Clinical Edge Journal Scan

Key clinical point: Patients with psoriatic arthritis (PsA) who were disease-modifying antirheumatic drug (DMARD)-naive or non-responders to previous conventional synthetic DMARD treatment (DMARD-failure) showed similar inflammation and structural damage on imaging.

Major finding: After adjusting for patient characteristics, structural imaging parameters including Achilles tendon structural damage and Joint Space Narrowing scores (both P > .6) were similar in DMARD-naive and DMARD-failure patients. Additionally, inflammatory imaging parameters (P > .2) showed no significant differences between the two groups, indicating that failing a DMARD was not associated with worsened imaging outcomes.

Study details: This cross-sectional study evaluated 80 patients with PsA from TOFA-PREDICT trial who were either DMARD-naive (n = 40) or DMARD non-responders (n = 40).

Disclosures: This study was supported by Pfizer. The collaboration project was co-funded by the public-private partnerships allowance by Health~Holland, Top Sector Life Sciences & Health. Six authors declared receiving research grants, consulting fees, and support from various sources, including Pfizer. Other authors declared no conflicts of interest.

Source: Renkli NÖ, Kleinrensink NJ, Spierings J, et al, and the TOFA-PREDICT author group. Multimodal imaging of structural damage and inflammation in psoriatic arthritis: A comparison of DMARD-naive and DMARD-failure patients. Rheumatology (Oxford). 2024 (Aug 17). doi: 10.1093/rheumatology/keae450 Source

Key clinical point: Patients with psoriatic arthritis (PsA) who were disease-modifying antirheumatic drug (DMARD)-naive or non-responders to previous conventional synthetic DMARD treatment (DMARD-failure) showed similar inflammation and structural damage on imaging.

Major finding: After adjusting for patient characteristics, structural imaging parameters including Achilles tendon structural damage and Joint Space Narrowing scores (both P > .6) were similar in DMARD-naive and DMARD-failure patients. Additionally, inflammatory imaging parameters (P > .2) showed no significant differences between the two groups, indicating that failing a DMARD was not associated with worsened imaging outcomes.

Study details: This cross-sectional study evaluated 80 patients with PsA from TOFA-PREDICT trial who were either DMARD-naive (n = 40) or DMARD non-responders (n = 40).

Disclosures: This study was supported by Pfizer. The collaboration project was co-funded by the public-private partnerships allowance by Health~Holland, Top Sector Life Sciences & Health. Six authors declared receiving research grants, consulting fees, and support from various sources, including Pfizer. Other authors declared no conflicts of interest.

Source: Renkli NÖ, Kleinrensink NJ, Spierings J, et al, and the TOFA-PREDICT author group. Multimodal imaging of structural damage and inflammation in psoriatic arthritis: A comparison of DMARD-naive and DMARD-failure patients. Rheumatology (Oxford). 2024 (Aug 17). doi: 10.1093/rheumatology/keae450 Source

Key clinical point: Patients with psoriatic arthritis (PsA) who were disease-modifying antirheumatic drug (DMARD)-naive or non-responders to previous conventional synthetic DMARD treatment (DMARD-failure) showed similar inflammation and structural damage on imaging.

Major finding: After adjusting for patient characteristics, structural imaging parameters including Achilles tendon structural damage and Joint Space Narrowing scores (both P > .6) were similar in DMARD-naive and DMARD-failure patients. Additionally, inflammatory imaging parameters (P > .2) showed no significant differences between the two groups, indicating that failing a DMARD was not associated with worsened imaging outcomes.

Study details: This cross-sectional study evaluated 80 patients with PsA from TOFA-PREDICT trial who were either DMARD-naive (n = 40) or DMARD non-responders (n = 40).

Disclosures: This study was supported by Pfizer. The collaboration project was co-funded by the public-private partnerships allowance by Health~Holland, Top Sector Life Sciences & Health. Six authors declared receiving research grants, consulting fees, and support from various sources, including Pfizer. Other authors declared no conflicts of interest.

Source: Renkli NÖ, Kleinrensink NJ, Spierings J, et al, and the TOFA-PREDICT author group. Multimodal imaging of structural damage and inflammation in psoriatic arthritis: A comparison of DMARD-naive and DMARD-failure patients. Rheumatology (Oxford). 2024 (Aug 17). doi: 10.1093/rheumatology/keae450 Source

Key clinical point: This largest and longest safety analysis on risankizumab demonstrated its long-term safety in patients with psoriatic arthritis (PsA), consistent with previously published reports.

Major finding: The rate of treatment-emergent adverse events (AE) was 142.6 events per 100 patient-years (E/100 PY), serious AE was 8.6 E/100 PY, and AE leading to discontinuation was 1.8 E/100 PY. The rates of serious infections, cancer, major cardiovascular events, and hepatic events remained consistent or decreased in frequency through 6 months or 1 year. No additional safety concerns were reported.

