1
|
Ha WS, Jeong J, Song S, Yum J, Chu MK. Trends in Triptan Usage in Korea: A Population-Based Cohort Study. J Korean Med Sci 2024; 39:e222. [PMID: 39137809 PMCID: PMC11319107 DOI: 10.3346/jkms.2024.39.e222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Accepted: 06/24/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND Migraine presents a significant global health problem that emphasizes the need for efficient acute treatment options. Triptans, introduced in the early 1990s, have substantially advanced migraine management owing to their effectiveness compared to that of traditional medications. However, data on triptan use in migraine management from Asian countries, where migraines tend to have milder symptoms than those in European and North American countries, are limited. This study aimed to identify the trends in triptan usage in Korea. METHODS This retrospective cohort study used data from the Korean National Health Insurance Service-National Sample Cohort spanning from 2002 to 2019. Patients with migraine were identified using the International Classification of Diseases 10th revision codes, and triptan prescriptions were evaluated annually in terms of quantity, pills per patient, and associated costs. The distribution of triptan prescriptions across different medical specialties was also examined. Factors contributing to the odds of triptan use were analyzed using multivariable logistic regression. RESULTS From 2002 to 2019, the total number of triptan tablets, prescriptions, and patients using triptans increased by 24.0, 17.1, and 13.6 times, respectively, with sumatriptan being the most frequently prescribed type of triptan. Additionally, the number of prescriptions and related costs have consistently increased despite stable pricing because of government regulation. By 2019, only approximately one-tenth of all patients with migraines had been prescribed triptans, although there was a notable increase in prescriptions over the study period. These prescription patterns varied according to the physician's specialty. After adjusting for patient-specific factors including age and sex, the odds of prescribing triptans were higher for neurologists than for internal medicine physicians (odds ratio 2.875, P < 0.001), while they were lower for general practitioners (odds ratio 0.220, P < 0.001). CONCLUSION The findings revealed an increasing trend in triptan use among individuals with migraines in Korea, aligning with global usage patterns. Despite these increases, the overall prescription rate of triptans remains low, indicating potential underutilization and highlighting the need for improved migraine management strategies across all medical fields. Further efforts are necessary to optimize the use of triptans in treating migraines effectively.
Collapse
Affiliation(s)
- Woo-Seok Ha
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - JaeWook Jeong
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Seungwon Song
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Jungyon Yum
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Min Kyung Chu
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
| |
Collapse
|
2
|
Terruzzi A, AlMadani A, Al-Rukn S, Farghaly M, Dallal SA, Zayed M, Vainstein N, Fathy M, Uboweja A, Natarajan A, Subramanyam K, Ramachandrachar BC, Aljabban A. A Retrospective Analysis of Disease Epidemiology, Comorbidity Burden, Treatment Patterns, and Healthcare Resource Utilization of Migraine in the United Arab Emirates. Pain Ther 2024:10.1007/s40122-024-00634-1. [PMID: 39030417 DOI: 10.1007/s40122-024-00634-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 06/26/2024] [Indexed: 07/21/2024] Open
Abstract
INTRODUCTION Migraine is a recurrent, disabling neurological disorder with a substantial global disease burden. However, limited real-world data are available on the patient characteristics, treatment patterns, comorbidities, and economic burden of migraine in the United Arab Emirates (UAE). In this study, we evaluated the disease burden, comorbidities, treatment patterns, specialties involved in migraine diagnosis, and healthcare resource utilization (HCRU) and associated costs in patients with migraine in Dubai, UAE. METHODS A retrospective, secondary database cohort study was conducted from 01 January 2014 to 31 March 2022 using the Dubai Real-World Database. Patients aged ≥ 18 years with at least one diagnosis claim for migraine with continuous enrollment during the study period were included. Patients were stratified into treatment sub-cohorts. Outcomes were evaluated in terms of clinical characteristics, comorbidities, specialists visited, treatment patterns, and HCRU. RESULTS The study included 203,222 patients (mean age: 40 years), with male predominance (55.4%). About 13.4% of patients had specific cardiovascular comorbidities. Frequently prescribed drug classes were nonsteroidal anti-inflammatory drugs (84.4%), triptans (29.8%), and beta-blockers (12.8%), while only 1.0% of patients with migraine were prescribed newer medications like calcitonin gene-related peptide antagonists. General medicine was the most frequently visited specialty on the index date (51.5%). The all-cause and migraine-specific median gross costs during the 12-month post-index period were US $1252.6 (2.4-564,740.7) and US $198.1 (0-168,903.3) respectively, with maximum contribution from inpatients. The contribution of migraine-specific median costs to all-cause median costs was highest for the diagnosis-related group (64.9%), followed by consumables (35.2%), medications (32.0%), procedures (24.5%), and services (24.5%). CONCLUSION Migraine significantly impacts healthcare costs in the UAE. The role of newer therapies in migraine management should be explored to reduce the associated socioeconomic burden and improve patients' quality of life.
Collapse
Affiliation(s)
| | | | | | - Mohamed Farghaly
- Health Economics and Insurance Policies Department, Dubai Health Authority, Dubai, UAE
| | | | - Mostafa Zayed
- Health Economics and Outcomes Research (HEOR), Pfizer, Dubai, UAE
| | - Nora Vainstein
- Cardiovascular Scientific Expert Emerging Market, Pfizer, Dubai, UAE
| | | | - Anup Uboweja
- Value and Implementation Global Medical and Scientific Affairs, MSD, Mumbai, Maharashtra, India
| | | | | | | | - Ali Aljabban
- Pfizer, Dubai Media City, P.O. Box 502749, Dubai, UAE.
| |
Collapse
|
3
|
Giannouli E, Giannouli E, Alexoudi A, Arvaniti C, Fakas N, Constantinidis TS, Kouremenos E, Mitsikostas DD. Validity and reliability of the Greek Migraine-Specific Quality of Life Questionnaire (MSQ Version 2.1-GR). J Patient Rep Outcomes 2024; 8:72. [PMID: 39007966 PMCID: PMC11250746 DOI: 10.1186/s41687-024-00762-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 07/08/2024] [Indexed: 07/16/2024] Open
Abstract
BACKGROUND To assess the validity and reliability of the Migraine-Specific Quality of Life Questionnaire 2.1 (MSQv.2.1) in a group of Greek migraineurs. DESIGN-SAMPLE-METHODS The Greek version of MSQv.2.1 (MSQv.2.1-GR), a self-report measure with 14 items in 3 domains (Role Restrictive (RR), Role Preventive (RP) and Emotional Function (EF)), was administered during a cross-sectional study to 141 Greek adult migraineurs and 135 controls without migraine or any other primary headache disorder, along with Migraine Disability Assessment Scale (MIDAS) and Short Form Health Survey (SF-12) to assess validity. MSQv.2.1-GR was re-administered in a group of participants with migraine two weeks afterwards to assess reliability. Content and construct validity was assessed using Intraclass Correlation Coefficient (ICC), Spearman rho, McDonald's omega, Cronbach's alpha. Confirmatory factor analysis (CFA) was used to test the latent structure of the MSQv.2.1-GR in migraineurs. RESULTS A total of 276 adults participated in the study. Internal consistency of the three MSQv.2.1-GR scales RR, RP and EF yielded a range of McDonald's omega from 0.832 to 0.923 (Cronbach's alpha from 0.814 to 0.923). CFA confirmed the proposed three-factor MSQv.2.1-GR latent structure with acceptable goodness of fit indices and factor loadings. Correlations were established between MSQv2.1-GR component and MIDAS scores, showing moderate and statistically significant relationships (from - 0.519 to -0.562, all p < 0.001) for RR, RP and EF. Correlations between MSQv2.1-GR and SF-12 component scores were identified, with values from 0.1 to 0.4, indicating low to moderate associations. ICC was calculated at 0.997, indicating a high level of reliability between the measures. Notably, all MSQv2.1-GR scores (RR, RP, EF) were significantly higher in the controls compared to migraineurs (p < 0.001 for all scales). These findings suggest that MSQv2.1-GR is internally consistent, shows significant correlations with relevant measures, and is effective in discriminating controls from migraineurs. CONCLUSION MSQv2.1-GR is a valid and reliable tool to determine the effect migraine has on the quality of life of Greek-speaking migraineurs.
