Migraine News Roundup – January 2021 Edition

Staying in the loop about migraine topics isn’t easy when there’s so many other things to worry about (like when is this current attack going to end…?). The Migraine Buddy team sought some feedback from the community and we’ve decided to introduce monthly roundups of news and updates about migraine treatments, research, as well as other relevant subjects.

Each month, the Migraine Buddy team will select 3-5 content pieces that caught our attention and provide information which we believe can be insightful for the community. They are listed in no particular order, and here are our picks for January:

Efficacy of levetiracetam for migraine prophylaxis: A systematic review and meta-analysis

• A quantitative analysis to evaluate the effectiveness of an antiepileptic drug, levetiracetam (LEV), for migraine prevention

• Based on meta-analysis and systematic review of 4 randomized controlled trials (192 patients) and 4 prospective studies (85 patients)

• The main outcomes to determine efficacy of levetiracetam: number of patients with >50% headache frequency reduction, frequency of headache, and headache severity 

• Results from the meta-analysis demonstrated “significant reduction in headache frequency and improvement in headache severity after LEV intervention compared with the placebo”. To elaborate further, “[t]he efficacy of LEV on migraine prophylaxis seems to be more significant in more than two months of intervention”, compared to a shorter period of intervention 

• This positive observation was also echoed in the systematic review, where it “demonstrated favorable preventive effects of LEV in both pediatric and adult patients with migraine.”

READ MORE: Yen, P.-H. et al. (2021). Efficacy of levetiracetam for migraine prophylaxis: A systematic review and meta-analysis. Journal of the Formosan Medical Association, 120(1), 755–764.

The impact of pain-related emotions on migraine

• A study to understand how pain-related emotional responses can affect the perception of pain and disability in 145 migraine patients

• The researchers utilized three measurement tools “to evaluate pain-related emotional aspects”: PASS (Pain Anxiety Symptoms Scale), PCS (Pain Catastrophizing Scale), and PSQ (Pain Sensitivity Questionnaire).

• “PASS, PCS, and PSQ scores of migraine patients were significantly higher than those of the control group. PASS and PCS were significantly associated with headache pain intensity, abortive medication use, and headache disability.”

• Results from the study “showed that migraine patients had altered emotional and cognitive responses to pain perception”, whereby “headache severity has direct loading on emotion and subsequently influenced migraine-related disability.”

• Additionally, “[d]isability has a significant effect on the frequency of abortive medication use”. The study concluded that “[i]n the therapeutic aspect of migraines, the strategy for disability considering pain-related emotional factors could be important.”

READ MORE: Kim, S. et al. (2021). The impact of Pain-related emotions on migraine. Scientific Reports, 11(1), 577.

Association between response to triptans and response to erenumab: real-life data

• An observational study to assess for correlations between responses to two medications that target the calcitonin gene-related peptide pathway in migraine

• Researchers were keen to understand the possibility of three correlations between triptans and erenumab (Aimovig) response in 140 migraine patients:

  • Whether previous response to triptans predicts the subsequent efficacy of erenumab

  • Whether the loss of efficacy – wear-off – of triptans over time predicts erenumab ineffectiveness

  • Whether erenumab treatment improves the efficacy of triptans.

• Results from this study demonstrated that “patients reporting response to at least one triptan have a higher likelihood to respond to erenumab treatment compared with triptan non-responders.”

• The information from this study can be helpful for clinicians “to advise patients about their chances of response to erenumab treatment”; however, it should not be the strict selection criteria to receive Aimovig treatment as there were also many triptan non-responders who had favorable outcomes with erenumab

READ MORE: Frattale, I. et al. (2021). Association between response to triptans and response to erenumab: real-life data. The Journal of Headache and Pain, 22(1).