Study details: This integrated safety analysis used data from four phase 2-3 trials involving 1542 patients with PsA and 20 phase 1-4 trials involving 3658 patients with plaque psoriasis, all of whom received ≥1 dose of risankizumab.

Disclosures: This study was funded by AbbVie. Risankizumab was jointly developed by AbbVie and Boehringer Ingelheim. Five authors declared being full-time employees of and may own stock or stock options of AbbVie. Other authors declared having ties with various sources, including AbbVie.

Source: Gordon KB, Blauvelt A, Bachelez H, et al. Long-term safety of risankizumab in patients with psoriatic disease: A comprehensive analysis from clinical trials. Dermatol Ther (Heidelb). 2024;14:2523-2538 (Aug 17). doi: 10.1007/s13555-024-01238-5 Source

Key clinical point: This largest and longest safety analysis on risankizumab demonstrated its long-term safety in patients with psoriatic arthritis (PsA), consistent with previously published reports.

Major finding: The rate of treatment-emergent adverse events (AE) was 142.6 events per 100 patient-years (E/100 PY), serious AE was 8.6 E/100 PY, and AE leading to discontinuation was 1.8 E/100 PY. The rates of serious infections, cancer, major cardiovascular events, and hepatic events remained consistent or decreased in frequency through 6 months or 1 year. No additional safety concerns were reported.

Study details: This integrated safety analysis used data from four phase 2-3 trials involving 1542 patients with PsA and 20 phase 1-4 trials involving 3658 patients with plaque psoriasis, all of whom received ≥1 dose of risankizumab.

Disclosures: This study was funded by AbbVie. Risankizumab was jointly developed by AbbVie and Boehringer Ingelheim. Five authors declared being full-time employees of and may own stock or stock options of AbbVie. Other authors declared having ties with various sources, including AbbVie.

Source: Gordon KB, Blauvelt A, Bachelez H, et al. Long-term safety of risankizumab in patients with psoriatic disease: A comprehensive analysis from clinical trials. Dermatol Ther (Heidelb). 2024;14:2523-2538 (Aug 17). doi: 10.1007/s13555-024-01238-5 Source

Key clinical point: This largest and longest safety analysis on risankizumab demonstrated its long-term safety in patients with psoriatic arthritis (PsA), consistent with previously published reports.

Major finding: The rate of treatment-emergent adverse events (AE) was 142.6 events per 100 patient-years (E/100 PY), serious AE was 8.6 E/100 PY, and AE leading to discontinuation was 1.8 E/100 PY. The rates of serious infections, cancer, major cardiovascular events, and hepatic events remained consistent or decreased in frequency through 6 months or 1 year. No additional safety concerns were reported.

Study details: This integrated safety analysis used data from four phase 2-3 trials involving 1542 patients with PsA and 20 phase 1-4 trials involving 3658 patients with plaque psoriasis, all of whom received ≥1 dose of risankizumab.

Disclosures: This study was funded by AbbVie. Risankizumab was jointly developed by AbbVie and Boehringer Ingelheim. Five authors declared being full-time employees of and may own stock or stock options of AbbVie. Other authors declared having ties with various sources, including AbbVie.

Source: Gordon KB, Blauvelt A, Bachelez H, et al. Long-term safety of risankizumab in patients with psoriatic disease: A comprehensive analysis from clinical trials. Dermatol Ther (Heidelb). 2024;14:2523-2538 (Aug 17). doi: 10.1007/s13555-024-01238-5 Source

Key clinical point: Switching between biologic and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARD) was common due to treatment inefficacy in patients with psoriatic arthritis (PsA), with concomitant therapies and multiple prior treatments being significant risk factors.

Major finding: Overall, 40% of patients switched between b/tsDMARD, with 85.1% switches due to treatment inefficacy. The risk for switching was not affected by b/tsDMARD type (P > .05) but increased with multiple b/tsDMARD courses (adjusted hazard ratio [aHR] 1.22; P = .010), concomitant glucocorticoids (aHR 2.05; P = .001), and sulfalazine use (aHR 2.25; P = .006). Women and those with inflammatory back pain also faced an increased risk for switching.

Study details: This longitudinal retrospective study included 141 patients with PsA (age ≥ 16 years) who were treated with b/tsDMARD.

Disclosures: This study was supported by the Instituto de Salud Carlos III, Ministry of Health, Spain, and Red de Enfermedades Inflamatorias, with co-funding from el Fondo Europeo de Desarrollo Regional. The authors declared no conflicts of interest.

