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Do autonomic symptoms influence headache frequency and treatment response in migraine?
Key clinical point: Autonomic symptoms were prevalent in patients with episodic or chronic migraine but demonstrated no significant correlation with headache frequency, treatment response, or reversion from chronic to episodic migraine.
Major finding: Overall, 60.5% of patients reported a Composite Autonomic Symptom Scale (COMPASS-31) score of ≥30. The median monthly headache days (P = .002) and Migraine Disability Assessment Score (P = .01) reduced significantly during the study period but change in the mean weighted COMPASS-31 score was not significant (P = .885), with no correlation observed between the COMPASS-31 score and monthly headache frequency or reversion from chronic to episodic migraine.
Study details: This was a prospective longitudinal cohort study including 43 patients with episodic or chronic migraine who completed 12 months of treatment and follow-up surveys.
Disclosures: This study did not report the source of funding. Four authors declared receiving funding, grants, or payment for developing educational presentations, serving on advisory boards, or being involved in clinical trials sponsored by various sources.
Source: Ray JC et al. Autonomic symptoms in migraine: Results of a prospective longitudinal study. Front Neurol. 2022;13:1036798 (Nov 3). Doi: 10.3389/fneur.2022.1036798
Key clinical point: Autonomic symptoms were prevalent in patients with episodic or chronic migraine but demonstrated no significant correlation with headache frequency, treatment response, or reversion from chronic to episodic migraine.
Major finding: Overall, 60.5% of patients reported a Composite Autonomic Symptom Scale (COMPASS-31) score of ≥30. The median monthly headache days (P = .002) and Migraine Disability Assessment Score (P = .01) reduced significantly during the study period but change in the mean weighted COMPASS-31 score was not significant (P = .885), with no correlation observed between the COMPASS-31 score and monthly headache frequency or reversion from chronic to episodic migraine.
Study details: This was a prospective longitudinal cohort study including 43 patients with episodic or chronic migraine who completed 12 months of treatment and follow-up surveys.
Disclosures: This study did not report the source of funding. Four authors declared receiving funding, grants, or payment for developing educational presentations, serving on advisory boards, or being involved in clinical trials sponsored by various sources.
Source: Ray JC et al. Autonomic symptoms in migraine: Results of a prospective longitudinal study. Front Neurol. 2022;13:1036798 (Nov 3). Doi: 10.3389/fneur.2022.1036798
Key clinical point: Autonomic symptoms were prevalent in patients with episodic or chronic migraine but demonstrated no significant correlation with headache frequency, treatment response, or reversion from chronic to episodic migraine.
Major finding: Overall, 60.5% of patients reported a Composite Autonomic Symptom Scale (COMPASS-31) score of ≥30. The median monthly headache days (P = .002) and Migraine Disability Assessment Score (P = .01) reduced significantly during the study period but change in the mean weighted COMPASS-31 score was not significant (P = .885), with no correlation observed between the COMPASS-31 score and monthly headache frequency or reversion from chronic to episodic migraine.
Study details: This was a prospective longitudinal cohort study including 43 patients with episodic or chronic migraine who completed 12 months of treatment and follow-up surveys.
Disclosures: This study did not report the source of funding. Four authors declared receiving funding, grants, or payment for developing educational presentations, serving on advisory boards, or being involved in clinical trials sponsored by various sources.
Source: Ray JC et al. Autonomic symptoms in migraine: Results of a prospective longitudinal study. Front Neurol. 2022;13:1036798 (Nov 3). Doi: 10.3389/fneur.2022.1036798
Elevated peripheral inflammatory markers may help support migraine diagnosis
Key clinical point: During acute headaches, patients with migraine had elevated levels of peripheral inflammatory markers (PIM), specifically the neutrophil-to-lymphocyte ratio (NLR) and the neutrophil-to-monocyte ratio (NMR), which could fairly differentiate between the migraine and no headache groups.
Major finding: Patients with migraine had higher NLR, NMR, and monocyte-to-lymphocyte ratio (all P < .001) compared with control individuals without headache and higher NMR (P < .001) and higher NLR (P = .051) compared with patients with non-migraine headaches during acute headache attacks. NLR and NMR could fairly differentiate between the migraine and no headache groups (NLR: area under the curve [AUC] 0.65; NMR: AUC 0.61; P < .001).
Study details: This was a retrospective analysis of 4005 patients with acute headache attack, including those with migraine (n = 1453) or non-migraine (n = 2552) headaches, and 88,586 control individuals without headache.
Disclosures: This study was supported by Basic Science Research Program through the National Research Foundataion of Korea funded by the Ministry of Education and others. The authors declared no conflicts of interest.
