Dementia and Alzheimer Disease

Epilepsy

Migraine

Headache and Migraine

MS Advanced Practice Providers

Multiple Sclerosis

NMOSD

MS and Demyelinating Disorders

Parkinson Disease

Movement Disorders

Ataxia

Chronic Inflammatory Demyelinating Polyneuropathy

Muscular Dystrophy

Neuromuscular

Insomnia

Narcolepsy

Sleep Disorders

Stroke

News

Media

All Videos

Medical World News

Podcasts

Weekly Recap

Cure Connections

Insights

Special Report

NeurologyLive Peer Exchange

Medcast

Peers & Perspectives

Roundtable Discussions

Conferences

Conference Coverage

Conference Listing

CME/CE

Partners

Publications

NeurologyLive

Bridging the Gaps

International Journal of MS Care

Resources

Expert Authors

FDA News

Features

Fellows' Corner

Future Leaders in Neurology

Giants of Multiple Sclerosis

Interactive Tools

Live Events

Neurology Resources

Virtual Events

Subscribe

Articles

The professor of neurology at Northwestern University Feinberg School of Medicine discussed the NSD-ISS and its potential to refine PD diagnosis and clinical trial selection through biomarker-driven staging.

NeuroVoices: Tanya Simuni, MD, FAAN, on Using the Neuronal Synuclein Disease Integrated Staging System Framework to Advance Parkinson Disease Staging

Videos

The associate researcher at the University of California, San Francisco discussed a refined EAE model that could better replicate MS pathology, enabling deeper insights into demyelination, neuronal loss, and remyelination. [WATCH TIME: 6 minutes]

Analyzing Better Preclinical Models in Multiple Sclerosis Research: Christian Cordano, MD, PhD

Treatment with the Chordate System led to a significantly greater reduction in monthly headache days during the performance assessment period, with a reduction of 3.5 days compared to 1.2 days in the sham group.

Kinetic Oscillation Stimulation Proves to be Therapeutically Beneficial for Chronic Migraine

The professor of neurology and neurosurgery at McGill University discussed the evolving understanding of neuroimmune interactions in MS, highlighting how these interactions contribute to disease progression and potential repair mechanisms. [WATCH TIME: 4 minutes]

Assessing Neuroimmune Interactions in the Progression and Management of Multiple Sclerosis: Jack P. Antel, MD

, has been with the team since September 2022. Follow her on Twitter 

Marco Meglio, Assistant Managing Editor for 

, has been with the team since October 2019. Follow him on Twitter 

Daniel Ontaneda, MD, PhD, an associate professor of neurology at the Cleveland Clinic Lerner College of Medicine, gave thoughts and perspectives on some of the emerging, promising advances in multiple sclerosis care expected to come to fruition in 2025.

Repair, Remyelination, and Progress: What’s Driving MS Innovation in 2025?

The child neurologist and neuroimmunologist at Nationwide Children’s Hospital provided clinical insight on the complexities of treating pediatric MOGAD, including treatment options, decision-making factors, and emerging therapies. [WATCH TIME: 4 minutes]

Treatment Decisions and Personalization for Pediatric MOGAD: Kelsey Poisson, MD

Mind Moments®, a podcast from NeurologyLive®, brings you an exclusive interview with Sonal Bhatia, MD, FACNS. [LISTEN TIME: 24 minutes]

Episode 136: Raising Epilepsy Awareness for Purple Day

NeurologyLive is your direct connection to the latest neurology news and interviews with expert neurologists in multimedia formats.

About Us

Advisory Board

Editorial

Contact Us

Advertise

Contact MJH LS

Do Not Sell My Information

Terms and Conditions

Privacy

NeurologyLive – Clinical Neurology News and Neurology Expert Insights

Facebook

LinkedIN

YouTube

Spotlight

ACTRIMS 2025

ISC 2025

Clinical Focus

Dementia/Alzheimer

Headache/Migraine

Video Series

News Network

1.125rem

Clinical

 Migraine Disease Spotlight page offers specific updates and coverage on the latest expert conversations and data readouts related to the treatment and management of patients with migraine disorders.

Findings from previous phase 3 trial showed that treatment with AXS-07 resulted in significant reductions in headache pain freedom, migraine symptoms, and rescue medication use.