Source: Freites-Nuñez D, Leon L, Toledano E, et al. Switching related to inefficacy in biologics and targeted synthetic therapies for psoriatic arthritis: A comparative real-life study. Ther Adv Musculoskelet Dis. 2024 (Aug 31). doi:10.1177/1759720X241273083 Source

Key clinical point: Switching between biologic and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARD) was common due to treatment inefficacy in patients with psoriatic arthritis (PsA), with concomitant therapies and multiple prior treatments being significant risk factors.

Major finding: Overall, 40% of patients switched between b/tsDMARD, with 85.1% switches due to treatment inefficacy. The risk for switching was not affected by b/tsDMARD type (P > .05) but increased with multiple b/tsDMARD courses (adjusted hazard ratio [aHR] 1.22; P = .010), concomitant glucocorticoids (aHR 2.05; P = .001), and sulfalazine use (aHR 2.25; P = .006). Women and those with inflammatory back pain also faced an increased risk for switching.

Study details: This longitudinal retrospective study included 141 patients with PsA (age ≥ 16 years) who were treated with b/tsDMARD.

Disclosures: This study was supported by the Instituto de Salud Carlos III, Ministry of Health, Spain, and Red de Enfermedades Inflamatorias, with co-funding from el Fondo Europeo de Desarrollo Regional. The authors declared no conflicts of interest.

Source: Freites-Nuñez D, Leon L, Toledano E, et al. Switching related to inefficacy in biologics and targeted synthetic therapies for psoriatic arthritis: A comparative real-life study. Ther Adv Musculoskelet Dis. 2024 (Aug 31). doi:10.1177/1759720X241273083 Source

Key clinical point: Switching between biologic and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARD) was common due to treatment inefficacy in patients with psoriatic arthritis (PsA), with concomitant therapies and multiple prior treatments being significant risk factors.

Major finding: Overall, 40% of patients switched between b/tsDMARD, with 85.1% switches due to treatment inefficacy. The risk for switching was not affected by b/tsDMARD type (P > .05) but increased with multiple b/tsDMARD courses (adjusted hazard ratio [aHR] 1.22; P = .010), concomitant glucocorticoids (aHR 2.05; P = .001), and sulfalazine use (aHR 2.25; P = .006). Women and those with inflammatory back pain also faced an increased risk for switching.

Study details: This longitudinal retrospective study included 141 patients with PsA (age ≥ 16 years) who were treated with b/tsDMARD.

Disclosures: This study was supported by the Instituto de Salud Carlos III, Ministry of Health, Spain, and Red de Enfermedades Inflamatorias, with co-funding from el Fondo Europeo de Desarrollo Regional. The authors declared no conflicts of interest.

Source: Freites-Nuñez D, Leon L, Toledano E, et al. Switching related to inefficacy in biologics and targeted synthetic therapies for psoriatic arthritis: A comparative real-life study. Ther Adv Musculoskelet Dis. 2024 (Aug 31). doi:10.1177/1759720X241273083 Source

Key clinical point: Patients with early oligoarticular psoriatic arthritis (PsA) treated with apremilast vs placebo showed greater disease control and minimal disease activity response with a maximum of one swollen joint and one tender joint count (MDA-Joints).

Major finding: At week 16, a higher proportion of patients receiving apremilast vs placebo achieved MDA-Joints response based on sentinel joints (33.9% vs 16.0%; P = .0008) and total joints (21.3% vs 7.9%; nominal P = .0028). No new safety signals were reported.

Study details: This phase 4 FOREMOST trial included 308 patients with early oligoarticular PsA previously treated with non-steroidal anti-inflammatory drugs or ≥2 conventional synthetic disease-modifying antirheumatic drugs and were randomly assigned to receive apremilast (n = 203) or placebo (n = 105).

Disclosures: This study was funded by Amgen. Five authors declared being employees and owning stocks of Amgen. Several authors have declared other ties with Amgen and other sources.

Source: Gossec L, Coates LC, Gladman DD, et al. Treatment of early oligoarticular psoriatic arthritis with apremilast: Primary outcomes at week 16 from the FOREMOST randomised controlled trial. Ann Rheum Dis. 2024 (Aug 20). doi: 10.1136/ard-2024-225833 Source

Key clinical point: Patients with early oligoarticular psoriatic arthritis (PsA) treated with apremilast vs placebo showed greater disease control and minimal disease activity response with a maximum of one swollen joint and one tender joint count (MDA-Joints).

Major finding: At week 16, a higher proportion of patients receiving apremilast vs placebo achieved MDA-Joints response based on sentinel joints (33.9% vs 16.0%; P = .0008) and total joints (21.3% vs 7.9%; nominal P = .0028). No new safety signals were reported.

Study details: This phase 4 FOREMOST trial included 308 patients with early oligoarticular PsA previously treated with non-steroidal anti-inflammatory drugs or ≥2 conventional synthetic disease-modifying antirheumatic drugs and were randomly assigned to receive apremilast (n = 203) or placebo (n = 105).