Source: Lee S-H et al. Role of peripheral inflammatory markers in patients with acute headache attack to differentiate between migraine and non-migraine headache. J Clin Med. 2022;11(21):6538 (Nov 3). Doi: 10.3390/jcm11216538
Key clinical point: During acute headaches, patients with migraine had elevated levels of peripheral inflammatory markers (PIM), specifically the neutrophil-to-lymphocyte ratio (NLR) and the neutrophil-to-monocyte ratio (NMR), which could fairly differentiate between the migraine and no headache groups.
Major finding: Patients with migraine had higher NLR, NMR, and monocyte-to-lymphocyte ratio (all P < .001) compared with control individuals without headache and higher NMR (P < .001) and higher NLR (P = .051) compared with patients with non-migraine headaches during acute headache attacks. NLR and NMR could fairly differentiate between the migraine and no headache groups (NLR: area under the curve [AUC] 0.65; NMR: AUC 0.61; P < .001).
Study details: This was a retrospective analysis of 4005 patients with acute headache attack, including those with migraine (n = 1453) or non-migraine (n = 2552) headaches, and 88,586 control individuals without headache.
Disclosures: This study was supported by Basic Science Research Program through the National Research Foundataion of Korea funded by the Ministry of Education and others. The authors declared no conflicts of interest.
Source: Lee S-H et al. Role of peripheral inflammatory markers in patients with acute headache attack to differentiate between migraine and non-migraine headache. J Clin Med. 2022;11(21):6538 (Nov 3). Doi: 10.3390/jcm11216538
Key clinical point: During acute headaches, patients with migraine had elevated levels of peripheral inflammatory markers (PIM), specifically the neutrophil-to-lymphocyte ratio (NLR) and the neutrophil-to-monocyte ratio (NMR), which could fairly differentiate between the migraine and no headache groups.
Major finding: Patients with migraine had higher NLR, NMR, and monocyte-to-lymphocyte ratio (all P < .001) compared with control individuals without headache and higher NMR (P < .001) and higher NLR (P = .051) compared with patients with non-migraine headaches during acute headache attacks. NLR and NMR could fairly differentiate between the migraine and no headache groups (NLR: area under the curve [AUC] 0.65; NMR: AUC 0.61; P < .001).
Study details: This was a retrospective analysis of 4005 patients with acute headache attack, including those with migraine (n = 1453) or non-migraine (n = 2552) headaches, and 88,586 control individuals without headache.
Disclosures: This study was supported by Basic Science Research Program through the National Research Foundataion of Korea funded by the Ministry of Education and others. The authors declared no conflicts of interest.
Source: Lee S-H et al. Role of peripheral inflammatory markers in patients with acute headache attack to differentiate between migraine and non-migraine headache. J Clin Med. 2022;11(21):6538 (Nov 3). Doi: 10.3390/jcm11216538
Real-world predictors of response to anti-CGRP mAb in migraine
Key clinical point: Migraine pain characteristics indicating peripheral or central sensitization may help predict ≥50% response to anti-calcitonin gene-related peptide (anti-CGRP) monoclonal antibodies (mAb) in patients with high frequency episodic migraine (HFEM) or chronic migraine (CM).
Major finding: In HFEM, unilateral pain (UP) + unilateral cranial autonomic symptoms (UA) positively predicted ≥50% response (odds ratio [OR] 4.23; P = .004), whereas in CM, UP (OR 1.46; P = .039), UA (OR 1.49; P = .026), UP+UA (OR 1.90; P = .012), and UP+allodynia (OR 1.71; P = .034) positively predicted ≥50% response and obesity negatively predicted ≥50% response (OR 0.21; P = .006).
Study details: This was a real-life prospective cohort study including 864 anti-CGRP mAb-naive patients with HFEM or CM and unresponsiveness or contraindications for or low tolerability to >3 migraine preventive medications, who were prescribed erenumab, galcanezumab, or fremanezumab for ≥24 weeks.
Disclosures: This study was partially supported by the Italian Ministry of Health IRCCS San Raffaele Roma. Several authors reported receiving personal compensation, travel grants, honoraria, or research support from various sources.
Source: Barbanti P et al. Predictors of response to anti-CGRP monoclonal antibodies: A 24-week, multicenter, prospective study on 864 migraine patients. J Headache Pain. 2022;23:138 (Nov 1). Doi: 10.1186/s10194-022-01498-6
Key clinical point: Migraine pain characteristics indicating peripheral or central sensitization may help predict ≥50% response to anti-calcitonin gene-related peptide (anti-CGRP) monoclonal antibodies (mAb) in patients with high frequency episodic migraine (HFEM) or chronic migraine (CM).