Collapse
Affiliation(s)
- Ermioni Giannouli
- Headache Clinic, Athens Medical Centre: Omilos Iatrikou Athinon, 5-7 Distomou Street, Marousi, Athens, Greece.
| | - Eleni Giannouli
- 1st Psychiatric Clinic, Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Athanasia Alexoudi
- First Department of Neurosurgery, Evangelismos Hospital, Medical School, National and Kapodistrian University of Athens, Neurological Institute of Athens, Athens, Greece
| | - Chryssa Arvaniti
- Second Department, Medical School, Attikon Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Fakas
- Neurology Department, 401 General Military Hospital, Athens, Greece
| | | | | | - Dimos-Dimitrios Mitsikostas
- First Department of Neurology, Medical School, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| |
Collapse
|
4
|
Rosignoli C, Caponnetto V, Onofri A, Trozzi V, Tartaglione L, Silvestro M, Russo A, Sacco S, Ornello R. Monoclonal antibodies targeting the calcitonin gene-related peptide pathway improve the effectiveness of acute medication-a real-world study. Neurol Sci 2024; 45:3305-3312. [PMID: 38340218 PMCID: PMC11176241 DOI: 10.1007/s10072-024-07380-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 01/30/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND One of the aims of migraine prevention is to improve response to acute migraine treatments. The aim of the present study was to assess whether monoclonal antibodies targeting the CGRP pathway (CGRP-mAbs) can improve the perceived efficacy of acute treatments. METHODS We included and followed up patients with chronic or episodic migraine from the Headache Centers of Avezzano-L'Aquila and Naples treated with CGRP-mAbs from March 2021 to December 2022. All patients filled out the Migraine Treatment Optimization Questionnaire (MTOQ), the Headache Impact Test (HIT-6), and the Migraine Impact and Disability Assessment Scale (MIDAS) at baseline and 3-6 months after the start of treatment with CGRP-mAbs. RESULTS Sixty-five patients (81.3%) completed the 6-month follow-up. Most patients were female (55, 84.6%), with a median age of 46 years (IQR 39-56). Median MTOQ score increased from 8 (interquartile range [IQR] 4-13) at baseline to 15 (IQR 11-17) at 3 months (p < 0.001) and 16 (IQR 13-17) at the 6-month follow-up (p < 0.001). Median migraine days over 90-day periods decreased from 40 (IQR 24-60) to 24 (IQR 15-30) at 3 months (p < 0.001) and to 20 (IQR 12-24) at 6 months (p < 0.001). Median monthly intake of acute medication decreased from 55 doses (IQR 29-80.5) to 24 doses (IQR 15-40) at 3 months and 18 doses (IQR 11-30) at 6 months (p < 0.001). CONCLUSIONS We showed that 6 months of preventive treatment with CGRP-mAbs led to a significantly better effectiveness of acute treatments, paralleled by decreased monthly migraine days and acute treatment intake.
Collapse
Affiliation(s)
- Chiara Rosignoli
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Valeria Caponnetto
- Department of Life, Health and Environmental Science, University of L'Aquila, L'Aquila, Italy
| | - Agnese Onofri
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Vittorio Trozzi
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Lorenzo Tartaglione
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", 80138, Naples, Italy
| | - Marcello Silvestro
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", 80138, Naples, Italy
| | - Antonio Russo
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", 80138, Naples, Italy
| | - Simona Sacco
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Raffaele Ornello
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| |
Collapse
|
5
|
Kwon MJ, Kim JK, Kim MJ, Yoo DM, Lee NE, Han KM, Kim NY, Kang HS, Choi HG, Kim ES. Associations between Chronic Kidney Disease and Migraine Incidence: Findings from a Korean Longitudinal Big Data Study. J Pers Med 2024; 14:356. [PMID: 38672983 PMCID: PMC11051226 DOI: 10.3390/jpm14040356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 03/26/2024] [Accepted: 03/26/2024] [Indexed: 04/28/2024] Open
Abstract
While headaches frequently occur in individuals with chronic kidney disease (CKD), there are few statistical evaluations of their connection to migraines in population-based studies. In this nationwide longitudinal follow-up study of Korean health examination data (2002-2019), a total of 15,443 participants with CKD and 61,772 matched controls were enrolled. We applied overlap-weighted Cox proportional hazard regression models to assess hazard ratios, examining the correlation between CKD and the development of migraines. After accounting for various factors, we observed a modest reduction of approximately 11% in the likelihood of migraine occurrence among CKD patients (95% confidence intervals = 0.81-0.97) during the 16-year monitoring period. Subgroup analysis revealed a significant association among specific demographic and health conditions, including individuals aged 70 or older, females, overweight individuals, nonsmokers, and those without hypertension or diabetes. Our research may indicate a potential relationship between CKD and the onset of migraines in Korean adults, suggesting a slight reduction in the probability of the occurrence of migraines among those with CKD. These findings emphasize the need for attentive follow-up and preventive management in individuals without the identified protective factors, particularly in male CKD patients under the age of 70 with hypertension.
Collapse
Affiliation(s)
- Mi Jung Kwon
- Department of Pathology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea;
- Laboratory of Brain and Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Anyang 14068, Republic of Korea; (D.M.Y.); (N.-E.L.); (K.M.H.)
| | - Jwa-Kyung Kim
- Division of Nephrology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea;
| | - Min-Jeong Kim
- Department of Radiology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea;
| | - Dae Myoung Yoo
- Laboratory of Brain and Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Anyang 14068, Republic of Korea; (D.M.Y.); (N.-E.L.); (K.M.H.)
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang 14068, Republic of Korea
| | - Na-Eun Lee
- Laboratory of Brain and Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Anyang 14068, Republic of Korea; (D.M.Y.); (N.-E.L.); (K.M.H.)
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang 14068, Republic of Korea
| | - Kyeong Min Han
- Laboratory of Brain and Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Anyang 14068, Republic of Korea; (D.M.Y.); (N.-E.L.); (K.M.H.)
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang 14068, Republic of Korea
| | - Nan Young Kim
- Hallym Institute of Translational Genomics and Bioinformatics, Hallym University Medical Center, Anyang 14068, Republic of Korea;
| | - Ho Suk Kang
- Division of Gastroenterology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea;
| | - Hyo Geun Choi
- Suseo Seoul E.N.T. Clinic, 10, Bamgogae-ro 1-gil, Gangnam-gu, Seoul 06349, Republic of Korea;
| | - Eun Soo Kim
- Department of Radiology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea;
| |
Collapse
|
6
|
Lyu S, Zhang CS, Zhang AL, Guo X, Hua R, Mao Z, Su Q, Xue CC, Sun J. Real-world observations and impacts of Chinese herbal medicine for migraine: results of a registry-based cohort study. Front Pharmacol 2024; 15:1330589. [PMID: 38370478 PMCID: PMC10874640 DOI: 10.3389/fphar.2024.1330589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 01/15/2024] [Indexed: 02/20/2024] Open
Abstract
Background: Migraine is a prevalent, recurrent condition with substantial disease burden. Chinese herbal medicine (CHM) has been used frequently for migraine in controlled clinical settings. This study is to summarise the characteristics of patients who seek clinical care in a tertiary Chinese medicine hospital in China; to gather their preferences and values of using CHM; to explore the effect of CHM for migraine and its comorbidities in a real-world setting, and to collect first-hand expertise of clinicians' practice pattern in prescribing CHM for migraine. Methods: This registry-based cohort study was prospectively conducted at Guangdong Provincial Hospital of Chinese Medicine from December 2020 to May 2022. Adult migraine patients seeking their initial anti-migraine clinical care at the hospital were consecutively recruited and followed up for 12 weeks. Practitioners specialised in headache management prescribed individualised treatments without research interference. Standardised case report forms were employed to gather information on patients' preferences and perspective of seeking clinical care, as well as to assess participants' migraine severity, comorbidities, and quality of life, at 4-weeks intervals. Various analytical methods were utilised based on the computed data. Results: In this study, we observed 248 participants. Of these, 73 received CHM treatment for 28 days or longer. Notably, these participants exhibited a greater disease severity, compared to those treated with CHM for less than 28 days. Of the 248 participants, 83.47% of them expected CHM would effectively reduce the severity of their migraine, around 50% expected effects for migraine-associated comorbidities, while 51.61% expressing concerns about potential side effects. CHM appeared to be effective in reducing monthly migraine days and pain intensity, improving patients' quality of life, and potentially reducing comorbid anxiety, with a minimum of 28 days CHM treatment. Herbs such as gan cao, gui zhi, chuan xiong, fu ling, bai zhu, yan hu suo, etc. were frequently prescribed for migraine, based on patients' specific symptoms. Conclusion: CHM appeared to be beneficial for migraine and comorbid anxiety in real-world clinical practice when used continuously for 28 days or more. Clinical Trial Registration: clinicaltrials.gov, identifier ChiCTR2000041003.