Disclosures: This study was funded by Amgen. Five authors declared being employees and owning stocks of Amgen. Several authors have declared other ties with Amgen and other sources.

Source: Gossec L, Coates LC, Gladman DD, et al. Treatment of early oligoarticular psoriatic arthritis with apremilast: Primary outcomes at week 16 from the FOREMOST randomised controlled trial. Ann Rheum Dis. 2024 (Aug 20). doi: 10.1136/ard-2024-225833 Source

Key clinical point: Patients with early oligoarticular psoriatic arthritis (PsA) treated with apremilast vs placebo showed greater disease control and minimal disease activity response with a maximum of one swollen joint and one tender joint count (MDA-Joints).

Major finding: At week 16, a higher proportion of patients receiving apremilast vs placebo achieved MDA-Joints response based on sentinel joints (33.9% vs 16.0%; P = .0008) and total joints (21.3% vs 7.9%; nominal P = .0028). No new safety signals were reported.

Study details: This phase 4 FOREMOST trial included 308 patients with early oligoarticular PsA previously treated with non-steroidal anti-inflammatory drugs or ≥2 conventional synthetic disease-modifying antirheumatic drugs and were randomly assigned to receive apremilast (n = 203) or placebo (n = 105).

Disclosures: This study was funded by Amgen. Five authors declared being employees and owning stocks of Amgen. Several authors have declared other ties with Amgen and other sources.

Source: Gossec L, Coates LC, Gladman DD, et al. Treatment of early oligoarticular psoriatic arthritis with apremilast: Primary outcomes at week 16 from the FOREMOST randomised controlled trial. Ann Rheum Dis. 2024 (Aug 20). doi: 10.1136/ard-2024-225833 Source

Key clinical point: Although valsartan is not typically used for migraine treatment, it was found to reduce migraine frequency and severity as effectively as propranolol, and in some instances, more effectively.

Major findings: Valsartan vs propranolol significantly reduced the mean score of migraine frequency and severity (1.82 vs 2.39; P = .042), and a lower rate of grade 3 headaches (0% vs 7.14%; P = .029) and a lower Headache Index score (1.41 vs 3.22; P = .048) in patients with migraine. Conversely, propranolol was more effective than valsartan in lowering the Headache Unit Index score (0.06 vs 0.13; P = .025).

Study details: This double-blind trial included 56 adult patients with migraine who were randomly assigned to receive propranolol (20 mg twice daily) or valsartan (40 mg once daily) for 12 weeks.

Disclosure: This study was supported by a grant from Urmia University of Medical Sciences. The authors declared no conflicts of interest.

Source: Mosarrezaii A, Tahazadeh D, Soleimantabar H, Panahi P. Comparison of the efficacy of propranolol versus valsartan in the prevention of migraine: A randomized controlled trial. Pain Manag Nurs. 2024 (Aug 13). doi: 10.1016/j.pmn.2024.07.001 Source

Key clinical point: Although valsartan is not typically used for migraine treatment, it was found to reduce migraine frequency and severity as effectively as propranolol, and in some instances, more effectively.

Major findings: Valsartan vs propranolol significantly reduced the mean score of migraine frequency and severity (1.82 vs 2.39; P = .042), and a lower rate of grade 3 headaches (0% vs 7.14%; P = .029) and a lower Headache Index score (1.41 vs 3.22; P = .048) in patients with migraine. Conversely, propranolol was more effective than valsartan in lowering the Headache Unit Index score (0.06 vs 0.13; P = .025).

Study details: This double-blind trial included 56 adult patients with migraine who were randomly assigned to receive propranolol (20 mg twice daily) or valsartan (40 mg once daily) for 12 weeks.

Disclosure: This study was supported by a grant from Urmia University of Medical Sciences. The authors declared no conflicts of interest.

Source: Mosarrezaii A, Tahazadeh D, Soleimantabar H, Panahi P. Comparison of the efficacy of propranolol versus valsartan in the prevention of migraine: A randomized controlled trial. Pain Manag Nurs. 2024 (Aug 13). doi: 10.1016/j.pmn.2024.07.001 Source

Key clinical point: Although valsartan is not typically used for migraine treatment, it was found to reduce migraine frequency and severity as effectively as propranolol, and in some instances, more effectively.

Major findings: Valsartan vs propranolol significantly reduced the mean score of migraine frequency and severity (1.82 vs 2.39; P = .042), and a lower rate of grade 3 headaches (0% vs 7.14%; P = .029) and a lower Headache Index score (1.41 vs 3.22; P = .048) in patients with migraine. Conversely, propranolol was more effective than valsartan in lowering the Headache Unit Index score (0.06 vs 0.13; P = .025).

Study details: This double-blind trial included 56 adult patients with migraine who were randomly assigned to receive propranolol (20 mg twice daily) or valsartan (40 mg once daily) for 12 weeks.