Major finding: In HFEM, unilateral pain (UP) + unilateral cranial autonomic symptoms (UA) positively predicted ≥50% response (odds ratio [OR] 4.23; P = .004), whereas in CM, UP (OR 1.46; P = .039), UA (OR 1.49; P = .026), UP+UA (OR 1.90; P = .012), and UP+allodynia (OR 1.71; P = .034) positively predicted ≥50% response and obesity negatively predicted ≥50% response (OR 0.21; P = .006).
Study details: This was a real-life prospective cohort study including 864 anti-CGRP mAb-naive patients with HFEM or CM and unresponsiveness or contraindications for or low tolerability to >3 migraine preventive medications, who were prescribed erenumab, galcanezumab, or fremanezumab for ≥24 weeks.
Disclosures: This study was partially supported by the Italian Ministry of Health IRCCS San Raffaele Roma. Several authors reported receiving personal compensation, travel grants, honoraria, or research support from various sources.
Source: Barbanti P et al. Predictors of response to anti-CGRP monoclonal antibodies: A 24-week, multicenter, prospective study on 864 migraine patients. J Headache Pain. 2022;23:138 (Nov 1). Doi: 10.1186/s10194-022-01498-6
Key clinical point: Migraine pain characteristics indicating peripheral or central sensitization may help predict ≥50% response to anti-calcitonin gene-related peptide (anti-CGRP) monoclonal antibodies (mAb) in patients with high frequency episodic migraine (HFEM) or chronic migraine (CM).
Major finding: In HFEM, unilateral pain (UP) + unilateral cranial autonomic symptoms (UA) positively predicted ≥50% response (odds ratio [OR] 4.23; P = .004), whereas in CM, UP (OR 1.46; P = .039), UA (OR 1.49; P = .026), UP+UA (OR 1.90; P = .012), and UP+allodynia (OR 1.71; P = .034) positively predicted ≥50% response and obesity negatively predicted ≥50% response (OR 0.21; P = .006).
Study details: This was a real-life prospective cohort study including 864 anti-CGRP mAb-naive patients with HFEM or CM and unresponsiveness or contraindications for or low tolerability to >3 migraine preventive medications, who were prescribed erenumab, galcanezumab, or fremanezumab for ≥24 weeks.
Disclosures: This study was partially supported by the Italian Ministry of Health IRCCS San Raffaele Roma. Several authors reported receiving personal compensation, travel grants, honoraria, or research support from various sources.
Source: Barbanti P et al. Predictors of response to anti-CGRP monoclonal antibodies: A 24-week, multicenter, prospective study on 864 migraine patients. J Headache Pain. 2022;23:138 (Nov 1). Doi: 10.1186/s10194-022-01498-6
Efficacy and safety of zolmitriptan nasal spray for acute treatment of pediatric migraine
Key clinical point: Despite no significant improvement in pain-free status, high-dose zolmitriptan nasal spray (ZNS) provided clinically relevant improvements with a favorable safety profile in the acute treatment of migraine in patients aged 6-11 years.
Major finding: At 2 hours postdose, high-dose ZNS vs placebo led to a numerically higher proportion of patients achieving pain-free status (odds ratio [OR] 1.51; 95% CI 0.96-2.38) and a significantly higher proportion of patients reporting a headache response (OR 1.75; P = .009). No serious treatment-emergent adverse events were reported.
Study details: This was a phase 3 crossover trial with an open-label extension including 186 patients aged 6-11 years with migraine with or without aura who were randomly assigned to receive ZNS (patients <50 kg: 2.5 or 1 mg; patients ≥50 kg: 5 or 2.5 mg) or placebo.
Disclosures: This trial was funded by AstraZeneca and conducted by Amneal Pharmaceuticals LLC, which also supported the study’s publication. Two authors declared being employees of Amneal or a company contracted by Amneal. Two authors reported ties with various other sources.
Source: Yonker ME et al. A multicenter, randomized, double-blind, placebo-controlled, crossover trial to evaluate the efficacy and safety of zolmitriptan nasal spray for the acute treatment of migraine in patients aged 6 to 11 years, with an open-label extension. Headache. 2022;62(9):1207-1217 (Oct 26). Doi: 10.1111/head.14391
Key clinical point: Despite no significant improvement in pain-free status, high-dose zolmitriptan nasal spray (ZNS) provided clinically relevant improvements with a favorable safety profile in the acute treatment of migraine in patients aged 6-11 years.
