ET Associated With Substantial HCRU, MS Phenotypes Share Common Mechanisms, Hypertension Risk in Menopausal Women With Migraine

This week's Neurology News Network covered the rising amount of health care resource utilization associated with essential tremor, risk factors shared by multiple sclerosis phenotypes, and the increased risk of hypertension in menopausal women with a history of migraine.

Welcome to this special edition of Neurology News Network. I’m Marco Meglio. Please excuse our appearance this week as a majority of the US workforce, including the NeurologyLive team, moves to working remote as we come together to help reduce the spread of the novel coronavirus.

Essential tremor (ET) is associated with substantial health care resource utilization (HCRU) and economic burden on affected patients and the US healthcare system, according to data presented at the 2021 International Society for Pharmacoeconomics and Outcomes Research Annual Meeting. In addition to highlighting economic burden, the posters presented also revealed the high prevalence of multiple comorbidities in patients with ET that vary among patients undergoing different approaches to therapy. A budget impact analysis suggested that Cala Health’s lead product, Cala Trio, is a cost-saving treatment option for patients with ET. Cala Trio is the only non-invasive, wrist-worn prescription therapy currently available for ET. Kate Rosenbluth, PhD, founder and chief scientific officer, Cala Health, said in a statement, “Results from the retrospective analyses provide clear evidence that psychiatric disorders and multiple comorbidities are highly prevalent among patients with ET and that, in addition to the clinical burden that ET imposes on patients, this disease is a source of substantial HCRU costs.”

Using 2 Swedish population-based case-control studies, researchers concluded that both environmental and lifestyle factors are associated with the increased risk of developing multiple sclerosis, both relapsing-onset MS and progressive-onset MS, supporting the notion that the different clinical phenotypes share common underlying disease mechanisms. A total of 7520 relapsing-onset cases, 540 progressive-onset cases, and 11,386 controls matched by age, sex, and residential area were included in the analysis. Environmental factors such as ever smoking was associated with increased risk of both relapsing-onset MS and progressive-onset MS. Current smoking led to greater impact on disease risk than previous smoking, while cumulative dose of smoking led to significant trends showing increased risk for both MS phenotypes. Information was obtained regarding current heigh and body weight at age 20 years, with body mass index (BMI) calculated by dividing weight in kilograms by heigh in meters squared. All told, being “overweight” was associated with a small increased risk of relapsing-onset MS and progressive-onset MS, whereas obesity had a more pronounced impact on the risk of the disease.

Research from a longitudinal cohort study of menopausal women demonstrated an increased risk of hypertension in those with a history of migraine, as well as no significant differences between migraine with and without aura.A total of 56,202 menopausal women participating in the French E3N cohort had data collected on the relations between migraine and hypertension, controlling for potential confounding and using Cox proportional hazards models. Researchers identified 12,501 cases of incident hypertension, including 3100 among women with migraine, and 9401 among women without migraine, across 826,419 person years.The incident rate of hypertension was 14.3 per every 1000 person-years in women without migraine compared to 19.2 per 1000 person-years among women with migraine. The investigators wrote, "practitioners should be made aware that women with a history of migraine should be considered at a higher risk of hypertension.”

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