Disclosure: This study was supported by a grant from Urmia University of Medical Sciences. The authors declared no conflicts of interest.

Source: Mosarrezaii A, Tahazadeh D, Soleimantabar H, Panahi P. Comparison of the efficacy of propranolol versus valsartan in the prevention of migraine: A randomized controlled trial. Pain Manag Nurs. 2024 (Aug 13). doi: 10.1016/j.pmn.2024.07.001 Source

Key clinical point: Migraine may have a protective effect against some cardiovascular diseases, such as coronary artery disease (CAD) and ischemic stroke, in this Mendelian randomization (MR) analysis, with coronary atherosclerosis (CA) and myocardial infarction (MI), reducing the risk for migraine in reverse MR analysis.

Major findings: Genetically predicted risk of migraine was associated with a lower risk for CAD (odds ratio [OR] 0.881; P = .023) and ischemic stroke (OR 0.912; P = .006). Reciprocally, CA (OR 0.865; P = .001) and MI (OR 0.798; P = .012) were associated with a lower risk for migraine.

Study details: This bidirectional MR study analyzed the causal effect of migraine on CVD using data from 873,341 and 554,569 individuals, and the causal effect of CVD on migraine using data from 484,598 and 463,010 individuals, using large-scale Genome-Wide Association Study databases.

Disclosure: The study was supported by the National Natural Science Foundation of China, and others. The authors reported no conflicts of interest.

Source: Duan X, Du X, Zheng G, et al. Causality between migraine and cardiovascular disease: A bidirectional Mendelian randomization study. J Headache Pain. 2024;25:130 (Aug 13). doi: 10.1186/s10194-024-01836-w Source

Key clinical point: Migraine may have a protective effect against some cardiovascular diseases, such as coronary artery disease (CAD) and ischemic stroke, in this Mendelian randomization (MR) analysis, with coronary atherosclerosis (CA) and myocardial infarction (MI), reducing the risk for migraine in reverse MR analysis.

Major findings: Genetically predicted risk of migraine was associated with a lower risk for CAD (odds ratio [OR] 0.881; P = .023) and ischemic stroke (OR 0.912; P = .006). Reciprocally, CA (OR 0.865; P = .001) and MI (OR 0.798; P = .012) were associated with a lower risk for migraine.

Study details: This bidirectional MR study analyzed the causal effect of migraine on CVD using data from 873,341 and 554,569 individuals, and the causal effect of CVD on migraine using data from 484,598 and 463,010 individuals, using large-scale Genome-Wide Association Study databases.

Disclosure: The study was supported by the National Natural Science Foundation of China, and others. The authors reported no conflicts of interest.

Source: Duan X, Du X, Zheng G, et al. Causality between migraine and cardiovascular disease: A bidirectional Mendelian randomization study. J Headache Pain. 2024;25:130 (Aug 13). doi: 10.1186/s10194-024-01836-w Source

Key clinical point: Migraine may have a protective effect against some cardiovascular diseases, such as coronary artery disease (CAD) and ischemic stroke, in this Mendelian randomization (MR) analysis, with coronary atherosclerosis (CA) and myocardial infarction (MI), reducing the risk for migraine in reverse MR analysis.

Major findings: Genetically predicted risk of migraine was associated with a lower risk for CAD (odds ratio [OR] 0.881; P = .023) and ischemic stroke (OR 0.912; P = .006). Reciprocally, CA (OR 0.865; P = .001) and MI (OR 0.798; P = .012) were associated with a lower risk for migraine.

Study details: This bidirectional MR study analyzed the causal effect of migraine on CVD using data from 873,341 and 554,569 individuals, and the causal effect of CVD on migraine using data from 484,598 and 463,010 individuals, using large-scale Genome-Wide Association Study databases.

Disclosure: The study was supported by the National Natural Science Foundation of China, and others. The authors reported no conflicts of interest.

Source: Duan X, Du X, Zheng G, et al. Causality between migraine and cardiovascular disease: A bidirectional Mendelian randomization study. J Headache Pain. 2024;25:130 (Aug 13). doi: 10.1186/s10194-024-01836-w Source

Key clinical point: Administration of monthly or quarterly fremanezumab reduced acute medication use and alleviated migraine-associated symptoms in patients with episodic migraine (EM).

Major findings: Fremanezumab, administered monthly vs placebo significantly reduced the acute medication use for headaches (–2.98 vs –0.01; P < .001) and number of days with nausea or vomiting (–1.59 vs –0.66; P = .023) in the first month after initial dosage, with continued benefits till months 2 and 3. Fremanezumab, administered quarterly, also yielded promising outcomes.

Study details: Findings are from an exploratory endpoint analysis of a phase 2b/3 randomized trial including patients with EM who were randomly assigned to receive either monthly fremanezumab (n =  121), quarterly fremanezumab (n =  119), or placebo (n =  117) in monthly intervals.