Major finding: At 2 hours postdose, high-dose ZNS vs placebo led to a numerically higher proportion of patients achieving pain-free status (odds ratio [OR] 1.51; 95% CI 0.96-2.38) and a significantly higher proportion of patients reporting a headache response (OR 1.75; P = .009). No serious treatment-emergent adverse events were reported.
Study details: This was a phase 3 crossover trial with an open-label extension including 186 patients aged 6-11 years with migraine with or without aura who were randomly assigned to receive ZNS (patients <50 kg: 2.5 or 1 mg; patients ≥50 kg: 5 or 2.5 mg) or placebo.
Disclosures: This trial was funded by AstraZeneca and conducted by Amneal Pharmaceuticals LLC, which also supported the study’s publication. Two authors declared being employees of Amneal or a company contracted by Amneal. Two authors reported ties with various other sources.
Source: Yonker ME et al. A multicenter, randomized, double-blind, placebo-controlled, crossover trial to evaluate the efficacy and safety of zolmitriptan nasal spray for the acute treatment of migraine in patients aged 6 to 11 years, with an open-label extension. Headache. 2022;62(9):1207-1217 (Oct 26). Doi: 10.1111/head.14391
Key clinical point: Despite no significant improvement in pain-free status, high-dose zolmitriptan nasal spray (ZNS) provided clinically relevant improvements with a favorable safety profile in the acute treatment of migraine in patients aged 6-11 years.
Major finding: At 2 hours postdose, high-dose ZNS vs placebo led to a numerically higher proportion of patients achieving pain-free status (odds ratio [OR] 1.51; 95% CI 0.96-2.38) and a significantly higher proportion of patients reporting a headache response (OR 1.75; P = .009). No serious treatment-emergent adverse events were reported.
Study details: This was a phase 3 crossover trial with an open-label extension including 186 patients aged 6-11 years with migraine with or without aura who were randomly assigned to receive ZNS (patients <50 kg: 2.5 or 1 mg; patients ≥50 kg: 5 or 2.5 mg) or placebo.
Disclosures: This trial was funded by AstraZeneca and conducted by Amneal Pharmaceuticals LLC, which also supported the study’s publication. Two authors declared being employees of Amneal or a company contracted by Amneal. Two authors reported ties with various other sources.
Source: Yonker ME et al. A multicenter, randomized, double-blind, placebo-controlled, crossover trial to evaluate the efficacy and safety of zolmitriptan nasal spray for the acute treatment of migraine in patients aged 6 to 11 years, with an open-label extension. Headache. 2022;62(9):1207-1217 (Oct 26). Doi: 10.1111/head.14391
Zavegepant nasal spray effective and safe for acute treatment of migraine
Key clinical point: A single dose of zavegepant nasal spray (20 or 10 mg) was effective for the acute treatment of migraine with a favorable safety profile.
Major finding: At 2 hours, a significantly higher proportion of patients treated with 20 mg or 10 mg zavegepant vs placebo reported freedom from pain (23.1% and 22.5% vs 15.5%; P = .0055 and .0113, respectively) and most bothersome symptoms (42.5% and 41.9% vs 33.7%; P = .0094 and .0155, respectively), with adverse events being mostly mild or moderate and no indications for hepatotoxicity.
Study details: This phase 2/3 trial included 1673 patients with migraine with or without aura who were randomly assigned to receive zavegepant (5, 10, 20 mg) or placebo to treat a single migraine attack of moderate-to-severe pain intensity.
Disclosures: This study was funded by Biohaven Pharmaceuticals, Inc. Seven authors declared being employees and holding stock or stock options in Biohaven Pharmaceuticals. RB Lipton declared holding stock options in Biohaven Pharmaceuticals and Manistee and reported ties with various other sources.
Source: Croop R et al. Zavegepant nasal spray for the acute treatment of migraine: A phase 2/3 double-blind, randomized, placebo-controlled, dose-ranging trial. Headache. 2022;62(9):1153-1163 (Oct 14). Doi: 10.1111/head.14389
Key clinical point: A single dose of zavegepant nasal spray (20 or 10 mg) was effective for the acute treatment of migraine with a favorable safety profile.
Major finding: At 2 hours, a significantly higher proportion of patients treated with 20 mg or 10 mg zavegepant vs placebo reported freedom from pain (23.1% and 22.5% vs 15.5%; P = .0055 and .0113, respectively) and most bothersome symptoms (42.5% and 41.9% vs 33.7%; P = .0094 and .0155, respectively), with adverse events being mostly mild or moderate and no indications for hepatotoxicity.