Collapse
Affiliation(s)
- Shaohua Lyu
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine and Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
- The China-Australia International Research Centre for Chinese Medicine, STEM College, RMIT University, Melbourne, VIC, Australia
| | - Claire Shuiqing Zhang
- The China-Australia International Research Centre for Chinese Medicine, STEM College, RMIT University, Melbourne, VIC, Australia
| | - Anthony Lin Zhang
- The China-Australia International Research Centre for Chinese Medicine, STEM College, RMIT University, Melbourne, VIC, Australia
| | - Xinfeng Guo
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine and Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Rong Hua
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine and Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Zhenhui Mao
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine and Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Qiaozhen Su
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine and Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Charlie Changli Xue
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine and Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
- The China-Australia International Research Centre for Chinese Medicine, STEM College, RMIT University, Melbourne, VIC, Australia
| | - Jingbo Sun
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine and Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, Guangzhou, China
- Guangdong Provincial Key Laboratory of Research on Emergency in TCM, Guangzhou, China
| |
Collapse
|
7
|
Bentivegna E, Galastri S, Onan D, Martelletti P. Unmet Needs in the Acute Treatment of Migraine. Adv Ther 2024; 41:1-13. [PMID: 37943442 PMCID: PMC10796525 DOI: 10.1007/s12325-023-02650-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 08/16/2023] [Indexed: 11/10/2023]
Abstract
Migraine represents the most common neurologic disorder, ranking second among the world's causes of disability [expressed as years lived with disability (YLDs)]. Patients often do not receive the best therapy because of safety issues, tolerance, and prescription accessibility. General practitioners are not always educated about the disease, and specialists are few and often difficult to reach. Therapies are limited and have many side effects that can impede the prescription. Prophylactic therapy is recommended in case of four or more headaches a month, eight or more headache days a month, debilitating headaches, and medication-overuse headaches. The available therapeutic options are in constant development. The classic one consists of non-specific drugs: β-blockers, tricyclics, antiepileptics, and botulinum toxin. Monoclonal antibodies targeting the calcitonin gene receptor (CGRP) peptide or its receptor are the only ones specifically designed to treat migraine. Their efficiency and convenient safety profile have been demonstrated in a number of trials versus both placebo and classic therapies. The treatment of acute migraine attack consists of medications designed to affect the painful symptoms. For over 30 years, the cornerstones of treatment in clinical practice have continued to be represented by triptans and non-steroidal anti-inflammatory drugs (NSAIDs), with the well-know related adverse effects. Opioids are used inappropriately and overprescribed. Polytherapy is strongly not recommended but is still a common practice because treatment is not optimized and thus not efficient. Great promise comes from gepants, also targeting CGRP, and ditans, 5-HT1F receptor agonists. They seem to outweigh the risk of medication overuse headache because of their efficacy and rapid onset and have no cardiovascular contraindications. Nonetheless, these points remain to be confirmed. Although therapies have been implemented in the last years, significant unmet treatment needs remain a reality in patients' lives. This commentary aims to identify the most important unmet needs in the acute treatment of migraine, analyzing the current status of available therapies and their limits. We also analyzed some of the prophylactic therapies available, especially focusing on anti-CGRP monoclonal antibodies, to better understand the importance of setting a therapeutic strategy that includes the two modes, both acute and prophylactic, to reach the best result. We hope that having an overview of the shortcomings will help to provide constructive ideas for improvement.
Collapse
Affiliation(s)
- Enrico Bentivegna
- Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, Sapienza University, Via di Grottarossa 1035-1039, 00189, Rome, Italy.
| | - Silvia Galastri
- Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, Sapienza University, Via di Grottarossa 1035-1039, 00189, Rome, Italy
| | - Dilara Onan
- Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, Sapienza University, Via di Grottarossa 1035-1039, 00189, Rome, Italy
- Back and Neck Health Unit, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Paolo Martelletti
- Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, Sapienza University, Via di Grottarossa 1035-1039, 00189, Rome, Italy
- Regional Referral Headache Centre, Sant'Andrea Hospital, Rome, Italy
| |
Collapse
|
8
|
Raffaelli B, Rubio-Beltrán E, Cho SJ, De Icco R, Labastida-Ramirez A, Onan D, Ornello R, Ruscheweyh R, Waliszewska-Prosół M, Messina R, Puledda F. Health equity, care access and quality in headache - part 2. J Headache Pain 2023; 24:167. [PMID: 38087219 PMCID: PMC10717448 DOI: 10.1186/s10194-023-01699-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 11/30/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Headache disorders are a global public health concern affecting diverse populations. This review examines headache service organizations in low-, middle-, and high-income countries. It addresses global challenges in pharmacological headache treatment, with a focus on safety, tolerability, reproductive and child health, and outlines disparities in accessing innovative treatments worldwide. MAIN BODY Organized headache services are essential due to the wide prevalence and varying severity of headache disorders. The tiered headache service model is globally recognized, although its implementation varies based on financial and workforce considerations. Headache burden affects well-being, causing disability, economic challenges, and work limitations, irrespective of location or income. All nations still require improved diagnosis and treatment, and the majority of countries face obstacles including limited access, awareness, economic barriers, and inadequate health policies. Provided adequate internet availability, telemedicine could help improve health equity by expanding access to headache care, since it can offer patients access to services without lengthy waiting times or extensive travel and can provide healthcare unavailable in underserved areas due to staff shortages. Numerous health disparities restrict global access to many headache medications, especially impacting individuals historically excluded from randomized controlled trials, such as those with cardiovascular and cerebrovascular conditions, as well as pregnant women. Furthermore, despite advancements in researching migraine treatments for young patients, the options for treatment remain limited. Access to headache treatment relies on factors like medication availability, approval, financial coverage, and healthcare provider expertise. Inadequate public awareness leads to neglect by policymakers and undertreatment by patients and healthcare providers. Global access discrepancies are exacerbated by the introduction of novel disease-specific medications, particularly impacting Asian, African, and Latin American nations excluded from clinical trials. While North America and Europe experience broad availability of migraine treatments, the majority of countries worldwide lack access to these therapies. CONCLUSIONS Healthcare disparities, treatment access, and medication availability are concerning issues in headache medicine. Variations in national healthcare systems impact headache management, and costly innovative drugs are widening these gaps. Healthcare practitioners and experts should acknowledge these challenges and work towards minimizing access barriers for equitable global headache care in the future.
Collapse
Affiliation(s)
- Bianca Raffaelli
- Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany.
