In this episode, Medicom’s correspondent covers 6 presentations from the International Headache Congress (IHC 2021), held virtually from 8-12 September 2021.
The topics discussed are: SQUARE was the first study that prospectively collected real-world data on erenumab treatment under routine medical care in Switzerland. In both genders with either episodic or chronic migraine and in patients with different prior prophylactic treatment failures (PPTFs), erenumab significantly improved quality of life and migraine-related disability and decreased need for acute migraine therapy.Headaches after vaccination against the SARS-CoV-2 virus show a broad symptom complex. The constellation of accompanying symptoms together with the temporal and spatial headache characteristics delineate a specific phenotype. The BioNTech/Pfizer vaccine displayed the lowest headache intensity, the shortest headache duration, and the longest onset latency after vaccinationA combined analysis of 2 genome-wide association studies (GWAS) identified 4 risk loci for cluster headache. The discovery of these risk loci provides robust evidence that the disease has a genetic basis. For patients without a confirmed diagnosis of atrial fibrillation (AF), the probability of AF – as predicted by an artificial intelligence (AI)-enabled ECG algorithm – is significantly higher in migraine patients with aura compared to those without aura, even after adjusting for age and sex.Occipital nerve stimulation resulted in a rapid and persistent reduction of attack frequency in patients with medically intractable chronic cluster headache. In addition, the intervention was deemed safe in this randomised, double-blind, phase 3 study from the Netherlands. Rimegepant is a small molecule CGRP receptor antagonist, approved for both acute and preventive treatment of migraine. Acute treatment with this drug conferred long-term improvements in median time to 30% and 50% reductions in monthly migraine days (MMDs). This was found in a post hoc analysis from an open label safety study.
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Table of Contents: IHC 2021
Featured articles
Letter from the Editor
COVID-19
Telemedicine beneficial for headache care during the pandemic
Comparison of headaches after SARS-CoV-2 vaccination
Grey matter cortical changes in patients with persistent headache after COVID-19
Increased risk of cerebral venous thrombosis in COVID-19
Patient Perception and Symptoms
Predictors of health-related quality of life in cluster headache
Dry eye disease is more prevalent in migraine
Voice change and throat swelling are cranial autonomic symptoms in primary headache
Association between physical inactivity and headache disorders
Increased suicidal attempts and risks of ideation in medication-overuse headache
Cardioembolic Comorbidities
AI-enabled ECG algorithm predicts atrial fibrillation risk in migraine
Migraine may not be a risk factor for stroke
Imaging
Functional brainstem somatotopy of the trigeminal nerve during nociception
Morphological changes in cluster headache between attacks
Interictal pontine metabolism in migraine patients without aura
Genome-Wide Association Studies
Largest genome-wide association study of migraine to date
Robust evidence that cluster headache has a genetic basis
Pharmacological Treatment
Insights in drug-drug interactions facilitate rational polypharmacy
Rimegepant confers long-term improvements in MMDs
First real-world effectiveness data of erenumab is promising
Galcanezumab effective in patients with episodic or chronic cluster headache
Central effects and affected somatosensory processing with galcanezumab in migraine
Long-term safety and tolerability of atogepant in migraine
Non-Pharmacological Treatment
Occipital nerve stimulation effective and safe in chronic cluster headache
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