Study details: This phase 2/3 trial included 1673 patients with migraine with or without aura who were randomly assigned to receive zavegepant (5, 10, 20 mg) or placebo to treat a single migraine attack of moderate-to-severe pain intensity.
Disclosures: This study was funded by Biohaven Pharmaceuticals, Inc. Seven authors declared being employees and holding stock or stock options in Biohaven Pharmaceuticals. RB Lipton declared holding stock options in Biohaven Pharmaceuticals and Manistee and reported ties with various other sources.
Source: Croop R et al. Zavegepant nasal spray for the acute treatment of migraine: A phase 2/3 double-blind, randomized, placebo-controlled, dose-ranging trial. Headache. 2022;62(9):1153-1163 (Oct 14). Doi: 10.1111/head.14389
Key clinical point: A single dose of zavegepant nasal spray (20 or 10 mg) was effective for the acute treatment of migraine with a favorable safety profile.
Major finding: At 2 hours, a significantly higher proportion of patients treated with 20 mg or 10 mg zavegepant vs placebo reported freedom from pain (23.1% and 22.5% vs 15.5%; P = .0055 and .0113, respectively) and most bothersome symptoms (42.5% and 41.9% vs 33.7%; P = .0094 and .0155, respectively), with adverse events being mostly mild or moderate and no indications for hepatotoxicity.
Study details: This phase 2/3 trial included 1673 patients with migraine with or without aura who were randomly assigned to receive zavegepant (5, 10, 20 mg) or placebo to treat a single migraine attack of moderate-to-severe pain intensity.
Disclosures: This study was funded by Biohaven Pharmaceuticals, Inc. Seven authors declared being employees and holding stock or stock options in Biohaven Pharmaceuticals. RB Lipton declared holding stock options in Biohaven Pharmaceuticals and Manistee and reported ties with various other sources.
Source: Croop R et al. Zavegepant nasal spray for the acute treatment of migraine: A phase 2/3 double-blind, randomized, placebo-controlled, dose-ranging trial. Headache. 2022;62(9):1153-1163 (Oct 14). Doi: 10.1111/head.14389
Increased risk for anxiety and depression in children and adolescents with migraine
Key clinical point: The odds of anxiety and depression disorders were significantly higher in children and adolescents with migraine compared with control individuals, highlighting the need to routinely screen children and adolescents with migraine for anxiety and depression.
Major finding: Children and adolescents with migraine vs control individuals were at a higher risk for anxiety disorders (odds ratio [OR] 1.93; 95% CI 1.49-2.50), depressive disorders (OR 2.01; 95% CI 1.46-2.78), and mixed internalizing (anxiety and depressive) disorders (OR 4.69; 95% CI 3.08-7.14).
Study details: This was a systematic review of 80 observational studies, of which 51 involving children and adolescents with migraine and control individuals were included in the meta-analysis.
Disclosures: This study was supported by the Alberta Children’s Hospital Research Institute (ACHRI) and Cumming School of Medicine, Canada. SL Orr reported receiving royalties for book publication, grant funding from the Canadian Health Research and ACHRI, and serving on the editorial boards of journals and the American Migraine Foundation.
Source: Falla K et al. Anxiety and depressive symptoms and disorders in children and adolescents with migraine: A systematic review and meta-analysis. JAMA Pediatr. 2022 (Oct 31). Doi: 10.1001/jamapediatrics.2022.3940
Key clinical point: The odds of anxiety and depression disorders were significantly higher in children and adolescents with migraine compared with control individuals, highlighting the need to routinely screen children and adolescents with migraine for anxiety and depression.
Major finding: Children and adolescents with migraine vs control individuals were at a higher risk for anxiety disorders (odds ratio [OR] 1.93; 95% CI 1.49-2.50), depressive disorders (OR 2.01; 95% CI 1.46-2.78), and mixed internalizing (anxiety and depressive) disorders (OR 4.69; 95% CI 3.08-7.14).
Study details: This was a systematic review of 80 observational studies, of which 51 involving children and adolescents with migraine and control individuals were included in the meta-analysis.
Disclosures: This study was supported by the Alberta Children’s Hospital Research Institute (ACHRI) and Cumming School of Medicine, Canada. SL Orr reported receiving royalties for book publication, grant funding from the Canadian Health Research and ACHRI, and serving on the editorial boards of journals and the American Migraine Foundation.
Source: Falla K et al. Anxiety and depressive symptoms and disorders in children and adolescents with migraine: A systematic review and meta-analysis. JAMA Pediatr. 2022 (Oct 31). Doi: 10.1001/jamapediatrics.2022.3940
Key clinical point: The odds of anxiety and depression disorders were significantly higher in children and adolescents with migraine compared with control individuals, highlighting the need to routinely screen children and adolescents with migraine for anxiety and depression.