- Clinician Scientist Program, Berlin Institute of Health (BIH), Berlin, Germany.
| | - Eloísa Rubio-Beltrán
- Headache Group, Wolfson SPaRC, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Soo-Jin Cho
- Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
| | - Roberto De Icco
- Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Headache Science & Neurorehabilitation Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Alejandro Labastida-Ramirez
- Headache Group, Wolfson SPaRC, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Dilara Onan
- Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Yozgat Bozok University, Yozgat, Türkiye
| | - Raffaele Ornello
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Ruth Ruscheweyh
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
- German Migraine and Headache Society, Frankfurt, Germany
| | | | - Roberta Messina
- Neuroimaging Research Unit and Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Francesca Puledda
- Headache Group, Wolfson SPaRC, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| |
Collapse
|
9
|
Razzak N, Khan H, Tariq H, Aslam M. Association between risk factors and migraine in Pakistani females. BMC Womens Health 2023; 23:642. [PMID: 38042798 PMCID: PMC10693022 DOI: 10.1186/s12905-023-02810-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 11/26/2023] [Indexed: 12/04/2023] Open
Abstract
BACKGROUND Migraine is a typical cripple issue of the brain identified with cerebral pain which is an indication of numerous health conditions. About 18% of women (27 million) and 6% of men (10 million) are afflicted by migraine in the United States. Based on a case-control study, to explore the different risk factors, causing migraine in females and examine the association between risk factors and migraine. METHODS A sample of 1055 individuals were selected in different areas of Lahore from September 2019 to March 2020. The information was obtained by using the direct interview method and questionnaire method. Descriptive analysis, bivariate analysis and binary logistic regression analysis were carried out in data analysis. RESULTS Among 1055 individuals 740 cases and 315 controls were included. In a binary logistic regression model, physical activities, stress, summer season, menstruation and morning were the risk factors that cause migraine and these were found to be positively significant with the odds ratios and 95% confidence interval of odds ratios (1.399; 1.122-1.746), (1.510; 1.187-1.922), (1.595; 1.374-1.851), (1.513; 1.247-1.836) and (1.309; 1.028-1.665) respectively. Nausea, isolation and back head pain were caused by migraine and these were found positively significant with the odds ratios and 95% confidence interval of odds ratios(1.290; 1.122-1.484), (1.882; 1.617-2.190) and (1.285; 1.123-1.471) respectively. CONCLUSIONS Stress, physical Activities and Menstruation increase the risk of migraine but weight loss, Breakfast, lunch, thirst, injury and Second trimester during pregnancy reduce the risk of migraine.
Collapse
Affiliation(s)
- Nida Razzak
- Department of Statistics, GC University Lahore, Lahore, Pakistan
| | - Hina Khan
- Department of Statistics, GC University Lahore, Lahore, Pakistan.
| | - Huma Tariq
- Additional Controller of Examination, GC University Lahore, Lahore, Pakistan
| | - Muhammad Aslam
- Department of Statistics, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia.
| |
Collapse
|
10
|
Martelletti P, Leonardi M, Ashina M, Burstein R, Cho SJ, Charway-Felli A, Dodick DW, Gil-Gouveia R, Grazzi L, Lampl C, MaassenVanDenBrink A, Minen MT, Mitsikostas DD, Olesen J, Owolabi MO, Reuter U, Ruiz de la Torre E, Sacco S, Schwedt TJ, Serafini G, Surya N, Tassorelli C, Wang SJ, Wang Y, Wijeratne T, Raggi A. Rethinking headache as a global public health case model for reaching the SDG 3 HEALTH by 2030. J Headache Pain 2023; 24:140. [PMID: 37884869 PMCID: PMC10604921 DOI: 10.1186/s10194-023-01666-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 09/05/2023] [Indexed: 10/28/2023] Open
Abstract
The 2030 Agenda for Sustainable Development sets out, through 17 Sustainable Development Goals (SDGs), a path for the prosperity of people and the planet. SDG 3 in particular aims to ensure healthy lives and promote well-being for all at all ages and includes several targets to enhance health. This review presents a "headache-tailored" perspective on how to achieve SDG 3 by focusing on six specific actions: targeting chronic headaches; reducing the overuse of acute pain-relieving medications; promoting the education of healthcare professionals; granting access to medication in low- and middle-income countries (LMIC); implementing training and educational opportunities for healthcare professionals in low and middle income countries; building a global alliance against headache disorders. Addressing the burden of headache disorders directly impacts on populations' health, as well as on the possibility to improve the productivity of people aged below 50, women in particular. Our analysis pointed out several elements, and included: moving forward from frequency-based parameters to define headache severity; recognizing and managing comorbid diseases and risk factors; implementing a disease management multi-modal management model that incorporates pharmacological and non-pharmacological treatments; early recognizing and managing the overuse of acute pain-relieving medications; promoting undergraduate, postgraduate, and continuing medical education of healthcare professionals with specific training on headache; and promoting a culture that favors the recognition of headaches as diseases with a neurobiological basis, where this is not yet recognized. Making headache care more sustainable is an achievable objective, which will require multi-stakeholder collaborations across all sectors of society, both health-related and not health-related. Robust investments will be needed; however, considering the high prevalence of headache disorders and the associated disability, these investments will surely improve multiple health outcomes and lift development and well-being globally.
Collapse
Affiliation(s)
- Paolo Martelletti
- Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
| | - Matilde Leonardi
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, Milan, 20133, Italy
| | - Messoud Ashina
- Department of Neurology, Danish Headache Center, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Rami Burstein
- John Hedley-Whyte Professor of Anesthesia and Neuroscience at the Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Soo-Jin Cho
- Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Military Hospital, Hwaseong, Korea
| | | | - David W Dodick
- Department of Neurology, Mayo Clinic, Scottsdale, AZ, USA
| | - Raquel Gil-Gouveia
- Neurology Department, Hospital da Luz Headache Center, Hospital da Luz Lisboa., Lisbon, Portugal
- Center for Interdisciplinary Research in Health, Universidade Católica Portuguesa, Lisbon, Portugal
| | - Licia Grazzi
- Neuroalgology Unit and Headache Center, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Christian Lampl
- Department of Neurology and Stroke Unit, Koventhospital Barmherzige Brüder Linz, Linz, Austria
- Headache Medical Center Linz, Linz, Austria
| | - Antoinette MaassenVanDenBrink
- Division of Vascular Medicine and Pharmacology, Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Mia T Minen
- Department of Neurology, NYU Langone Health, NY, New York, USA
| | - Dimos Dimitrios Mitsikostas
- 1st Neurology Department, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Jes Olesen
- Department of Neurology, Danish Headache Center, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mayowa Ojo Owolabi
- Faculty of Clinical Sciences; Center for Genomic and Precision Medicine, College of Medicine,, University of Ibadan, Ibadan, Nigeria
| | - Uwe Reuter
- Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany
- Universitätsmedizin Greifswald, Greifswald, Germany
| | | | - Simona Sacco
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Todd J Schwedt
- Department of Neurology, Mayo Clinic, Scottsdale, AZ, USA
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | | | - Cristina Tassorelli
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Shuu-Jiun Wang
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Neurology, The Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yonggang Wang
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Tissa Wijeratne
- Department of Neurology, Sunshine Hospital, St Albans, VIC, Australia
| | - Alberto Raggi
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, Milan, 20133, Italy.
| |
Collapse
|
11
|
Liu H, Dong M, Liu K, Jia Z, Gui W, Cheng Y, Lv Y, Qu K, Zhao H, Chen J, Zhang D, Fan Z, Yang X, Hu D, Xie H, Li M, Wen B, Chen S, Xu P, Rong Q, He Q, Ren Z, Yan F, Zhao H, Chen M, Yu T, Qu H, An X, Guo H, Zhang X, Pan X, Wang X, Qiu S, Zhang L, Zhao H, Pan X, Wan Q, Yan L, Liu J, Yu Z, Zhang M, Ran Y, Han X, Yu S, Dong Z. Status of diagnosis and preventative treatment for primary headache disorders: real-world data of unmet needs in China. J Headache Pain 2023; 24:119. [PMID: 37653478 PMCID: PMC10472552 DOI: 10.1186/s10194-023-01654-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 08/15/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Headache disorders are widely prevalent and pose a considerable economic burden on individuals and society. Globally, misdiagnosis and inadequate treatment of primary headache disorders remain significant challenges, impeding the effective management of such conditions. Despite advancements in headache management over the last decade, a need for comprehensive evaluations of the status of primary headache disorders in China regarding diagnosis and preventative treatments persists. METHODS In the present study, we analyzed the established queries in the Survey of Fibromyalgia Comorbidity with Headache (SEARCH), focusing on previous diagnoses and preventative treatment regimens for primary headache disorders. This cross-sectional study encompassed adults diagnosed with primary headache disorders who sought treatment at 23 hospitals across China between September 2020 to May 2021. RESULTS The study comprised 2,868 participants who were systematically examined. Migraine and tension-type headaches (TTH) constituted a majority of the primary headache disorders, accounting for 74.1% (2,124/2,868) and 23.3% (668/2,868) of the participants, respectively. Medication overuse headache (MOH) affected 8.1% (231/2,868) of individuals with primary headache disorders. Over half of the individuals with primary headache disorders (56.6%, 1,624/2,868) remained undiagnosed. The previously correct diagnosis rates for migraine, TTH, TACs, and MOH were 27.3% (580/2,124), 8.1% (54/668), 23.2% (13/56), and 3.5% (8/231), respectively. The misdiagnosis of "Nervous headache" was found to be the most prevalent among individuals with migraine (9.9%, 211/2,124), TTH (10.0%, 67/668), trigeminal autonomic cephalalgias (TACs) (17.9%, 10/56), and other primary headache disorders (10.0%, 2/20) respectively. Only a minor proportion of individuals with migraine (16.5%, 77/468) and TTH (4.7%, 2/43) had received preventive medication before participating in the study. CONCLUSIONS While there has been progress made in the rate of correct diagnosis of primary headache disorders in China compared to a decade ago, the prevalence of misdiagnosis and inadequate treatment of primary headaches remains a veritable issue. As such, focused efforts are essential to augment the diagnosis and preventive treatment measures related to primary headache disorders in the future.
