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Migrain update

Stewart J Tepper
OBJECTIVE: To briefly update and correct the available data on anti-calcitonin gene-related peptide (CGRP) therapies for headache since the American Headache Society 60th Scientific Meeting, San Francisco, June 2018. BACKGROUND: CGRP is a target for primary headache therapies. METHODS: The author briefly reviews the new data and publications on gepants and anti-CGRP and anti-CGRP receptor monoclonal antibodies since the writing of his previous review in May 2018, with an emphasis on data provided at the American Headache Society 60th Scientific Meeting, San Francisco, June 2018...
November 2018: Headache
Frederick R Taylor
BACKGROUND: Calcitonin gene-related peptide (CGRP) therapeutics introduce new excitement and possibly yet to be determined distressing discords in the field of Headache Medicine. Growth in knowledge of CGRP in the pathophysiology of migraine introduced CGRP antagonism to headache treatment. Potential adverse effects on the other circulatory and neurovascular diseases have been foremost concerns. Failures in development of gepants and growth in knowledge of monoclonal antibody therapeutics combined to deliver the anti-CGRP monoclonal antibodies (mAbs)...
November 3, 2018: Headache
Calli L Cook, Glenn C Shedd
BACKGROUND AND PURPOSE: Migraine headache is an enormous health care burden resulting in billions of dollars in workforce revenue lost and millions of lost workdays per year. Migraine headaches and depression are common comorbidities and require expertise in treatment and prevention. METHODS: The aim of this article is to update the nurse practitioner (NP) on best clinical practices for managing the patient with migraine and previously diagnosed depression. This will include an overview of the pathophysiology of migraine, as well as criteria for diagnosis, treatment, prevention, and patient teaching...
November 2018: Journal of the American Association of Nurse Practitioners
Richard B Lipton, Sagar Munjal, Aftab Alam, Dawn C Buse, Kristina M Fanning, Michael L Reed, Todd J Schwedt, David W Dodick
OBJECTIVES: To summarize the baseline methods for the Migraine in America Symptoms and Treatment (MAST) Study and evaluate gender differences in sociodemographics and headache features; consultation and diagnosis patterns; and patterns of acute and preventive treatment use for migraine among study participants. BACKGROUND: The MAST Study is a longitudinal, internet-based panel study of symptoms, approaches to management, and unmet treatment needs among US adults with migraine...
October 2018: Headache
Ying Fan, Min Chen, Jinqiang Zhang, Philippe Maincent, Xuefeng Xia, Wen Wu
Intranasal drug delivery is emerging as a reliable and promising pathway to deliver a wide range of therapeutic agents including small and large molecules, peptides and proteins, genes to the central nervous system for the treatment of brain diseases such as Alzheimer's disease, Parkinson's disease, depression, migraine, schizophrenia, and glioma. This presents noninvasive entry into the brain via direct nose-to-brain and/or indirect nose-to-blood-to-brain routes. Several nanocarrier-based strategies have been developed to transport therapeutic agents to the brain including nanoparticles, liposomes, and exosomes following intranasal delivery...
2018: Critical Reviews in Therapeutic Drug Carrier Systems
Emma Fisher, Emily Law, Joanne Dudeney, Tonya M Palermo, Gavin Stewart, Christopher Eccleston
BACKGROUND: This is an update of the original Cochrane review first published in Issue 1, 2003, and previously updated in 2009, 2012 and 2014. Chronic pain, defined as pain that recurs or persists for more than three months, is common in childhood. Chronic pain can affect nearly every aspect of daily life and is associated with disability, anxiety, and depressive symptoms. OBJECTIVES: The aim of this review was to update the published evidence on the efficacy of psychological treatments for chronic and recurrent pain in children and adolescents...
September 29, 2018: Cochrane Database of Systematic Reviews
Pamela Vo, Shihua Wen, Marie-Josée Martel, Dimos Mitsikostas, Uwe Reuter, Jan Klatt
Objective This study evaluated the benefit-risk profile of erenumab relative to other therapies approved for migraine prophylaxis and available in the majority of European countries. Methods Trials were identified via a published systematic literature review updated to December 2017 using MEDLINE. Erenumab's pivotal trials study reports were also included (NCT02066415, NCT02456740). From these sources, ≥ 50% responder rates and discontinuations due to adverse events were extracted to generate numbers needed to treat and harm and likelihood of being helped or harmed, a quantitative benefit-risk measure...