Major finding: Children and adolescents with migraine vs control individuals were at a higher risk for anxiety disorders (odds ratio [OR] 1.93; 95% CI 1.49-2.50), depressive disorders (OR 2.01; 95% CI 1.46-2.78), and mixed internalizing (anxiety and depressive) disorders (OR 4.69; 95% CI 3.08-7.14).
Study details: This was a systematic review of 80 observational studies, of which 51 involving children and adolescents with migraine and control individuals were included in the meta-analysis.
Disclosures: This study was supported by the Alberta Children’s Hospital Research Institute (ACHRI) and Cumming School of Medicine, Canada. SL Orr reported receiving royalties for book publication, grant funding from the Canadian Health Research and ACHRI, and serving on the editorial boards of journals and the American Migraine Foundation.
Source: Falla K et al. Anxiety and depressive symptoms and disorders in children and adolescents with migraine: A systematic review and meta-analysis. JAMA Pediatr. 2022 (Oct 31). Doi: 10.1001/jamapediatrics.2022.3940
Increased risk for anxiety and depression in children and adolescents with migraine
Key clinical point: The odds of anxiety and depression disorders were significantly higher in children and adolescents with migraine compared with control individuals, highlighting the need to routinely screen children and adolescents with migraine for anxiety and depression.
Major finding: Children and adolescents with migraine vs control individuals were at a higher risk for anxiety disorders (odds ratio [OR] 1.93; 95% CI 1.49-2.50), depressive disorders (OR 2.01; 95% CI 1.46-2.78), and mixed internalizing (anxiety and depressive) disorders (OR 4.69; 95% CI 3.08-7.14).
Study details: This was a systematic review of 80 observational studies, of which 51 involving children and adolescents with migraine and control individuals were included in the meta-analysis.
Disclosures: This study was supported by the Alberta Children’s Hospital Research Institute (ACHRI) and Cumming School of Medicine, Canada. SL Orr reported receiving royalties for book publication, grant funding from the Canadian Health Research and ACHRI, and serving on the editorial boards of journals and the American Migraine Foundation.
Source: Falla K et al. Anxiety and depressive symptoms and disorders in children and adolescents with migraine: A systematic review and meta-analysis. JAMA Pediatr. 2022 (Oct 31). Doi: 10.1001/jamapediatrics.2022.3940
Key clinical point: The odds of anxiety and depression disorders were significantly higher in children and adolescents with migraine compared with control individuals, highlighting the need to routinely screen children and adolescents with migraine for anxiety and depression.
Major finding: Children and adolescents with migraine vs control individuals were at a higher risk for anxiety disorders (odds ratio [OR] 1.93; 95% CI 1.49-2.50), depressive disorders (OR 2.01; 95% CI 1.46-2.78), and mixed internalizing (anxiety and depressive) disorders (OR 4.69; 95% CI 3.08-7.14).
Study details: This was a systematic review of 80 observational studies, of which 51 involving children and adolescents with migraine and control individuals were included in the meta-analysis.
Disclosures: This study was supported by the Alberta Children’s Hospital Research Institute (ACHRI) and Cumming School of Medicine, Canada. SL Orr reported receiving royalties for book publication, grant funding from the Canadian Health Research and ACHRI, and serving on the editorial boards of journals and the American Migraine Foundation.
Source: Falla K et al. Anxiety and depressive symptoms and disorders in children and adolescents with migraine: A systematic review and meta-analysis. JAMA Pediatr. 2022 (Oct 31). Doi: 10.1001/jamapediatrics.2022.3940
Key clinical point: The odds of anxiety and depression disorders were significantly higher in children and adolescents with migraine compared with control individuals, highlighting the need to routinely screen children and adolescents with migraine for anxiety and depression.
Major finding: Children and adolescents with migraine vs control individuals were at a higher risk for anxiety disorders (odds ratio [OR] 1.93; 95% CI 1.49-2.50), depressive disorders (OR 2.01; 95% CI 1.46-2.78), and mixed internalizing (anxiety and depressive) disorders (OR 4.69; 95% CI 3.08-7.14).
Study details: This was a systematic review of 80 observational studies, of which 51 involving children and adolescents with migraine and control individuals were included in the meta-analysis.
Disclosures: This study was supported by the Alberta Children’s Hospital Research Institute (ACHRI) and Cumming School of Medicine, Canada. SL Orr reported receiving royalties for book publication, grant funding from the Canadian Health Research and ACHRI, and serving on the editorial boards of journals and the American Migraine Foundation.