FDA Approves Axsome Therapeutics’ AXS-07 for Migraine Treatment

Adjusted models confirmed a consistent negative correlation between serum vitamin D and migraine prevalence, with statistical significance (P < 0.05) across all analyses.

Serum Vitamin D Levels Negatively Correlated With Prevalence of Migraine, Study Suggests

Specialized teams at the AHN Headache Center, in Pittsburgh, Pennsylvania, offer crucial diagnoses and novel therapies for patients with migraine.

Ahead of the Pain: AHN's Approach to Treating Migraine

Early data from the pilot RELIEV-CM trial showed significant reductions in headache and migraine days, with 56% of patients showing a 50% reduction in symptoms at 4 weeks, and 100% at 12 weeks.

Testing Begins for RELIEV-CM2 Study of ShiraTronics Neuromodulation Device in Chronic Migraine

Nerivio, a nondrug option for acute migraine attacks and prevention of migraine with or without aura, has been FDA-approved for several years in adolescents aged 12 and older as well as adults.

FDA Approves Expanded Age Indication for Nerivio Migraine Device in Pediatric Patients 

The associate professor in pain management and emergency medicine at UC San Diego shared her reaction to the FDA approval of suzetrigine, a selective, nonaddictive alternative to opioids for acute pain management. 

A Shared Perspective on the Newly Approved Nonopioid Alternative for Acute Pain: Jessica Oswald, MD, MPH

“[Suzetrigine] redefines a standard of care about providing nonopioid pain relief with fewer [adverse] effects. There are potential future applications in chronic pain, although more research is needed.”

Acute pain, often resulting from surgery, accidents, injuries, or from neurologic conditions, is known as a significant and potentially debilitating condition. Each year, over 80 million patients in the United States receive prescriptions for moderate-to-severe acute pain, with nearly 40 million being prescribed opioids. However, opioid use for acute pain carries risks, as around 10% of patients initially treated with opioids develop prolonged use, and approximately 85,000 individuals annually are diagnosed with opioid use disorder. Beyond individual consequences, poorly managed acute pain can lead to chronic pain, reduced quality of life, and increased strain on the healthcare system.

 (Journavx; Vertex Pharmaceuticals) for the treatment of moderate-to-severe acute pain, making it the first new drug class for acute pain in over 2 decades. This approval was supported by a phase 3 clinical program that included 2 randomized, double-blind, placebo-controlled trials—one in post-abdominoplasty surgery and another in post-bunionectomy surgery—as well as a broader safety and efficacy study involving both surgical and non-surgical pain conditions. By targeting only peripheral pain signals without affecting the brain, suzetrigine provides effective pain relief while avoiding the addictive potential and adverse effects associated with opioids.

Following the approval, Jessica Oswald, MD, MPH, an associate professor in pain management and emergency medicine at UC San Diego, shared her insights and initial reaction in a recent interview with 

. During the discussion, Oswald, also a steering committee member at Vertex, addressed key questions regarding suzetrigine’s place in the pain management landscape, including how it compared with traditional opioid treatments in terms of efficacy and safety across different patient populations. She also explored the potential impact of suzetrigine’s availability on perioperative and emergency pain management strategies. Additionally, Oswald delved into the broader implications of NaV inhibitors, such as suzetrigine, on the future of chronic pain treatment and ongoing research in the field.

REFERENCES
1. Vertex Announces FDA Approval of JOURNAVX™ (suzetrigine), a First-in-Class Treatment for Adults With Moderate-to-Severe Acute Pain. News Release. Published January 30, 2025. Accessed February 21, 2025. https://investors.vrtx.com/news-releases/news-release-details/vertex-announces-fda-approval-journavxtm-suzetrigine-first-class
2. Vertex Announces FDA Acceptance of New Drug Application for Suzetrigine for the Treatment of Moderate-to-Severe Acute Pain. News Release. Vertex. July 30, 2024. Accessed February 21, 2025. https://news.vrtx.com/news-releases/news-release-details/vertex-announces-fda-acceptance-new-drug-application-suzetrigine

The associate professor in pain management and emergency medicine at UC San Diego shared her reaction to the FDA approval of suzetrigine, a selective, nonaddictive alternative to opioids for acute pain management. [WATCH TIME: 4 minutes]

The professor of neurology at the Geisel School of Medicine at Dartmouth talked about how the combination therapy involving meloxicam and rizatriptan may provide a more effective approach to treating migraine. 