Disclosures: This study was funded by Otsuka Pharmaceutical Co., Ltd. Five authors declared being full-time employees of Otsuka Pharmaceutical Co., Ltd. Other authors declared having other ties with various sources, including Otsuka Pharmaceutical Co., Ltd.

Source: Tatsumoto M, Ishida M, Iba K, et al. Effects of fremanezumab on migraine-associated symptoms and medication use in Japanese and Korean patients with episodic migraine: Exploratory endpoint analysis of a multicenter, randomized, double-blind, placebo-controlled trial. Headache. 2024 (Sept 2). doi: 10.1111/head.14810 Source

Key clinical point: Administration of monthly or quarterly fremanezumab reduced acute medication use and alleviated migraine-associated symptoms in patients with episodic migraine (EM).

Major findings: Fremanezumab, administered monthly vs placebo significantly reduced the acute medication use for headaches (–2.98 vs –0.01; P < .001) and number of days with nausea or vomiting (–1.59 vs –0.66; P = .023) in the first month after initial dosage, with continued benefits till months 2 and 3. Fremanezumab, administered quarterly, also yielded promising outcomes.

Study details: Findings are from an exploratory endpoint analysis of a phase 2b/3 randomized trial including patients with EM who were randomly assigned to receive either monthly fremanezumab (n =  121), quarterly fremanezumab (n =  119), or placebo (n =  117) in monthly intervals.

Disclosures: This study was funded by Otsuka Pharmaceutical Co., Ltd. Five authors declared being full-time employees of Otsuka Pharmaceutical Co., Ltd. Other authors declared having other ties with various sources, including Otsuka Pharmaceutical Co., Ltd.

Source: Tatsumoto M, Ishida M, Iba K, et al. Effects of fremanezumab on migraine-associated symptoms and medication use in Japanese and Korean patients with episodic migraine: Exploratory endpoint analysis of a multicenter, randomized, double-blind, placebo-controlled trial. Headache. 2024 (Sept 2). doi: 10.1111/head.14810 Source

Key clinical point: Administration of monthly or quarterly fremanezumab reduced acute medication use and alleviated migraine-associated symptoms in patients with episodic migraine (EM).

Major findings: Fremanezumab, administered monthly vs placebo significantly reduced the acute medication use for headaches (–2.98 vs –0.01; P < .001) and number of days with nausea or vomiting (–1.59 vs –0.66; P = .023) in the first month after initial dosage, with continued benefits till months 2 and 3. Fremanezumab, administered quarterly, also yielded promising outcomes.

Study details: Findings are from an exploratory endpoint analysis of a phase 2b/3 randomized trial including patients with EM who were randomly assigned to receive either monthly fremanezumab (n =  121), quarterly fremanezumab (n =  119), or placebo (n =  117) in monthly intervals.

Disclosures: This study was funded by Otsuka Pharmaceutical Co., Ltd. Five authors declared being full-time employees of Otsuka Pharmaceutical Co., Ltd. Other authors declared having other ties with various sources, including Otsuka Pharmaceutical Co., Ltd.

Source: Tatsumoto M, Ishida M, Iba K, et al. Effects of fremanezumab on migraine-associated symptoms and medication use in Japanese and Korean patients with episodic migraine: Exploratory endpoint analysis of a multicenter, randomized, double-blind, placebo-controlled trial. Headache. 2024 (Sept 2). doi: 10.1111/head.14810 Source

Key clinical point: Eicosapentaenoic acid (EPA), used with standard prophylactic pharmacotherapy, significantly reduced migraine headache days (MHD) and migraine attacks in patients with chronic migraine (CM).

Major findings: The score relating to headache impact was significantly lower in the EPA vs placebo group at weeks 4 (P = .017) and 8 (P = .042). At 8 weeks, EPA treatment led to a greater reduction in mean MHD (−9.76 vs −4.60; P < .001) and mean number of attacks per month (3 vs 4; P = .012) than placebo. In the EPA group, only three patients experienced nausea and gastrointestinal upset.

Study details: This randomized controlled trial included 60 adult patients with CM who received 1000 mg EPA or placebo twice daily for 8 weeks and continued their first-line preventive pharmacotherapy throughout the trial.

Disclosure: The study was supported by the research committee of Shahid Beheshti University of Medical Sciences, Iran. The authors declared no conflicts of interest.

Source: Mohammadnezhad G, Assarzadegan F, Koosha M, Esmaily H. Eicosapentaenoic acid versus placebo as adjunctive therapy in chronic migraine: A randomized controlled trial. Headache. 2024 (Sept 2). doi: 10.1111/head.14808  Source

Key clinical point: Eicosapentaenoic acid (EPA), used with standard prophylactic pharmacotherapy, significantly reduced migraine headache days (MHD) and migraine attacks in patients with chronic migraine (CM).