September 19, 2018: Cephalalgia: An International Journal of Headache
Elaine Harris
The present Industry Update covers the period 1-31 May 2018. Sources of information included company press releases, regulatory and patent agency notices and various news websites. Regulatory approvals of this month include Novartis (Basel, Switzerland) and Amgen's (CA, USA), Aimovig as a preventive treatment for migraines and Breckenridge's (CO, USA) delayed-release capsules, Duloxetine. This month also saw DURECT (CA, USA) and Sandoz (Upper Bavaria, Germany) renegotiate their agreement for the development, manufacture and commercialization of the extended-release depot product POSIMIR® ...
September 2018: Therapeutic Delivery
Heidi K Blume
PURPOSE OF REVIEW: Headache following concussion and mild traumatic brain injury is very common in pediatrics. There is significant concern about appropriate management of acute and persistent headache following mild head injuries in children among affected youth, their families and care providers. RECENT FINDINGS: The current article will review definitions and diagnoses of posttraumatic headache (PTHA), recent research regarding risk factors for persistence of postconcussion symptoms and headaches, current recommendations for the evaluation of youth with PTHA, recent data regarding efficacy of treatment options for PTHA, and current recommendations for the treatment of acute and persistent PTHA...
September 17, 2018: Current Opinion in Pediatrics
Eric P Baron
BACKGROUND: Comprehensive literature reviews of historical perspectives and evidence supporting cannabis/cannabinoids in the treatment of pain, including migraine and headache, with associated neurobiological mechanisms of pain modulation have been well described. Most of the existing literature reports on the cannabinoids Δ9 -tetrahydrocannabinol (THC) and cannabidiol (CBD), or cannabis in general. There are many cannabis strains that vary widely in the composition of cannabinoids, terpenes, flavonoids, and other compounds...
July 2018: Headache
João Eudes Magalhães, Pedro Augusto Sampaio Rocha-Filho
Migraine and cerebrovascular diseases are disabling disorders, which are possibly closely interrelated. Heterogeneous and scattered evidence in literature remains a challenge. We searched for systematic reviews including diverse cerebrovascular events in migraineurs and reported relevant original studies to update the evidence when necessary. The studies show that migraine is associated with increased risk of transient ischemic attacks, any stroke, and possibly hemorrhagic stroke. In addition, migraine with aura increases the risk of ischemic stroke and white matter abnormalities...
September 2018: Headache
Antonio Russo, Gianluca Coppola, Francesco Pierelli, Vincenzo Parisi, Marcello Silvestro, Alessandro Tessitore, Gioacchino Tedeschi
Background: It is well-known that both inter- and intra-individual differences exist in the perception of pain; this is especially true in migraine, an elusive pain disorder of the head. Although electrophysiology and neuroimaging techniques have greatly contributed to a better understanding of the mechanisms involved in migraine during recent decades, the exact characteristics of pain threshold and pain intensity perception remain to be determined, and continue to be a matter of debate. Objective: The aim of this review is to provide a comprehensive overview of clinical, electrophysiological, and functional neuroimaging studies investigating changes during various phases of the so-called "migraine cycle" and in different migraine phenotypes, using pain threshold and pain intensity perception assessments...
2018: Frontiers in Neurology
Hiran Thabrew, Karolina Stasiak, Sarah E Hetrick, Stephen Wong, Jessica H Huss, Sally N Merry
BACKGROUND: Long-term physical conditions affect 10% to 12% of children and adolescents worldwide; these individuals are at greater risk of developing psychological problems, particularly anxiety and depression. Access to face-to-face treatment for such problems is often limited, and available interventions usually have not been tested with this population. As technology improves, e-health interventions (delivered via digital means, such as computers and smart phones and ranging from simple text-based programmes through to multimedia and interactive programmes, serious games, virtual reality and biofeedback programmes) offer a potential solution to address the psychological needs of this group of young people...