The Rationale Behind Recently Approved AXS-07 Combination Therapy for Migraine: Stewart Tepper, MD

"What we're really after clinically is ‘one and done.’ We want to treat and have [the patient] pain-free in 2 hours, without significant [adverse] effects most of the time, and without a recurrence of the headache.”

Combination therapies in migraine management involve using 2 or more treatments, either acute or preventive, together to address different aspects of the migraine process. Common acute treatments, such as nonsteroidal anti-inflammatory drugs and triptans, target distinct mechanisms in the inflammatory and neural pathways of migraines. When used together, these treatments provide incremental benefits. For instance, the combination of sumatriptan and naproxen sodium has proven effective in treating migraines. Other fixed combinations include acetaminophen/aspirin/caffeine and combinations containing butalbital.

Research supports the efficacy of combination therapy, with 62% of studies showing improved outcomes compared with monotherapy. Additionally, 90% of studies reported no significant increase in adverse effects, suggesting that combination therapies can enhance efficacy without compromising tolerability. However, some studies did not demonstrate superior benefits, underlining the need for further research to identify which drug combinations are most effective.

 (Symbravo; Axsome Therapeutics), a combination therapy of meloxicam and rizatriptan, highlighted the potential for tailored, effective migraine treatment, offering a new option for adults with migraine with or without aura.

, a professor of neurology at the Geisel School of Medicine at Dartmouth, sat down in a recent interview with 

to further share his perspective on the approval. Tepper, who also serves as the vice president of the New England Institute for Neurology and Headache, talked about how this newly approved combination therapy may improve outcomes compared with monotherapy medications on their own.In the conversation, he also spoke about the challenges healthcare providers may face in ensuring patients follow combination therapy protocols. In addition, he spoke on how pharmacokinetic properties of new formulations like AXS-07 might contribute to more rapid and sustained migraine relief.

REFERENCES
1. Pellesi L, Garcia-Azorin D, Rubio-Beltrán E, et al. Combining treatments for migraine prophylaxis: the state-of-the-art. J Headache Pain. 2024;25(1):214. Published 2024 Dec 5. doi:10.1186/s10194-024-01925-w
2. Lipton RB, Ailani J, Blumenfeld AM. What Is Combination Treatment in Migraine? Moving Toward a Uniform Definition of a Familiar Principle. Neurol Ther. 2024;13(6):1535-1540. doi:10.1007/s40120-024-00669-8
3. Axsome Therapeutics Announces FDA Approval of SYMBRAVO® (meloxicam and rizatriptan) for the Acute Treatment of Migraine with or without Aura in Adults. News Release. Axsome Therapeutics. Published January 30, 2025. Accessed February 4, 2025. https://axsometherapeuticsinc.gcs-web.com/news-releases/news-release-details/axsome-therapeutics-announces-fda-approval-symbravor-meloxicam

Editor’s note: Tepper has received advisory fees from numerous pharmaceutical and healthcare organizations, including AbbVie, Amgen, Axsome Therapeutics, Eli Lilly, Lundbeck, Novartis, Pfizer, Teva, and others. He has received honoraria for lectures and continuing medical education from institutions such as the American Academy of Neurology, the American Headache Society, Medscape, and multiple medical education providers. Additionally, he has received research funding from Aeon, AbbVie, Eli Lilly, Lundbeck, Neurolief, Pfizer, and Suven. Travel support has been provided by AbbVie, the American Headache Society, Diamond Headache Clinic, Eli Lilly, and Pfizer.

The professor of neurology at the Geisel School of Medicine at Dartmouth talked about how the combination therapy involving meloxicam and rizatriptan may provide a more effective approach to treating migraine. [WATCH TIME: 6 minutes]

The director of the Montefiore Headache Center at Albert Einstein College of Medicine provided an overview of the drug profile for the recently approved migraine treatment AXS-07.

Safety and Efficacy Considerations of Newly Approved Combination Therapy for Acute Migraine: Richard B. Lipton, MD

“In terms of use in clinical practice, we want to treat our patients with the simplest, most effective acute treatments available. So, you wouldn’t use a combination triptan–nonsteroidal product in a patient whose treatment needs were fully met by either a triptan alone or a nonsteroidal anti-inflammatory alone.”

Migraine is considered a debilitating neurological disorder marked by recurring episodes of intense, throbbing head pain, often accompanied by nausea and heightened sensitivity to light and sound. According to the American Migraine Foundation, more than 39 million Americans are impacted by this condition, making migraine the leading cause of disability among neurological conditions in the United States.

