Our most-popular articles relating to migraine in 2020 included new research on menstrual migraine and the efficacy of erenumab, a calcitonin gene-related peptide inhibitor, for migraine.
Our most popular articles relating to migraine in 2020 included new research on menstrual migraine and the efficacy of erenumab, a calcitonin gene-related peptide (CGRP) inhibitor, for migraine. Additional research on migraine as a risk factor for peripheral artery occlusive disease and the genetic overlap between the condition and sleep disturbances rounded out this year’s list of most-read articles.
According to results of a study published in the International Journal of Environmental Research and Public Health, the presence of migraine is a significant risk factor for the development of subsequent peripheral artery occlusive disease (PAOD). Findings of the retrospective cohort study were published in November 2020. PAOD is most commonly caused by atherosclerosis, which can lead to stenosis or occlusion of an artery and presents as intermittent claudication and critical limb ischemia. Of the roughly 75,000 participants in the study, 885 individuals with a migraine diagnosis and 530 individuals in the control group developed PAOD. Those in the study group also had a significantly higher adjusted hazard ratio for PAOD at 1.65.
Using resting-state functional MRI (rsfMRI) and structural MRI (sMRI), researchers highlighted structural and functional brain differences among those who experience menstrual-related migraine (MRM) and pure menstrual migraine (PMM). Results of the study were published in October 2020. Investigators found that patients with MRM exhibited lower amplitude of low-frequency fluctuations (ALFF) values at the dorsolateral prefrontal cortex and medial prefrontal cortex (mPFC) than patients with PMM. In addition, ALFF values in the mPFC were positively correlated with CGRP expression in the PMM group, whereas higher values in the mPFC were also related to higher expression of CGRP in the PMM group.
Mendelian randomization (MR) study results show that the genetic determinants of sleep and migraine partially overlap, suggesting that sleep disturbances may causally influence migraine etiology and could be targets for migraine treatment. Findings, published in November 2020, were based on cross-trait linkage disequilibrium score regression and MR using data from the United Kingdom Biobank cohort and the largest genome-wide association study of patients with migraine. In total, researchers found 7 sleep traits demonstrated genetic overlap with migraine, including difficulty awakening, insomnia symptoms, long sleep duration (≥9 hours), short sleep duration (<7 hours), sleep duration, napping, and daytime sleepiness.
Data from women with menstrual migraine enrolled in the Study to Evaluate the Efficacy and Safety of Erenumab in Migraine Prevention (STRIVE) showed that erenumab is a safe and effective option for treating the condition. All women included in the subgroup analysis were 50 years or younger and had a self-reported history of menstrual migraine attacks. Each participant received a placebo, a 70-mg dose of erenumab, or a 140-mg dose. Researchers found both doses of erenumab resulted in statistically significantly greater reductions in monthly migraine days as early as month 1 compared with the placebo arm. The overall safety profile of erenumab was similar to that of the placebo, and no cardiovascular adverse events were reported in patients with menstrual migraine.
An analysis published in Cephalalgia in December 2020 found that more than 50% of patients enrolled in a double-blind trial and open-label extension exhibited reversion from chronic migraine to episodic migraine after week 12 of the treatment phase. During the trial, all participants were randomized 3:2:2 to receive monthly placebo, erenumab 70 mg, or erenumab 140 mg. In addition, roughly two-thirds of patients with chronic migraine who received erenumab were likely to revert to episodic migraine and persist in this state after 64 weeks of treatment, researchers concluded. Patients who reverted had fewer prior failures of migraine preventive treatment compared with those who remained in chronic migraine.