Major findings: The score relating to headache impact was significantly lower in the EPA vs placebo group at weeks 4 (P = .017) and 8 (P = .042). At 8 weeks, EPA treatment led to a greater reduction in mean MHD (−9.76 vs −4.60; P < .001) and mean number of attacks per month (3 vs 4; P = .012) than placebo. In the EPA group, only three patients experienced nausea and gastrointestinal upset.

Study details: This randomized controlled trial included 60 adult patients with CM who received 1000 mg EPA or placebo twice daily for 8 weeks and continued their first-line preventive pharmacotherapy throughout the trial.

Disclosure: The study was supported by the research committee of Shahid Beheshti University of Medical Sciences, Iran. The authors declared no conflicts of interest.

Source: Mohammadnezhad G, Assarzadegan F, Koosha M, Esmaily H. Eicosapentaenoic acid versus placebo as adjunctive therapy in chronic migraine: A randomized controlled trial. Headache. 2024 (Sept 2). doi: 10.1111/head.14808  Source

Key clinical point: Eicosapentaenoic acid (EPA), used with standard prophylactic pharmacotherapy, significantly reduced migraine headache days (MHD) and migraine attacks in patients with chronic migraine (CM).

Major findings: The score relating to headache impact was significantly lower in the EPA vs placebo group at weeks 4 (P = .017) and 8 (P = .042). At 8 weeks, EPA treatment led to a greater reduction in mean MHD (−9.76 vs −4.60; P < .001) and mean number of attacks per month (3 vs 4; P = .012) than placebo. In the EPA group, only three patients experienced nausea and gastrointestinal upset.

Study details: This randomized controlled trial included 60 adult patients with CM who received 1000 mg EPA or placebo twice daily for 8 weeks and continued their first-line preventive pharmacotherapy throughout the trial.

Disclosure: The study was supported by the research committee of Shahid Beheshti University of Medical Sciences, Iran. The authors declared no conflicts of interest.

Source: Mohammadnezhad G, Assarzadegan F, Koosha M, Esmaily H. Eicosapentaenoic acid versus placebo as adjunctive therapy in chronic migraine: A randomized controlled trial. Headache. 2024 (Sept 2). doi: 10.1111/head.14808  Source

Key clinical point: Zavegepant nasal spray, administered as needed for up to eight doses per month, demonstrated long-term safety in the acute treatment of migraine over 1 year.

Major finding: The most common adverse events (AE), reported in ≥5% patients receiving zavegepant, were dysgeusia, nasal discomfort, COVID-19, nausea, nasal congestion, throat irritation, and back pain. In the 1-year period, only 6.8% patients discontinued treatment due to AE; dysgeusia was the most common cause, accounting for 1.5% of discontinuations. No deaths were reported.

Study details: This phase 2/3, open-label safety study included 603 adults with moderate to severe migraine who had a history of 2 to 8 moderate to severe attacks per month and were treated with intranasal 10 mg zavegepant daily for 1 year.

Disclosures: This study was funded by Biohaven Pharmaceuticals. Some authors declared being employees of or holding stocks of or stock options in Biohaven Pharmaceuticals. Some others declared having ties with various sources, including Biohaven Pharmaceuticals.

Source: Mullin K, Croop R, Mosher L, et al. Long-term safety of zavegepant nasal spray for acute treatment of migraine: A phase 2/3 open-label study. Cephalalgia. 2024 (Aug 30). doi: 10.1177/033310242412594 Source

Key clinical point: Zavegepant nasal spray, administered as needed for up to eight doses per month, demonstrated long-term safety in the acute treatment of migraine over 1 year.

Major finding: The most common adverse events (AE), reported in ≥5% patients receiving zavegepant, were dysgeusia, nasal discomfort, COVID-19, nausea, nasal congestion, throat irritation, and back pain. In the 1-year period, only 6.8% patients discontinued treatment due to AE; dysgeusia was the most common cause, accounting for 1.5% of discontinuations. No deaths were reported.

Study details: This phase 2/3, open-label safety study included 603 adults with moderate to severe migraine who had a history of 2 to 8 moderate to severe attacks per month and were treated with intranasal 10 mg zavegepant daily for 1 year.

Disclosures: This study was funded by Biohaven Pharmaceuticals. Some authors declared being employees of or holding stocks of or stock options in Biohaven Pharmaceuticals. Some others declared having ties with various sources, including Biohaven Pharmaceuticals.

Source: Mullin K, Croop R, Mosher L, et al. Long-term safety of zavegepant nasal spray for acute treatment of migraine: A phase 2/3 open-label study. Cephalalgia. 2024 (Aug 30). doi: 10.1177/033310242412594 Source

Key clinical point: Zavegepant nasal spray, administered as needed for up to eight doses per month, demonstrated long-term safety in the acute treatment of migraine over 1 year.