 Patient surveys have highlighted the significant demand for treatments that act more quickly, provide consistent relief, and reduce symptom recurrence. Notably, over 70% of patients have reported insufficient response to their current oral acute migraine therapies.

 (Symbravo; Axsome Therapeutics), a novel agent consisting of meloxicam and rizatriptan, as a new acute treatment of migraine with or without aura in adults. The approval was based on data from 2 phase 3 randomized controlled clinical trials—the MOMENTUM trial (NCT03896009) and the INTERCEPT trial (NCT04163185)—in which AXS-07 demonstrated a statistically significant elimination of migraine pain relative to placebo and active controls. Additionally, the most common adverse reactions in the controlled studies were somnolence and dizziness, being reported in 2% and 1% of patients in the AXS-07 and placebo arms, respectively.

, a professor of neurology and director of the Montefiore Headache Center at 

, discussed the role of combination therapy in acute migraine management. He highlighted how the combination of rizatriptan and meloxicam compared to other acute treatments in terms of efficacy and safety. Lipton also addressed the specific patient populations that may derive the most value from this approach, emphasizing the importance of selecting therapies based on individual treatment needs. Additionally, he underscored the critical role of timing in migraine treatment, explaining that early intervention can significantly improve treatment outcomes and overall patient response.

REFERENCES
1. Ashina M, Katsarava Z, Do TP, et al. Migraine: epidemiology and systems of care. Lancet. 2021;397(10283):1485-1495. doi:10.1016/S0140-6736(20)32160-7
2. Lipton RB, Munjal S, Buse DC, et al. Unmet Acute Treatment Needs From the 2017 Migraine in America Symptoms and Treatment Study. Headache. 2019;59(8):1310-1323. doi:10.1111/head.13588
3. Axsome Therapeutics Announces FDA Approval of SYMBRAVO® (meloxicam and rizatriptan) for the Acute Treatment of Migraine with or without Aura in Adults. News Release. Axsome Therapeutics. Published January 30, 2025. Accessed February 3, 2025. https://axsometherapeuticsinc.gcs-web.com/news-releases/news-release-details/axsome-therapeutics-announces-fda-approval-symbravor-meloxicam
4. Axsome Therapeutics Announces AXS-07 Achieves Co-Primary and Key Secondary Endpoints in MOMENTUM Phase 3 Migraine Trial in Patients with History of Inadequate Response. News release. Axsome Therapeutics. December 30, 2019. Accessed February 3, 2025. https://www.biospace.com/article/releases/axsome-therapeutics-announces-axs-07-achieves-co-primary-and-key-secondary-endpoints-in-momentum-phase-3-migraine-trial-in-patients-with-history-of-inadequate-response
5. Axsome Therapeutics announces AXS-07 achieves both co-primary endpoints and prevents migraine pain progression in the INTERCEPT phase 3 trial in the early treatment of migraine. news release. Axsome Therapeutics. April 6, 2020. Accessed February 3, 2025. https://www.finance.yahoo.com/news/axsome-therapeutics-announces-axs-07-100010869.html

The director of the Montefiore Headache Center at Albert Einstein College of Medicine provided an overview of the drug profile for the recently approved migraine treatment AXS-07. [WATCH TIME: 3 minutes] 

The professor of neurology at the Geisel School of Medicine at Dartmouth shared his reaction to the recent FDA approval of AXS-07, a combination of meloxicam and rizatriptan, as a new therapy for acute migraine management.  

Medical Insights on the Recent Approval of AXS-07 for Acute Migraine Treatment: Stewart Tepper, MD

“The hope is that as we educate practitioners, the understanding of why combining an [nonsteroidal anti-inflammatory drug] with a triptan should provide additional benefit in the acute treatment of migraine for patients will become more and more clear, and that is my hope for the future."

Migraine is a debilitating neurological disorder marked by recurrent episodes of pulsating head pain, often accompanied by nausea and sensitivity to light and sound. Current acute treatments remain suboptimal, with over 70% of patients expressing dissatisfaction because of slow or inconsistent pain relief and pain recurrence.

 Studies show poor acute treatment has been linked to an increased risk of chronic migraine, which may be mitigated by improving treatment outcomes. In addition, predictors of poor response have included allodynia, severe migraine pain, obesity, and morning migraines. Thus, there is an urgent need for new acute therapies that offer faster, more consistent, and sustained relief for this serious condition.