Source: Falla K et al. Anxiety and depressive symptoms and disorders in children and adolescents with migraine: A systematic review and meta-analysis. JAMA Pediatr. 2022 (Oct 31). Doi: 10.1001/jamapediatrics.2022.3940
Proton pump inhibitor use increases gastric cancer risk, says meta-analysis
Key clinical point: Proton pump inhibitor (PPI) use is significantly associated with an increased risk for gastric cancer.
Major finding: PPI users vs nonusers were significantly more likely to develop gastric cancer (odds ratio 1.75; 95% CI 1.28-2.40).
Study details: This study meta-analyzed 16 observational studies (cohort and case-control studies; n = 2,936,935) that evaluated the association between PPI use and the risk for gastric cancer.
Disclosures: This study was sponsored by grants from the Taipei Tzu Chi Hospital and Buddhist Tzu Chi Medical Foundation, Taiwan. The authors declared no conflicts of interest.
Source: Peng TR et al. Association between proton-pump inhibitors and the risk of gastric cancer: A systematic review and meta-analysis. Int J Clin Oncol. 2022 (Oct 12). Doi: 10.1007/s10147-022-02253-2
Key clinical point: Proton pump inhibitor (PPI) use is significantly associated with an increased risk for gastric cancer.
Major finding: PPI users vs nonusers were significantly more likely to develop gastric cancer (odds ratio 1.75; 95% CI 1.28-2.40).
Study details: This study meta-analyzed 16 observational studies (cohort and case-control studies; n = 2,936,935) that evaluated the association between PPI use and the risk for gastric cancer.
Disclosures: This study was sponsored by grants from the Taipei Tzu Chi Hospital and Buddhist Tzu Chi Medical Foundation, Taiwan. The authors declared no conflicts of interest.
Source: Peng TR et al. Association between proton-pump inhibitors and the risk of gastric cancer: A systematic review and meta-analysis. Int J Clin Oncol. 2022 (Oct 12). Doi: 10.1007/s10147-022-02253-2
Key clinical point: Proton pump inhibitor (PPI) use is significantly associated with an increased risk for gastric cancer.
Major finding: PPI users vs nonusers were significantly more likely to develop gastric cancer (odds ratio 1.75; 95% CI 1.28-2.40).
Study details: This study meta-analyzed 16 observational studies (cohort and case-control studies; n = 2,936,935) that evaluated the association between PPI use and the risk for gastric cancer.
Disclosures: This study was sponsored by grants from the Taipei Tzu Chi Hospital and Buddhist Tzu Chi Medical Foundation, Taiwan. The authors declared no conflicts of interest.
Source: Peng TR et al. Association between proton-pump inhibitors and the risk of gastric cancer: A systematic review and meta-analysis. Int J Clin Oncol. 2022 (Oct 12). Doi: 10.1007/s10147-022-02253-2
Gastric cancer surveillance holds value in SMAD4-associated juvenile polyposis syndrome
Key clinical point: The occurrence of gastric cancer is highest in patients with SMAD4-associated juvenile polyposis syndrome (JPS) and is not reported in those without identifiable pathogenic germline variants (PGV).
Major finding: Gastric cancer occurred in 10.1% (95% CI 3.2%-16.8%) of patients with SMAD4 PGV and in only 1 patient with BMPR1A PGV. It was not reported in patients without an identifiable PGV.
Study details: This was a meta-analysis of 11 retrospective studies including 637 patients with JPS, of which 272 had a SMAD4 PGV, 181 had a BMPR1A PGV, 106 had no identifiable PGV, and 78 had an unknown PGV status.
Disclosures: This study did not receive any specific funding. The authors declared no conflicts of interest.
Source: Singh AD et al. Occurrence of gastric cancer in patients with juvenile polyposis syndrome: A systematic review and meta-analysis. Gastrointest Endosc. 2022 (Oct 17). Doi: 10.1016/j.gie.2022.10.026
Key clinical point: The occurrence of gastric cancer is highest in patients with SMAD4-associated juvenile polyposis syndrome (JPS) and is not reported in those without identifiable pathogenic germline variants (PGV).
Major finding: Gastric cancer occurred in 10.1% (95% CI 3.2%-16.8%) of patients with SMAD4 PGV and in only 1 patient with BMPR1A PGV. It was not reported in patients without an identifiable PGV.
Study details: This was a meta-analysis of 11 retrospective studies including 637 patients with JPS, of which 272 had a SMAD4 PGV, 181 had a BMPR1A PGV, 106 had no identifiable PGV, and 78 had an unknown PGV status.
