients with chronic migraine treated with ≥2 consecutive cycles of onabotulinumtoxinA before ≥1 month of onabotulinumtoxinA and CGRP mAb combination treatment. Patients had a mean 20.3 monthly headache days (MHDs) before onabotulinumtoxinA …

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Fremanezumab lacks efficacy in established post-traumatic headache

No numerical or statistical differences between fremanezumab 675 mg/month and placebo were found in efficacy endpoints in a Phase 2 trial of patients with an established pattern of post-traumatic headache (PTH).1 In the Phase 2 study in 87 patients with a stable history of PTH, there was no difference in the observed change in moderate-to-severe headache …

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App-based study supports real world effectiveness of ubrogepant

Interim findings from a novel, app-based study have supported the real-world effectiveness of ubrogepant 50mg or 100 mg in combination with onabotulinumtoxinA (ubro+onabotA) or CGRP MAb treatment (ubro+MAb) or both (ubro+both) for the acute treatment of migraine. Over 30 days, study assessments were self-reported in an electronic diary format and collected via the Migraine Buddy …

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