AXS-07 (Axsome Therapeutics), a novel combination therapy, aims to address the limitations of current acute migraine treatments by leveraging multiple mechanisms of action. It consists of MoSEIC (Molecular Solubility Enhanced Inclusion Complex) meloxicam, a rapidly absorbed COX-2 preferential nonsteroidal anti-inflammatory drug (NSAID), and rizatriptan, a potent 5-HT1B/1D agonist known for its fast-acting efficacy in migraine relief. The proprietary MoSEIC delivery technology is designed to enhance meloxicam’s solubility and absorption while extending its plasma half-life. By combining these agents, AXS-07 offers a pharmacokinetic profile that may lead to more effective and sustained migraine management.

, marketed as Symbravo, as a new acute treatment for migraine with or without aura in adults, with supportive data from 2 phase 3 randomized controlled clinical trials—the MOMENTUM trial (NCT03896009) and the INTERCEPT trial (NCT04163185).

, a professor of neurology at the Geisel School of Medicine at Dartmouth and vice president of the New England Institute for Neurology and Headache, shared his reaction in a recent interview with 

In the conversation, Tepper discussed the benefits of combining an NSAID with a triptan for acute migraine, highlighting its enhanced efficacy over monotherapy. He also examined trial designs assessing real-world effectiveness of AXS-07 and emphasized the need for better provider education as well as patient access to this treatment.

REFERENCES
1. Smelt AF, Louter MA, Kies DA, et al. What do patients consider to be the most important outcomes for effectiveness studies on migraine treatment? Results of a Delphi study. PLoS One. 2014;9(6):e98933. Published 2014 Jun 16. doi:10.1371/journal.pone.0098933
2. Axsome Therapeutics Announces FDA Approval of SYMBRAVO® (meloxicam and rizatriptan) for the Acute Treatment of Migraine with or without Aura in Adults. News Release. Axsome Therapeutics. Published January 30, 2025. Accessed February 4, 2025. https://axsometherapeuticsinc.gcs-web.com/news-releases/news-release-details/axsome-therapeutics-announces-fda-approval-symbravor-meloxicam

The professor of neurology at the Geisel School of Medicine at Dartmouth shared his reaction to the recent FDA approval of AXS-07, a combination of meloxicam and rizatriptan, as a new therapy for acute migraine management.  [WATCH TIME: 4 minutes]

The director of the Montefiore Headache Center at Albert Einstein College of Medicine discussed the recent FDA approval of a new migraine treatment that combines rizatriptan and meloxicam. 

Clinical Perspective on Newly Approved Combination Therapy for Migraine: Richard B. Lipton, MD

"In treatment-refractory patients, the combination product produces excellent 2-hour pain freedom and freedom from the most bothersome symptom, corresponding to an early onset of action but also sustained benefits."

AXS-07 (Symbravo; Axsome Therapeutics), a novel agent consisting of meloxicam and rizatriptan, is thought to act by inhibiting calcitonin gene-related peptide (CGRP) release, reversing CGRP-mediated vasodilation, and inhibiting neuroinflammation, pain signal transmission, and central sensitization. In late January, the 

 as a new acute treatment of migraine with or without aura in adults, months after the agency accepted the company’s resubmission of its new drug application (NDA) in September 2024. The company noted that it expects AXS-07 to be commercially available in the United States in approximately 4 months.

In May 2022, the company received a complete response letter for its NDA submission of AXS-07, citing issues related to the chemistry, manufacturing, and controls considerations. At the time, the agency did not request any new clinical trials to be conducted.

 The original NDA, accepted for review in September 2021, was supported by data from 2 phase 3 randomized controlled clinical trials—the MOMENTUM trial (NCT03896009) and the INTERCEPT trial (NCT04163185). Overall, the studies revealed a statistically significant elimination of migraine pain with AXS-07 compared with placebo and active controls.