Disclosures: This study did not receive any specific funding. The authors declared no conflicts of interest.
Source: Singh AD et al. Occurrence of gastric cancer in patients with juvenile polyposis syndrome: A systematic review and meta-analysis. Gastrointest Endosc. 2022 (Oct 17). Doi: 10.1016/j.gie.2022.10.026
Key clinical point: The occurrence of gastric cancer is highest in patients with SMAD4-associated juvenile polyposis syndrome (JPS) and is not reported in those without identifiable pathogenic germline variants (PGV).
Major finding: Gastric cancer occurred in 10.1% (95% CI 3.2%-16.8%) of patients with SMAD4 PGV and in only 1 patient with BMPR1A PGV. It was not reported in patients without an identifiable PGV.
Study details: This was a meta-analysis of 11 retrospective studies including 637 patients with JPS, of which 272 had a SMAD4 PGV, 181 had a BMPR1A PGV, 106 had no identifiable PGV, and 78 had an unknown PGV status.
Disclosures: This study did not receive any specific funding. The authors declared no conflicts of interest.
Source: Singh AD et al. Occurrence of gastric cancer in patients with juvenile polyposis syndrome: A systematic review and meta-analysis. Gastrointest Endosc. 2022 (Oct 17). Doi: 10.1016/j.gie.2022.10.026
Gastric transcatheter chemoembolization shows promise against advanced gastric cancer with obstruction
Key clinical point: Gastric transcatheter chemoembolization (GTC) is a safe and effective alternative treatment method for advanced gastric cancer with obstruction.
Major finding: All patients achieved successful selection of tumor-feeding blood vessels and injection of chemotherapeutics and embolic agents, while 22 achieved a gastric outlet obstruction scoring system (GOOSS) score of ≥2. The median time of GTC was 83 minutes, and the median time of hospitalization after GTC was 3 days. One patient experienced abdominal pain during and after GTC. The pre- and post-intervention GOOSS scores were 1 and 2, respectively (P = .000).
Study details: This retrospective study included 42 patients with advanced gastric cancer complicated with obstruction who underwent GTC.
Disclosures: This study was supported by the Chongqing Science and Health Joint Project, China. The authors declared no conflicts of interest.
Source: Peng D et al. Gastric transcatheter chemoembolization can resolve advanced gastric cancer presenting with obstruction. Front Surg. 2022;9:1004064 (Oct 20). Doi: 10.3389/fsurg.2022.1004064
Key clinical point: Gastric transcatheter chemoembolization (GTC) is a safe and effective alternative treatment method for advanced gastric cancer with obstruction.
Major finding: All patients achieved successful selection of tumor-feeding blood vessels and injection of chemotherapeutics and embolic agents, while 22 achieved a gastric outlet obstruction scoring system (GOOSS) score of ≥2. The median time of GTC was 83 minutes, and the median time of hospitalization after GTC was 3 days. One patient experienced abdominal pain during and after GTC. The pre- and post-intervention GOOSS scores were 1 and 2, respectively (P = .000).
Study details: This retrospective study included 42 patients with advanced gastric cancer complicated with obstruction who underwent GTC.
Disclosures: This study was supported by the Chongqing Science and Health Joint Project, China. The authors declared no conflicts of interest.
Source: Peng D et al. Gastric transcatheter chemoembolization can resolve advanced gastric cancer presenting with obstruction. Front Surg. 2022;9:1004064 (Oct 20). Doi: 10.3389/fsurg.2022.1004064
Key clinical point: Gastric transcatheter chemoembolization (GTC) is a safe and effective alternative treatment method for advanced gastric cancer with obstruction.
Major finding: All patients achieved successful selection of tumor-feeding blood vessels and injection of chemotherapeutics and embolic agents, while 22 achieved a gastric outlet obstruction scoring system (GOOSS) score of ≥2. The median time of GTC was 83 minutes, and the median time of hospitalization after GTC was 3 days. One patient experienced abdominal pain during and after GTC. The pre- and post-intervention GOOSS scores were 1 and 2, respectively (P = .000).
Study details: This retrospective study included 42 patients with advanced gastric cancer complicated with obstruction who underwent GTC.
Disclosures: This study was supported by the Chongqing Science and Health Joint Project, China. The authors declared no conflicts of interest.
Source: Peng D et al. Gastric transcatheter chemoembolization can resolve advanced gastric cancer presenting with obstruction. Front Surg. 2022;9:1004064 (Oct 20). Doi: 10.3389/fsurg.2022.1004064