13th European Headache Federation Congress 2019

In a Phase 2b migraine prevention trial, atogepant has shown statistically significant and clinically relevant reductions in mean monthly migraine days (MMD) compared to placebo over a 12-week treatment period, together with clinically meaningful effects on responder rates (Table 1). Atogepant was well tolerated with no treatment-related serious adverse events, and liver function test results …

Ubrogepant and atogepant differentially inhibit CGRP-dependent vasodilator responses in intracranial and coronary arteries and are more potent in cranial than coronary vessels. Most importantly, they are devoid of vasoconstrictive properties on coronary arteries. This was how Dr Eloisa Rubio-Beltran, from Erasmus Medical Centre, Rotterdam, the Netherlands, summarised findings from a series of experiments with ubrogepant …

Gepants are likely to be clinically useful in patients with treatment needs unmet by current acute migraine therapies, concluded Professor Richard Lipton, from the Albert Einstein College of Medicine, New York, at the end of a review of gepant clinical trials. He pointed out that 34% of patients currently achieve an inadequate response to triptan …

A post-hoc analysis of data from a long-term safety study of patients who converted from chronic to episodic migraine with quarterly and monthly fremanezumab has confirmed continuing improvements in headache and migraine parameters at six and 12 months (Table 1), with safety data in line with previous results and no discontinuations due to adverse events. …

An updated analysis of the open label extension (OLE) of the LIBERTY trial in patients with episodic migraine who failed on two to four previous preventive therapies has confirmed the sustained efficacy of erenumab up to 64 weeks. The >50% responder rate for the overall population increased from week 12-40 and remained stable through to …

New data from the Phase 3b FOCUS trial have demonstrated the efficacy of quarterly and monthly fremanezumab treatment in patients with episodic and chronic migraine who had inadequate responses to two to four previous preventive therapies (Tables 1 and 2) Table 1. Mean change from baseline in monthly migraine days over 12 weeks Overall population …

Headache in patients with chronic migraine treated with galcanezumab or erenumab did not return to baseline levels within 16 weeks after termination of preventive therapy, according to data from a study carried out by Dr Uwe Reuter and colleagues at the University of Berlin, Germany. Monthly migraine days remained significantly lower than baseline, with a …

Significant improvements in monthly migraine activity seen with the first infusion of eptinezumab in the PROMISE-2 study of chronic migraine have been sustained with an additional quarterly infusion. Extended data, presented by Dr Roger Cady, from Alder BioPharmaceuticals, show that effects on monthly migraine days and responder rates were maintained through months 4-6 of treatment. …

Results of a meta analysis of placebo and nocebo responses in anti-CGRP monoclonal antibody trials suggest a higher than average placebo incidence and average/low nocebo phenomenon compared with standard therapies for episodic and chronic migraine (Table 1). The research reflects growing interest in the role of both placebo and nocebo effects as psychological components of …

Clinicians, patients and pharmaceutical companies must join forces to campaign for healthcare payers and providers to make migraine a priority and accelerate access to new treatments. This was the clear message from organisers of the European Headache Federation Congress 2019 on the opening day of the meeting. “With the arrival of the first migraine-specific therapies …