, AXS-07 met its coprimary end points with statistical significance, first showing a greater percentage of patients achieving pain freedom (19.9%) compared with placebo (6.7%; 

 <.001) 2 hours after dosing. Second, the absence of the most bothersome symptom (36.9%) compared with placebo (24.4%) was significant (

, principal investigator of the MOMENTUM study 

, professor of neurology and director of the Montefiore Headache Center at 

, discussed his initial reaction to the FDA approval of the new migraine treatment. He shared his excitement about how the combination of rizatriptan and meloxicam will change the landscape of migraine care, particularly for patients with poor responses to existing therapies. Lipton also highlighted key findings from MOMENTUM, noting the impressive efficacy of the treatment in refractory patients and its potential to drive positive outcomes for both clinical practice and future drug development.

REFERENCES
1. Axsome Therapeutics Announces FDA Approval of SYMBRAVO® (meloxicam and rizatriptan) for the Acute Treatment of Migraine with or without Aura in Adults. News Release. Axsome Therapeutics. Published January 30, 2025. Accessed February 3, 2025. https://axsometherapeuticsinc.gcs-web.com/news-releases/news-release-details/axsome-therapeutics-announces-fda-approval-symbravor-meloxicam
2. Axsome Therapeutics Receives FDA Complete Response Letter for New Drug Application for AXS-07 for the Acute Treatment of Migraine. News release. Axsome Therapeutics. May 2, 2022. Accessed February 3, 2025. https://www.prnewswire.com/news-releases/axsome-therapeutics-receives-fda-complete-response-letter-for-new-drug-application-for-axs-07-for-the-acute-treatment-of-migraine-301537093.html
3. Axsome Therapeutics Announces AXS-07 Achieves Co-Primary and Key Secondary Endpoints in MOMENTUM Phase 3 Migraine Trial in Patients with History of Inadequate Response. News release. Axsome Therapeutics. December 30, 2019. Accessed February 3, 2025. https://www.biospace.com/article/releases/axsome-therapeutics-announces-axs-07-achieves-co-primary-and-key-secondary-endpoints-in-momentum-phase-3-migraine-trial-in-patients-with-history-of-inadequate-response
4. Axsome Therapeutics announces AXS-07 achieves both co-primary endpoints and prevents migraine pain progression in the INTERCEPT phase 3 trial in the early treatment of migraine. news release. Axsome Therapeutics. April 6, 2020. Accessed February 3, 2025. https://www.finance.yahoo.com/news/axsome-therapeutics-announces-axs-07-100010869.html

Editor's Note: Lipton has received research support from the National Institutes of Health, the FDA, and the National Headache Foundation. He serves as consultant, advisory board member, or has received honoraria or research support from AbbVie/Allergan, Amgen, Biohaven, Dr. Reddy's Laboratories (Promius), electroCore, Eli Lilly and Company, GlaxoSmithKline, Lilly, Lundbeck, Merck, Novartis, Pfizer, Teva, Vector, and Vedanta Research. He receives royalties from Wolff's Headache, 8th edition (Oxford University Press, 2009) and Informa. He holds stock/options in Axon, Biohaven, Cooltech, and Mainistee.

The director of the Montefiore Headache Center at Albert Einstein College of Medicine discussed the recent FDA approval of a new migraine treatment that combines rizatriptan and meloxicam. [WATCH TIME: 5 minutes] 

The assistant professor of neurology at the Icahn School of Medicine at Mount Sinai provided an overview of a session on exercise and migraine presented at the 2024 Scottsdale Headache Symposium.

Overviewing Personalized Exercise Strategies for Migraine Management From AHS Scottsdale 2024: Anna Pace, MD

“The most important thing that seemed to be discussed across all of the studies is consistency. So whichever type of exercise a [patient] tries to pursue is really important [for them] to keep up with it.”

Migraine, a prevalent neurological disorder affecting approximately, is characterized by recurrent headaches often accompanied by nausea, sensitivity to light, and sound with physical activity frequently exacerbating symptoms. In some cases, migraine is accompanied by an aura, manifesting as focal neurological symptoms before or during the headache phase.1 This debilitating condition impacts daily life, causing work absences and social withdrawal, and imposes significant economic burdens. Despite the availability of pharmacological treatments, many patients experience limited efficacy, adverse effects, or adherence challenges, underscoring the need for effective nonpharmacological preventive strategies.

Exercise is widely recognized for its benefits in managing chronic pain conditions, including those often comorbid with migraine, such as depression, anxiety, and sleep disturbances. It has also been associated with improved self-esteem, which may contribute to alleviating migraine symptoms. However, some patients report exercise as a trigger for migraine attacks, leading to reduced physical activity during interictal periods.1 Furthermore, routine physical activity commonly exacerbates pain during migraine episodes and is included in the diagnostic criteria by the International Headache Society. These contrasting effects highlight the importance of tailored exercise regimens to maximize benefits and minimize potential triggers.