Collapse
Affiliation(s)
- Huanxian Liu
- Department of Neurology, the First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China
- International Headache Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Ming Dong
- Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Jilin, 130021, China
| | - Kaiming Liu
- Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, 310009, China
| | - Zhihua Jia
- Department of Neurology, the First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China
- International Headache Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Wei Gui
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Lujiang Road 17, Hefei, 230001, China
| | - Yingying Cheng
- Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Jilin, 130021, China
| | - Yudan Lv
- Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Jilin, 130021, China
| | - Kang Qu
- Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Jilin, 130021, China
| | - Hongru Zhao
- Department of Neurology, The First Affiliated Hospital of Soochow University, Jiangsu, 215006, China
| | - Jianjun Chen
- Department of Neurology, Lishui Municipal Central Hospital, Zhejiang, 323000, China
| | - Dan Zhang
- Department of Neurology, Sir Run Run Shaw Hospital, Zhejiang, 310020, China
| | - Zhiliang Fan
- Department of Neurology, Xing Tai People's Hospital, Hebei, 054001, China
| | - Xiaosu Yang
- Department of Neurology, Xiangya Hospital, Central South University, Hunan, 410013, China
| | - Dongmei Hu
- Department of Neurology, The Second Affiliated Hospital of Shandong First Medical University, Shandong, 271000, China
| | - Hongyan Xie
- Department of Neurology, The Second Affiliated Hospital of Shandong First Medical University, Shandong, 271000, China
| | - Mingxin Li
- Department of Neurology, Qilu Hospital, Shandong, 250012, China
| | - Bing Wen
- Department of Neurology, Qilu Hospital, Shandong, 250012, China
| | - Sufen Chen
- Department of Neurology, Changsha Central Hospital Affiliated to the University of South China, Hunan, 410004, China
| | - Peng Xu
- Department of Neurology, Affiliated Hospital of Jining Medical University, Shandong, 272000, China
| | - Qingqing Rong
- Department of Neurology, Affiliated Hospital of Jining Medical University, Shandong, 272000, China
| | - Qiu He
- Department of Neurology, The People's Hospital of Liaoning Province, Liaoning, 110016, China
| | - Zhanxiu Ren
- Department of Neurology, The People's Hospital of Liaoning Province, Liaoning, 110016, China
| | - Fanhong Yan
- Department of Neurology, Linyi Jinluo Hospital, Shandong, 276036, China
| | - Heling Zhao
- Department of Neurology, Linyi Jinluo Hospital, Shandong, 276036, China
| | - Min Chen
- Department of Neurology, Zhengzhou University First Affiliated Hospital, Henan, 450052, China
| | - Tingmin Yu
- Department of Neurology, The Second Hospital of Jilin University, Jilin, 130041, China
| | - Hongli Qu
- Department of Neurology, The First Affiliated Hospital of Xiamen University, Jilin, 130041, China
| | - Xingkai An
- Department of Neurology, The First Affiliated Hospital of Xiamen University, Jilin, 130041, China
| | - Huailian Guo
- Department of Neurology, People's Hospital, Peking University, Beijing, 100044, China
| | - Xinhua Zhang
- Department of Neurology, People's Hospital, Peking University, Beijing, 100044, China
| | - Xiaoping Pan
- Department of Neurology, Guangzhou First People's Hospital, Guangdong, 510180, China
| | - Xiaojuan Wang
- Department of Neurology, Guangzhou First People's Hospital, Guangdong, 510180, China
| | - Shi Qiu
- Department of Neurology, Aerospace Center Hospital, Beijing, 100049, China
| | - Lvming Zhang
- Department of Neurology, Aerospace Center Hospital, Beijing, 100049, China
| | - Hongling Zhao
- Department of Neurology, Da Lian Municipal Central Hospital, Liaoning, 116033, China
| | - Xin Pan
- Department of Neurology, Da Lian Municipal Central Hospital, Liaoning, 116033, China
| | - Qi Wan
- Department of Neurology, Jiangsu Province Hospital, Jiangsu, 210029, China
| | - Lanyun Yan
- Department of Neurology, Jiangsu Province Hospital, Jiangsu, 210029, China
| | - Jing Liu
- Department of Neurology, the First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China
- International Headache Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Zhe Yu
- Department of Neurology, the First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China
- International Headache Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Mingjie Zhang
- Department of Neurology, the First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China
- International Headache Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Ye Ran
- Department of Neurology, the First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China
- International Headache Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Xun Han
- Department of Neurology, the First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China
- International Headache Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Shengyuan Yu
- Department of Neurology, the First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China.
- International Headache Center, Chinese PLA General Hospital, Beijing, 100853, China.
| | - Zhao Dong
- Department of Neurology, the First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China.
- International Headache Center, Chinese PLA General Hospital, Beijing, 100853, China.
| |
Collapse
|
12
|
Karlsson WK, Ashina H, Cullum CK, Christensen RH, Al-Khazali HM, Amin FM, Ashina M. The Registry for Migraine (REFORM) study: methodology, demographics, and baseline clinical characteristics. J Headache Pain 2023; 24:70. [PMID: 37303034 DOI: 10.1186/s10194-023-01604-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 05/29/2023] [Indexed: 06/13/2023] Open
Abstract
BACKGROUND Erenumab has demonstrated effectiveness for prevention of migraine attacks, but the treatment is costly, and a considerable proportion of patients do not respond to it. The Registry for Migraine study (REFORM) was initiated to discover biomarkers that can predict response to erenumab in patients with migraine. The specific objective was to investigate differences in erenumab efficacy based on clinical information, blood-based biomarkers, structural and functional magnetic resonance imaging (MRI), and response to intravenous infusion of calcitonin gene-related peptide (CGRP). In this first report of the REFORM study, we provide a comprehensive description of the study methodology, and present the baseline characteristics of the study population. METHODS The REFORM study was a single-center, prospective, longitudinal cohort study in adults with migraine who were scheduled to receive preventive treatment with erenumab as part of a separate, open-label, single-arm phase IV trial. The study included four periods: a 2-week screening period (Weeks -6 to -5), 4-week baseline period (Week -4 to Day 1), 24-week treatment period (Day 1 to Week 24), and a 24-week follow-up period without treatment (Week 25 to Week 48). Demographic and clinical characteristics were recorded using a semi-structured interview, whilst outcome data were obtained using a headache diary, patient-reported outcomes, blood sampling, brain MRI, and responsiveness to intravenous infusion of CGRP. RESULTS The study enrolled 751 participants, with a mean age ± SD of 43.8 ± 12.2 years, of which 88.8% (n = 667) were female. At enrollment, 64.7% (n = 486) were diagnosed with chronic migraine, and 30.2% (n = 227) had history of aura. The mean monthly migraine days (MMDs) was 14.5 ± 7.0. Concomitant preventive medications were used by 48.5% (n = 364) of the participants, and 39.9% (n = 300) had failed ≥ 4 preventive medications. CONCLUSION The REFORM study enrolled a population with a high migraine burden and frequent use of concomitant medications. The baseline characteristics were representative of patients with migraine in specialized headache clinics. Future publications will report the results of the investigations presented in this article. TRIAL REGISTRATION The study and sub-studies were registered on ClinicalTrials.gov (NCT04592952; NCT04603976; and NCT04674020).