August 15, 2018: Cochrane Database of Systematic Reviews
Mary Choy
Lofexidine hydrocholoride (Lucemyra) for opioid withdrawal; erenumab-aooe (Aimovig) for migraine; and sodium zirconium cyclosilicate (Lokelma) for hyperkalemia.
August 2018: P & T: a Peer-reviewed Journal for Formulary Management
Abdul Albilali, Esma Dilli
PURPOSE OF REVIEW: To provide an updated overview of Photophobia with a particular focus on photophobia related to migraine. RECENT FINDINGS: Melanopsin-containing photoreceptors called intrinsically photosensitive retinal ganglion cells (ipRGCs) have been identified in the retina and explain the rational for photophobia in individuals who are blind. Photophobia, a sensory disturbance provoked by light, is a common neurological and ophthalmological symptom. Migraine, a common neurological condition, is pathognomonic of photophobia; however, other primary headache conditions, traumatic brain injury, and impairment of the optic pathway can cause photophobia...
July 30, 2018: Current Neurology and Neuroscience Reports
Sabina Cevoli, Valentina Favoni, Pietro Cortelli
Migraine is a common disabling neurological disorder which is characterised by recurring headache associated with a variety of sensory and autonomic symptoms. The pathophysiology of migraine remains not entirely understood, although many mechanisms involving the central and peripheral nervous system are now becoming clear. In particular, it is widely accepted that migraine is associated with energy metabolic impairment of the brain. The purpose of this review is to present an update overview of the energy metabolism involvement in the migraine pathophysiology...
June 22, 2018: Current Medicinal Chemistry
Anna E Kirkland, Gabrielle L Sarlo, Kathleen F Holton
Magnesium is well known for its diverse actions within the human body. From a neurological standpoint, magnesium plays an essential role in nerve transmission and neuromuscular conduction. It also functions in a protective role against excessive excitation that can lead to neuronal cell death (excitotoxicity), and has been implicated in multiple neurological disorders. Due to these important functions within the nervous system, magnesium is a mineral of intense interest for the potential prevention and treatment of neurological disorders...
June 6, 2018: Nutrients
Qingqing Huang, Xiping Liang, Shiqiang Wang, Xiaosong Mu
Both migraine and obesity are prevalent disorders in the general population, which are characterized by disability and impaired quality of life. Although so many researches had studied the association between migraine and obesity, there are still no full knowledge of the relationship between body mass index (BMI) and migraine, especially chronic migraine (CM). In this study, we analyzed a previous epidemiological survey data of primary headache patients in Chongqing, which surveyed consecutive neurological outpatients through face-to-face interview with physicians using a headache questionnaire...
2018: Behavioural Neurology
Huimin Tao, Teng Wang, Xin Dong, Qi Guo, Huan Xu, Qi Wan
BACKGROUND: Migraine is now ranked as the second most disabling disorder worldwide reported by the Global Burden of Disease Study 2016. As a noninvasive neurostimulation technique, transcutaneous electrical nerve stimulation(TENS) has been applied as an abortive and prophylactic treatment for migraine recently. We conduct this meta-analysis to analyze the effectiveness and safety of TENS on migraineurs. METHODS: We searched Medline (via PubMed), Embase, the Cochrane Library and the Cochrane Central Register of Controlled Trials to identify randomized controlled trials, which compared the effect of TENS with sham TENS on migraineurs...
May 29, 2018: Journal of Headache and Pain
Mukta Agrawal, Swarnlata Saraf, Shailendra Saraf, Sophia G Antimisiaris, Mahavir Bhupal Chougule, Sunday A Shoyele, Amit Alexander
According to the Alzheimer Association Report (2017), Alzheimer's disease (AD) is the 6th primary cause of death in the USA, which affects nearly 5.5 million people. In the year 2017 itself, the cost of AD treatment in the USA has been reported to rise to $259 billion. This statistic shows the severity of the disease in the USA which is very much similar across the globe. On the other hand, the treatment remains limited to a few conventional oral medications (approved by FDA). These are mainly acting superficially from mild to the moderate AD...
July 10, 2018: Journal of Controlled Release: Official Journal of the Controlled Release Society
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