At the 2024 American Headache Society's (AHS) Scottsdale Headache Symposium, held November 14-17, in Scottsdale, Arizona, attendee Anna Pace, MD presented in a wellness session on exercise and migraine. In a recent interview with 

, Pace, an assistant professor of neurology at the 

, talked about how healthcare providers could address patients' concerns about exercise potentially triggering migraines while encouraging physical activity. She also spoke about the factors that clinicians should prioritize when recommending specific types of exercise for migraine management. Moreover, Pace discussed how future research could standardize and compare exercise regimens to identify the most effective strategies for migraine relief.

REFERENCES
1. Amin FM, Aristeidou S, Baraldi C, et al. The association between migraine and physical exercise. J Headache Pain. 2018;19(1):83. Published 2018 Sep 10. doi:10.1186/s10194-018-0902-y

The assistant professor of neurology at the Icahn School of Medicine at Mount Sinai provided an overview of a session on exercise and migraine presented at the 2024 Scottsdale Headache Symposium. [WATCH TIME: 5 minutes]

SAP Partners

The pediatric neurologist at Duke Health and chief executive officer at Theranica talked about a remote electrical neuromodulation wearable that showed promising results for the treatment and prevention of migraine in pediatric patients. 

Advancing the Treatment of Pediatric Migraine With Nerivio REN Wearable: Klaus Werner, MD & Alon Ironi

"The [REN wearable] is indicated from the age of 8 and above, both for acute and preventive treatment, and has shown very good data in adolescents over a 6-month period."

Migraine is a chronic and debilitating neurological disorder affecting approximately 1 billion patients globally, including 10% of pediatric patients.

Effective management, both acute and preventive, is essential for these patients who are living with migraine, especially for those in pediatric populations.

 Thus, early diagnosis and intervention may be important to prevent long-term disability and the potential progression of the condition into adulthood. Among pediatric patients, untreated migraine could severely impact daily functioning, disrupting school attendance, social interactions, and sleep patterns, which can ultimately lead to a marked decline in overall quality of life.

 an expanded age indication for Theranica's Nerivio remote electrical neuromodulation (REN) wearable to treat pediatric patients aged 8 years and older with acute migraine.

This decision comes following a recent study (NCT06138756) led by Klaus Werner, MD, PhD, which showed that the REN wearable was safe and effective for treating acute migraine in patients aged between 6 years and 11 years.

 The study featured 293 patients with a median age of 11 years who used the REN wearable to treat at least 1 migraine attack. Of them, 18.4% reported at least 1 attack with aura, and the remaining 81.6% never reported aura. Notably, two-thirds (67.4%) of REN treatments were not followed by another REN treatment in 24 hours, indicating no retreatment and implying no recurrence in 24 hours.

Child Neurology Society (CNS) Annual Meeting

, held November 11-14, in San Diego, California, Werner, pediatric neurologist at Duke Health, presented real-world data on the REN wearable for acute migraine treatment.5 During the meeting, both Werner and 

, CEO and co-founder at Theranica, sat down with 

talk about how the future landscape of pediatric migraine treatment could evolve following Nerivio’s expanded indication. The duo also spoke about how this patient population responded to the noninvasive migraine treatment compared with traditional medication observed in clinical practice. Furthermore, the experts discussed the challenges that could be foreseen in implementing this new treatment across various pediatric populations.