Collapse
Affiliation(s)
- William Kristian Karlsson
- Department of Neurology, Danish Headache Center, Copenhagen University Hospital - Rigshospitalet, Valdemar Hansens Vej 5, Glostrup, 2600, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Håkan Ashina
- Department of Neurology, Danish Headache Center, Copenhagen University Hospital - Rigshospitalet, Valdemar Hansens Vej 5, Glostrup, 2600, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Brain and Spinal Cord Injury, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Christopher Kjær Cullum
- Department of Neurology, Danish Headache Center, Copenhagen University Hospital - Rigshospitalet, Valdemar Hansens Vej 5, Glostrup, 2600, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Rune Häckert Christensen
- Department of Neurology, Danish Headache Center, Copenhagen University Hospital - Rigshospitalet, Valdemar Hansens Vej 5, Glostrup, 2600, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Haidar Muhsen Al-Khazali
- Department of Neurology, Danish Headache Center, Copenhagen University Hospital - Rigshospitalet, Valdemar Hansens Vej 5, Glostrup, 2600, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Faisal Mohammad Amin
- Department of Neurology, Danish Headache Center, Copenhagen University Hospital - Rigshospitalet, Valdemar Hansens Vej 5, Glostrup, 2600, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Brain and Spinal Cord Injury, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Messoud Ashina
- Department of Neurology, Danish Headache Center, Copenhagen University Hospital - Rigshospitalet, Valdemar Hansens Vej 5, Glostrup, 2600, Copenhagen, Denmark.
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| |
Collapse
|
13
|
Yu S, Kim BK, Guo A, Kim MH, Zhang M, Wang Z, Liu J, Moon HS, Tan G, Yang Q, McGrath D, Hanna M, Stock DA, Gao Y, Croop R, Lu Z. Safety and efficacy of rimegepant orally disintegrating tablet for the acute treatment of migraine in China and South Korea: a phase 3, double-blind, randomised, placebo-controlled trial. Lancet Neurol 2023; 22:476-484. [PMID: 37210098 DOI: 10.1016/s1474-4422(23)00126-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/20/2023] [Accepted: 03/27/2023] [Indexed: 05/22/2023]
Abstract
BACKGROUND No acute treatments targeting calcitonin gene-related peptide (CGRP) have been approved for use in China or South Korea. We aimed to compare the efficacy and safety of rimegepant-an orally administered small molecule CGRP antagonist-with placebo in the acute treatment of migraine among adults in these countries. METHODS This double-blind, randomised, placebo-controlled, multicentre phase 3 trial was done at 86 outpatient clinics at hospitals and academic medical centres (73 in China and 13 in South Korea). Participants were adults (≥18 years) with at least a 1-year history of migraine who had two to eight moderate or severe attacks per month and fewer than 15 headache days per month within the 3 months before the screening visit. Participants were randomly assigned (1:1) to 75 mg rimegepant or placebo to treat a single migraine attack of moderate or severe pain intensity. Randomisation was stratified by the use of preventive medication and by country. The allocation sequence was generated and implemented by study personnel using an interactive web-response system accessed online from each study centre. All participants, investigators, and the sponsor were masked to treatment assignment. The coprimary endpoints of freedom from pain and freedom from the most bothersome symptom (nausea, phonophobia, or photophobia) 2 h after dosing were assessed in the modified intention-to-treat (mITT) population (randomly assigned participants who took study medication for a migraine attack of moderate or severe pain intensity, and provided at least one efficacy datapoint after treatment) using Cochran-Mantel Haenszel tests. Safety was assessed in all participants who received rimegepant or placebo. The study is registered with ClinicalTrials.gov, number NCT04574362, and is completed. FINDINGS 1431 participants were randomly assigned (716 [50%] to rimegepant and 715 [50%] to placebo). 668 (93%) participants in the rimegepant group and 674 (94%) participants in the placebo group received treatment. 1340 participants were included in the mITT analysis (666 [93%] in the rimegepant group and 674 [94%] in the placebo group). 2 h after dosing, rimegepant was superior to placebo for pain freedom (132 [20%] of 666 vs 72 [11%] of 674, risk difference 9·2, 95% CI 5·4-13·0; p<0·0001) and freedom from the most bothersome symptom (336 [50%] of 666 participants vs 241 [36%] of 674 participants, 14·8, 9·6-20·0; p<0·0001). The most common (≥1%) adverse events were protein in urine (8 [1%] of 668 participants in the rimepegant group vs 7 [1%] of 674 participants in the placebo group), nausea (7 [1%] of 668 vs 18 [3%] of 674), and urinary tract infection (5 [1%] of 668 vs 8 [1%] of 674). There were no rimegepant-related serious adverse events. INTERPRETATION Among adults living in China or South Korea, a single dose of 75 mg rimegepant was effective for the acute treatment of migraine. Safety and tolerability were similar to placebo. Our findings suggest that rimegepant might be a useful new addition to the range of medications for the acute treatment of migraine in China and South Korea, but further studies are needed to support long-term efficacy and safety and to compare rimegepant with other medications for the acute treatment of migraine in this population. FUNDING BioShin Limited. TRANSLATIONS For the Chinese and Korean translations of the abstract see Supplementary Materials section.
Collapse
Affiliation(s)
| | | | - Aihong Guo
- Yan'an University Xianyang Hospital, Xianyang, China
| | - Man-Ho Kim
- Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | | | - Zhen Wang
- Changsha Central Hospital, Changsha, China
| | | | - Heui-Soo Moon
- Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Ge Tan
- The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qian Yang
- Shanxi Provincial Hospital, Xi'an, China
| | | | | | | | | | | | | |
Collapse
|
14
|
Abstract
Migraine represents the most common cause of work disability in young women and the second one in the general population. Preventive treatment can reduce the frequency of attacks and their intensity, consequently improving the quality of life. Despite this, global health systems have shown important gaps in addressing optimal management of preventive therapy. Despite numerous adverse effects of traditional medications for migraine prevention being well known, these medications continue to be considered the standard of care for prophylaxis of this disease in many contexts. On the other hand, the widespread use of calcitonin gene-related peptide (CGRP) receptor antagonists, which have marked a breakthrough in prophylactic therapy of migraine, has been limited because of their high cost. We also highlight important shortcomings in migraine management by general practitioners (GPs) and poor patient education on the disease with a consequent delay in referring selected patients to dedicated headache centres. Over the next few years, we expect the headache medicine community to mobilize to address these gaps in preventive treatment of migraine.
Collapse
|
15
|
The impact of migraine and probable migraine on productivity loss in Korea: A cross-sectional online survey. PLoS One 2022; 17:e0277905. [PMID: 36441801 PMCID: PMC9704660 DOI: 10.1371/journal.pone.0277905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 11/04/2022] [Indexed: 11/29/2022] Open
Abstract
Migraine is an enormous burden on society, but relevant studies are limited. The population of interest of this study was migraine or probable migraine (PM) in Korea. In this population, we aimed to assess the productivity loss through the level of severity defined by monthly migraine days (MMD) and analgesic frequency and to estimate costs and associated factors of productivity loss. We conducted an online survey of adults with migraine symptoms. We defined migraine and PM using the modified International Classification of Headache Disorders, second edition. Severity level was defined by subgroups of MMD (0-3, 4-14, and ≥15 days) and analgesic frequency (0, 1, 2, 3, and ≥4 per week). Productivity loss was assessed using the Work Productivity and Activity Impairment questionnaire and consisted of absenteeism, presenteeism, overall work productivity loss, and activity impairment. The costs of productivity loss due to absenteeism and presenteeism were calculated in 2020 USD. We used negative binomial regression to identify the factors associated with the costs of productivity loss. We identified 362 respondents with migraine or PM. Mean age was 41.7 years, 75.7% were female (N = 274), and 73.2% (N = 265) were employed. On average, productivity losses due to absenteeism and presenteeism were 8.1% and 39.7%, respectively. As MMD increased, there was a trend toward increased activity impairment, presenteeism, and overall work productivity loss. The mean overall productivity loss cost was USD 44.61 per person per day. Duration of migraine attacks was significantly associated with higher absenteeism costs. The results of this study indicate that the higher the MMD, the greater the productivity loss in patients with migraine or PM in Korea. We also found that patients with low-frequency migraine and PM experienced substantial productivity loss. This study provides comprehensive evidence of the burden of migraine in Korea using a representative sample.