Major finding: The most common adverse events (AE), reported in ≥5% patients receiving zavegepant, were dysgeusia, nasal discomfort, COVID-19, nausea, nasal congestion, throat irritation, and back pain. In the 1-year period, only 6.8% patients discontinued treatment due to AE; dysgeusia was the most common cause, accounting for 1.5% of discontinuations. No deaths were reported.

Study details: This phase 2/3, open-label safety study included 603 adults with moderate to severe migraine who had a history of 2 to 8 moderate to severe attacks per month and were treated with intranasal 10 mg zavegepant daily for 1 year.

Disclosures: This study was funded by Biohaven Pharmaceuticals. Some authors declared being employees of or holding stocks of or stock options in Biohaven Pharmaceuticals. Some others declared having ties with various sources, including Biohaven Pharmaceuticals.

Source: Mullin K, Croop R, Mosher L, et al. Long-term safety of zavegepant nasal spray for acute treatment of migraine: A phase 2/3 open-label study. Cephalalgia. 2024 (Aug 30). doi: 10.1177/033310242412594 Source

Key clinical point: Women with either migraine or gestational diabetes mellitus (GDM) faced an increased long-term risk for developing major adverse cardiovascular and cerebrovascular events (MACCE) at a premature age (≤60 years), with the risk being significantly higher among those with both conditions.

Major findings: Women with migraine or GDM had a significantly higher 20-year risk for premature MACCE than women without these conditions (adjusted hazard ratio [aHR] 1.65; 95% CI 1.49-1.82 for migraine and aHR 1.64; 95% CI 1.37-1.96 for GDM). The risk was highest among women with both migraine and GDM (aHR 2.35; 95% CI 1.03-5.36).

Study details: This population-based longitudinal cohort study included 1,390,451 women, of which 56,811 had migraine, 24,700 had GDM, 1484 had both migraine and GDM, and 1,307,456 women had neither migraine nor GDM.

Disclosure: The study was funded by Aarhus University. The authors declared no conflicts of interest.

Source: Fuglsang CH, Pedersen L, Schmidt M, et al. The combined impact of migraine and gestational diabetes on long-term risk of premature myocardial infarction and stroke: A population-based cohort study. Headache. 2024 (Aug 28). doi: 10.1111/head.14821 Source

Key clinical point: Women with either migraine or gestational diabetes mellitus (GDM) faced an increased long-term risk for developing major adverse cardiovascular and cerebrovascular events (MACCE) at a premature age (≤60 years), with the risk being significantly higher among those with both conditions.

Major findings: Women with migraine or GDM had a significantly higher 20-year risk for premature MACCE than women without these conditions (adjusted hazard ratio [aHR] 1.65; 95% CI 1.49-1.82 for migraine and aHR 1.64; 95% CI 1.37-1.96 for GDM). The risk was highest among women with both migraine and GDM (aHR 2.35; 95% CI 1.03-5.36).

Study details: This population-based longitudinal cohort study included 1,390,451 women, of which 56,811 had migraine, 24,700 had GDM, 1484 had both migraine and GDM, and 1,307,456 women had neither migraine nor GDM.

Disclosure: The study was funded by Aarhus University. The authors declared no conflicts of interest.

Source: Fuglsang CH, Pedersen L, Schmidt M, et al. The combined impact of migraine and gestational diabetes on long-term risk of premature myocardial infarction and stroke: A population-based cohort study. Headache. 2024 (Aug 28). doi: 10.1111/head.14821 Source

Key clinical point: Women with either migraine or gestational diabetes mellitus (GDM) faced an increased long-term risk for developing major adverse cardiovascular and cerebrovascular events (MACCE) at a premature age (≤60 years), with the risk being significantly higher among those with both conditions.

Major findings: Women with migraine or GDM had a significantly higher 20-year risk for premature MACCE than women without these conditions (adjusted hazard ratio [aHR] 1.65; 95% CI 1.49-1.82 for migraine and aHR 1.64; 95% CI 1.37-1.96 for GDM). The risk was highest among women with both migraine and GDM (aHR 2.35; 95% CI 1.03-5.36).

Study details: This population-based longitudinal cohort study included 1,390,451 women, of which 56,811 had migraine, 24,700 had GDM, 1484 had both migraine and GDM, and 1,307,456 women had neither migraine nor GDM.

Disclosure: The study was funded by Aarhus University. The authors declared no conflicts of interest.

Source: Fuglsang CH, Pedersen L, Schmidt M, et al. The combined impact of migraine and gestational diabetes on long-term risk of premature myocardial infarction and stroke: A population-based cohort study. Headache. 2024 (Aug 28). doi: 10.1111/head.14821 Source