REFERENCES
1. Kabbouche MA, Gilman DK. Management of migraine in adolescents. Neuropsychiatr Dis Treat. 2008;4(3):535-548. doi:10.2147/ndt.s495
2. Charles JA, Peterlin BL, Rapoport AM, Linder SL, Kabbouche MA, Sheftell FD. Favorable outcome of early treatment of new onset child and adolescent migraine-implications for disease modification. J Headache Pain. 2009;10(4):227-233. doi:10.1007/s10194-009-0133-3
3. Szperka C. Headache in Children and Adolescents. Continuum (Minneap Minn). 2021;27(3):703-731. doi:10.1212/CON.0000000000000993
4. FDA Expands the Age Indication for Nerivio® as the First-and-Only REN Wearable for Migraine Treatment for Children Aged Eight and Above. News Release. Theranica. Published November 14, 2024. Accessed November 14, 2024. https://nerivio.com/press-releases/fda-expands-the-age-indication-for-nerivio-as-the-first-and-only-ren-wearable-for-migraine-treatment-for-children-aged-eight-and-above/
5. New Study Evaluates Use of the Nerivio® REN Wearable for Treatment of Migraine in Children Under the Age of 12. News release. Theranica. July 25, 2024. Accessed November 12, 2024. https://www.prnewswire.com/news-releases/new-study-evaluates-use-of-the-nerivio-ren-wearable-for-treatment-of-migraine-in-children-under-the-age-of-12-302206102.html
6. Werner K, Gerson T, Stark-Inbar, et al. Real-World Evidence of Remote Electrical Neuromodulation (REN) for the Acute Treatment of Migraine in Children Aged 6-11. Presented at 2024 Child Neurology Society (CNS) Annual Meeting: November 11-14, in San Diego, California.

The pediatric neurologist at Duke Health and chief executive officer at Theranica talked about a remote electrical neuromodulation wearable that showed promising results for the treatment and prevention of migraine in pediatric patients. [WATCH TIME: 5 minutes]

The neurologist in the Headache Center at Cleveland Clinic shared her post perspective on the 2024 AHS Scottsdale meeting which highlighted advancements in headache medicine and the growing impact of the field on patient care. 

Highlights on Exploring Advances in Headache Medicine from AHS Scottsdale 2024: MaryAnn Mays, MD

“It’s a great time to be in headache medicine as the advances have come out, and you can see the dramatic impact they have on patients, which has been great.”

Headache, including migraine, are among the most prevalent and disabling neurological conditions globally. Migraine, in particular, rank as the second leading cause of disability globally and the top cause among individuals under 50. Characterized by recurrent, debilitating episodes, migraine are often associated with a wide range of comorbidities, underscoring the need for comprehensive approaches to care and treatment.

The American Headache Society's (AHS) Scottsdale 2024 meeting brought together leading experts to discuss advancements in headache medicine. Held at the Camelback Resort for the final time, the event featured engaging precourses and presentations, addressing topics such as migraine as a systemic illness, diversity and inclusion in migraine research, and innovative therapies. Attendees included seasoned professionals, trainees, and advanced practitioners, reflecting the growing scope and interest in the field of headache medicine.

, an attendee, MaryAnn Mays, MD, neurologist in the Headache Center at 

, shared her insights into the AHS Scottsdale 2024 meeting, including key themes and emerging research areas. Topics included the growing understanding of migraine as a systemic condition, advancements in CGRP-targeted therapies, and lifestyle-focused approaches to patient care. As the event transitions to a new venue next year, the discussion highlighted the significance of continued innovation and collaboration in headache medicine.

The neurologist in the Headache Center at Cleveland Clinic shared her post perspective on the 2024 AHS Scottsdale meeting which highlighted advancements in headache medicine and the growing impact of the field on patient care. [WATCH TIME: 5 minutes]

Amaal Starling, MD, FAHS, FAAN, discussed findings from a post-hoc analysis of the phase 3 PREVAIL study assessing eptinezumab in chronic migraine.

Assessing Long-Term Benefit of Eptinezumab for Chronic Migraine: Amaal Starling, MD, FAHS, FAAN

"At two years of treatment, there were 23% of individuals that were previously diagnosed with chronic migraine, that had zero monthly headache days taken from that [Migraine Disability Assessment] headache frequency as a data point."

For patients with migraine experiencing less than 4 monthly headache days (MHDs), preventive treatment may be optimized. Beyond a reduction in frequency, efficacy with preventive migraine treatment can be defined by significant improvements in headache severity and related disability (e.g., Migraine Disability Assessment [MIDAS]). A post hoc analysis of the PREVAIL study (NCT02985398) assessed MIDAS-derived headache frequency, severity, and associated disability in patients with chronic migraine treated with eptinezumab (Vyepti; Lundbeck), an FDA-approved anti-calcitonin gene-related peptide (CGRP) monoclonal antibody used for preventive migraine.

The associate professor of neurology at Mayo Clinic College of Medicine discussed findings from a post-hoc analysis of the phase 3 PREVAIL study presented at AHS 2024 assessing eptinezumab in patients with chronic migraine. [WATCH TIME: 4 minutes]

Migraine

Latest News