Collapse
|
16
|
Lyu S, Zhang CS, Sun J, Weng H, Xue CC, Guo X, Zhang AL. Chinese herbal medicine for migraine management: A hospital-based retrospective analysis of electronic medical records. Front Med (Lausanne) 2022; 9:936234. [PMID: 36438031 PMCID: PMC9684313 DOI: 10.3389/fmed.2022.936234] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 10/13/2022] [Indexed: 11/11/2022] Open
Abstract
Background Migraine is a chronic neurological disease causing significant socioeconomic burden and impaired quality of life. Chinese medicine is commonly used for migraine in China. Clinical trials have generated evidence of the effectiveness of Chinese medicine therapies for migraine. However, little is known about how to use these therapies to treat migraine in real-world clinical settings. Methods In this retrospective study, we analyzed data from the electronic medical records (EMRs) of 2,023 migraine patients who attended the Guangdong Provincial Hospital of Chinese Medicine (GPHCM) between July 2018 and July 2020. Results More than three-quarters (77.21%) of the patients were female. Most (78.20%) of the patients were aged between 18 and 50 years, 18.49% were aged above 50 years, and the remaining 3.31% were under 18 years. Sleep disorders were the most documented comorbidity occurring in 27.29% of patients, and more common in females (29.77%) than male (18.87%). Fatigue was the most frequently reported trigger of migraine attacks among all patients (9.39%), while menstruation was the most common trigger for female patients (10.24%). Less than a quarter of patients (21.01%) reported a history of taking analgesic medication for their migraine. The median treatment duration reported by the patients was 10 days. Chinese herbal medicine (CHM) was the predominant treatment for migraine at the hospital (88.48%), while pharmacotherapies were prescribed to 28.97% of the patients. CHM was prescribed more often as a sole treatment (53.58% of patients) than combined with pharmacotherapies (27.39% of patients). Among patients who reported improvements after taking CHM, the most frequently used herbs were fu ling and chuan xiong, the most frequent patented CHM product was tong tian oral solution, and the main herbal formulae were chuan xiong cha tiao san and yi qi cong ming tang. Conclusion CHM formulae, such as chuan xiong cha tiao san and yi qi cong ming tang, patented CHM product tong tian oral solution, and some herbs are potentially effective treatments for migraine. As such, CHM can be used as an alternative to conventional pharmacotherapies for migraine and is worth further evaluation in randomized controlled trials.
Collapse
Affiliation(s)
- Shaohua Lyu
- The China Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, STEM College, RMIT University, Bundoora, VIC, Australia
- Guangdong Provincial Hospital of Chinese Medicine and Guangdong Provincial Academy of Chinese Medical Sciences, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Claire Shuiqing Zhang
- The China Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, STEM College, RMIT University, Bundoora, VIC, Australia
| | - Jingbo Sun
- Guangdong Provincial Hospital of Chinese Medicine and Guangdong Provincial Academy of Chinese Medical Sciences, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Heng Weng
- Guangdong Provincial Hospital of Chinese Medicine and Guangdong Provincial Academy of Chinese Medical Sciences, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Charlie Changli Xue
- The China Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, STEM College, RMIT University, Bundoora, VIC, Australia
- Guangdong Provincial Hospital of Chinese Medicine and Guangdong Provincial Academy of Chinese Medical Sciences, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xinfeng Guo
- Guangdong Provincial Hospital of Chinese Medicine and Guangdong Provincial Academy of Chinese Medical Sciences, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- *Correspondence: Xinfeng Guo,
| | - Anthony Lin Zhang
- The China Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, STEM College, RMIT University, Bundoora, VIC, Australia
- Anthony Lin Zhang,
| |
Collapse
|
17
|
Cho KH, Oh K, Kim S, Kim SR. Relationships among Symptoms, Disability, Type D Personality, and Quality of Life in Patients with Migraine: A Cross-Sectional Study in South Korea. Pain Manag Nurs 2022; 24:180-187. [PMID: 36089468 DOI: 10.1016/j.pmn.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 08/03/2022] [Accepted: 08/06/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Type D personality as a personality vulnerable to stress consists of negative affectivity and social inhibition, and it is related to symptoms and decreased quality of life in patients with chronic illness. AIM This study aimed to explore the relationships among migraine symptoms, disability, type D personality, and quality of life in patients with migraine. METHODS A convenience sample of 135 patients with migraine was collected at the neurologic outpatient clinics of two tertiary hospitals in South Korea. Frequency and severity of migraine symptoms, Migraine Disability Assessment, type D personality, and quality of life were investigated using a structured questionnaire. A descriptive cross-sectional design was used. RESULTS Sixty-one (45.2%) were classified as type D personality. The intensity of the most severe migraine and Migraine Disability Assessment scores in subjects with type D personality were significantly higher than those in subjects without type D personality. In addition, the quality of life score of subjects with type D personality was significantly lower than in subjects without type D personality. The intensity of the migraine, Migraine Disability Assessment score, and type D personality were significant factors influencing quality of life on stepwise multiple regression analysis. CONCLUSIONS Type D personality was related to migraine symptoms, disability, and quality of life in patients with migraine.
Collapse
Affiliation(s)
- Kyung-Hee Cho
- Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Kyungmi Oh
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Sunho Kim
- College of Nursing, Korea University, Seoul, Republic of Korea
| | - Sung Reul Kim
- College of Nursing, Korea University, Seoul, Republic of Korea.
| |
Collapse
|
18
|
Park S, Han S, Suh HS. The disease burden of migraine patients receiving prophylactic treatments in Korea: a population-based claims database analysis. BMC Health Serv Res 2022; 22:902. [PMID: 35821030 PMCID: PMC9277836 DOI: 10.1186/s12913-022-08191-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 06/14/2022] [Indexed: 11/24/2022] Open
Abstract
Background Despite guideline recommendations, the limited benefits and failure of prophylactic treatment in patients with migraine have been reported. This study aimed to estimate the incremental burden (i.e., healthcare resource use and cost) of disease in patients who received at least one prophylactic treatment compared to those who did not. Methods This study analyzed the Health Insurance Review and Assessment Service database, which covers the entire population of Korea from December 2014 to November 2019. We included adult patients with migraine (≥18 years) who had ≥1 claim with migraine diagnosis (G43) or received ≥1 prescription of triptan or ergotamine between December 2015 and November 2018. We defined two groups: (1) migraine patients who received at least one prophylactic treatment (prophylaxis group) and (2) migraine patients who never received prophylactic treatments (non-prophylaxis group). We performed propensity score matching to balance the baseline covariates between the two groups. In a matched cohort, we estimated healthcare resource use and costs in terms of outpatient visits, outpatient visits to neurologists, emergency department (ED) visits, and hospitalizations. Results After matching, 633,709 and 633,709 patients were identified in the prophylaxis and non-prophylaxis groups, respectively. The healthcare resource utilization was significantly higher in the prophylaxis group than in the non-prophylaxis group in terms of the number of outpatient visits (2.34 vs 1.70), outpatient visits to neurologists (2.23 vs 1.61), ED visits (1.07 vs 1.05), and hospitalizations (1.12 vs 1.09) (all P < 0.05). The estimated annual costs per patient were significantly higher in the prophylaxis group than in the non-prophylaxis group for outpatient (102.37 USD vs. 62.46 USD), neurology outpatient (141.80 USD vs. 120.30 USD), and ED visits (550.51 USD vs. 234.14 USD) and hospitalization (817.01 USD vs. 645.97 USD) (all P < 0.001). Conclusions Migraine patients who received ≥1 prophylactic treatment had a higher burden of disease than migraine patients who received no prophylaxis. This indicates that despite migraine prophylaxis, the migraine-related disease burden remains high, and more efficient migraine prophylaxis strategies are needed.
