International Headache Congress 2021

Real world studies are showing that CGRP mAbs are effective in significant patient groups excluded from randomised controlled trials (RCTs). They are also helping to identify predictors of treatment response and are extending understanding of safety issues. Professor Uwe Reuter, from the Charité University Berlin and the University of Greifswald, Germany, discussed data from the …

Stopping preventive treatment with CGRP mAbs typically leads to worsening migraine symptoms and, in some cases, a rebound effect, according to reports from clinicians in Germany, Portugal and Italy. Results of a German longitudinal study of 62 patients who received erenumab, fremanezumab or galcanezumab for at least eight months showed that mean monthly migraine days …

Twelve month data from the HALO study and six month results from the FOCUS study have shown few blood pressure-related adverse events with fremanezumab and minimal changes in systolic blood pressure (SBP) or diastolic blood pressure (DBP). In HALO, one patient had increased DBP and one had decreased SBP, both with quarterly fremanezumab. Mean blood …

Erenumab and galcanezumab have demonstrated similar efficacy and safety as preventive treatment in a very difficult-to-treat migraine population in Spain. Data were reported on 220 patients, 89% of whom had chronic migraine. Patients had failed on a mean 5.74 previous preventive therapies. With erenumab, monthly headache days (MHDs) decreased from 20.94 days at baseline to …

Long term acute treatment of migraine with rimegepant 75 mg as needed is associated with clinically relevant reductions in monthly migraine days (MMDs), according to post hoc results from an open label, 52-week safety study. There was no evidence of medication-related increases in headache frequency. In the study of 1,044 participants with ≥6 MMDs, the …

Real world experience from multiple new reports worldwide supports the use of CGRP mAbs in the treatment of cluster headache. From Korea, researchers reported results from 45 patients with episodic cluster headache who received at least one dose of galcanezumab 240 mg in two prefilled syringes of 120 mg.1 Patients took a range of preventive …

No new safety signals have been identified in the ADVANCE open label extension study of atogepant 60 mg once daily for 40 weeks, with a 4-week safety follow-up period. Of the 685 patients who rolled over from the ADVANCE trial and took at least one dose of study drug, 74.6% completed the 40-week treatment period. …

Approximately one in three non-responders to initial CGRP mAb treatment may benefit from switching to another antibody, according to results of two real world reports. In a retrospective cohort study of 25 non responders to erenumab (<30% reduction of monthly headache days [MHD] after three cycles), eight patients (32%) achieved a >30% reduction in MHD after switching …

High levels of patient satisfaction have been reported in an analysis of data from 302 US adult Migraine Buddy users who self-reported using at least four doses of ubrogepant, one in the preceding 14 days. Of the sample, 75.8% reported being satisfied with ubrogepant for pain relief at 2 hours, 83.4% at 4 hours and …

Long-term, real world experience with erenumab in high frequency episodic migraine (HFEM) and chronic migraine (CM) has shown sustained effectiveness, safety and tolerability in patients who failed on at least three previous preventive therapies. The results, from the 48-week EARLY 2 study in 15 Italian centres, also showed that responsiveness was positively associated with cutaneous …