Collapse
Affiliation(s)
- Seonyoung Park
- College of Pharmacy, Pusan National University, Busan, South Korea
| | - Sola Han
- Department of Regulatory Science, Kyung Hee University, Seoul, South Korea.,College of Pharmacy, Kyung Hee University, Seoul, South Korea.,College of Pharmacy, University of Texas at Austin, Austin, TX, USA
| | - Hae Sun Suh
- Department of Regulatory Science, Kyung Hee University, Seoul, South Korea. .,College of Pharmacy, Kyung Hee University, Seoul, South Korea.
| |
Collapse
|
19
|
Tang Y, Peng A, Peng B, He S, Zhao X, Zhu Y, Lai W, Song T, Chen L. Association between patent foramen ovale and migraine without aura: a community-based cross-sectional study in China. BMJ Open 2022; 12:e056937. [PMID: 35361647 PMCID: PMC8971771 DOI: 10.1136/bmjopen-2021-056937] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 03/06/2022] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES To assess the influence of patent foramen ovale (PFO) on the prevalence of migraine without aura based on propensity score-matched samples in Southwest China. DESIGN Propensity-matched cross-sectional study. PARTICIPANTS Residents over 20 years of age were recruited from 15 communities of Western China from July 2020 to October 2020. A total of 3741 residents having accepted to undergo contrast-transthoracic echocardiography and a standard structured questionnaire was assessed for the relationship between PFO and migraine without aura. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome measures were the prevalence of migraine without aura across different degrees of right-left shunts. RESULTS A total of 3741 participants were included. Among them, 881 participants were diagnosed with PFO. The prevalence of migraine without aura in the PFO group was 12.83%, significantly higher than the other group (7.83%, p<0.0001). Analyses of the matched samples showed that the presence of a PFO increased the morbidity risk of migraine without aura (p < 0.001; OR=1.71, 95% CI 1.19 to 2.47). CONCLUSION This community-based cross-sectional study pointed to a strong association between PFO and migraine without aura, especially when the shunt is large. TRIAL REGISTRATION NUMBER ChiCTR1900024623.
Collapse
Affiliation(s)
- Yusha Tang
- Department of Neurology, Sichuan University West China Hospital, Chengdu, China
| | - Anjiao Peng
- Department of Neurology, Sichuan University West China Hospital, Chengdu, China
| | - Bo Peng
- Department of Ultrasonography, Mianzhu City People's Hospital, Mianzhu, China
| | - Shixu He
- Department of Neurology, Sichuan University West China Hospital, Chengdu, China
| | - Xia Zhao
- Department of Clinical Research Management, Sichuan University West China Hospital, Chengdu, China
| | - Yuanfeng Zhu
- Department of Clinical Research Management, Sichuan University West China Hospital, Chengdu, China
| | - Wanlin Lai
- Department of Neurology, Sichuan University West China Hospital, Chengdu, China
| | - Tingting Song
- Department of Neurology, Sichuan University West China Hospital, Chengdu, China
| | - Lei Chen
- Department of Neurology, Sichuan University West China Hospital, Chengdu, China
| |
Collapse
|
20
|
Hirata K, Ueda K, Komori M, Zagar AJ, Selzler KJ, Nelson AM, Han Y, Jaffe DH, Matsumori Y, Takeshima T. Comprehensive population-based survey of migraine in Japan: results of the ObserVational Survey of the Epidemiology, tReatment, and Care Of MigrainE (OVERCOME [Japan]) study. Curr Med Res Opin 2021; 37:1945-1955. [PMID: 34429000 DOI: 10.1080/03007995.2021.1971179] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The ObserVational survey of the Epidemiology, tReatment, and Care Of MigrainE study in Japan (OVERCOME [Japan]) aimed to provide an up-to-date assessment of migraine epidemiology in Japan. METHODS OVERCOME (Japan) was a cross-sectional, population-based web survey of Japanese adults recruited from consumer panels. People with active migraine (met modified International Classification of Headache Disorders, 3rd edition [ICHD-3] criteria or had a self-reported physician diagnosis of migraine) answered questions about headache features, physician consultation patterns, and migraine medication use. The burden and impact of migraine were assessed using Migraine Disability Assessment (MIDAS) and Work Productivity and Activity Impairment scales. RESULTS In total, 231,747 respondents accessed the screener, provided consent, and were eligible for the survey. The migraine group included 17,071 respondents (mean ± SD age 40.7 ± 13.0 years; 66.5% female). ICHD-3 migraine criteria were met by 14,033 (82.2%) respondents; 9667 (56.6%) self-reported a physician diagnosis of migraine. The mean number of monthly headache days was 4.5 ± 5.7 and pain severity (0-10 scale) was 5.1 ± 2.2. In the migraine group, 20.7% experienced moderate to severe migraine-related disability (MIDAS score ≥ 11). Work productivity loss was 36.2% of work time missed, including 34.3% presenteeism. Only 57.4% of respondents had ever sought medical care for migraine/severe headache. Most respondents (75.2%) were currently using over-the-counter medications for migraine; 36.7% were using prescription nonsteroidal anti-inflammatory drugs, and only 14.8% were using triptans. Very few (9.2%) used preventive medications. CONCLUSIONS Unmet needs for migraine health care among people with migraine in Japan include low rates of seeking care and suboptimal treatment.
Collapse
Affiliation(s)
- Koichi Hirata
- Department of Neurology, Dokkyo Medical University, Mibu, Japan
| | - Kaname Ueda
- Japan Drug Development and Medical Affairs, Eli Lilly Japan K.K, Kobe, Japan
| | - Mika Komori
- Japan Drug Development and Medical Affairs, Eli Lilly Japan K.K, Kobe, Japan
| | - Anthony J Zagar
- Real World and Access Analytics, Eli Lilly and Company, Indianapolis, IN, USA
| | - Katherine J Selzler
- US Medical Affairs, Neuroscience Digital Health, Eli Lilly and Company, Indianapolis, IN, USA
| | - Ann Marie Nelson
- GPORWE-Bio-Medicines, Eli Lilly and Company, Indianapolis, IN, USA
| | - Yimei Han
- Statistical Analysis Capabilities, Eli Lilly and Company, Indianapolis, IN, USA
| | - Dena H Jaffe
- Real World Evidence, Kantar Health, Tel Aviv, Israel
| | | | - Takao Takeshima
- Department of Neurology Headache Center, Tominaga Hospital, Osaka, Japan
| |
Collapse
|
21
|
Affiliation(s)
- Paolo Martelletti
- Department of Clinical and Molecular Medicine, Sapienza University, Via di Grottarossa 1035, Rome 00189, Italy
- Regional Referral Headache Centre, Sant'Andrea University Hospital, Rome, Italy
| | - Martina Curto
- Department of Clinical and Molecular Medicine, Sapienza University, Via di Grottarossa 1035, Rome 00189, Italy
- International Consortium for Mood Psychotic and Mood Disorders Research, McLean Hospital, Belmont, MA, USA
- Department of Mental Health, Rome, Italy
| |
Collapse
|
22
|
Kim BK, Chu MK, Yu SJ, Dell'Agnello G, Han JH, Cho SJ. Correction to: Burden of migraine and unmet needs from the patients' perspective: a survey across 11 specialized headache clinics in Korea. J Headache Pain 2021; 22:56. [PMID: 34116628 PMCID: PMC8194232 DOI: 10.1186/s10194-021-01270-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Byung-Kun Kim
- Department of Neurology, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, South Korea
| | - Min Kyung Chu
- Department of Neurology, Severance Hospital, Yonsei University School of Medicine, Seoul, South Korea
| | | | | | | | - Soo-Jin Cho
- Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, South Korea.
| |
Collapse
|