NeurologyLive® Year in Review 2024: Top Stories in Headache and Migraine

In 2024, the NeurologyLive^® staff was kept on its toes while covering clinical news and data readouts from around the world across a number of key neurology subspecialty areas. Between major study publications and FDA decisions, and from societal conference sessions and expert interviews, the team spent all year bringing the latest updates to the website's front page.

Among our key focus areas is headache and migraine, two of the most common neurological diseases worldwide. Treatments for headaches have advanced over the years; however, providing lasting and effective treatment for all headache types has proven to be difficult for all practitioners. The field has been advanced significantly by the introduction of calcitonin gene-related peptide (CGRP)-targeting inhibitors, a class of highly effective and safe agents. Whatever the reason for the attention these stories got, their place here helps provide an understanding of the themes in this field over the course of 2024.

Here, we'll highlight some of the most-read content on NeurologyLive^® this year. Click the buttons to read further into these stories.

1. American Headache Society Calls for CGRP Medications to be Considered as First-Line Migraine Preventive Treatments

For the first time ever, the American Headache Society (AHS) is calling for calcitonin gene-related peptide (CGRP)-targeting therapies to be used as a first-line approach for migraine prevention. Following a comprehensive review of clinical trial and real-world experience, a recently published statement from the organization claimed that CGRP-targeting therapies have "rapidly become an indispensable option for the prevention of migraine."

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

The FDA has approved an expanded age indication for Theranica's Nerivio remote electrical neuromodulation (REN) wearable to treat patients aged 8 years and older with acute migraine. With this expanded indication, the needle-free alternative treatment becomes the first cleared nondrug therapy for acute migraine treatment in pediatric patients and the only prescribed preventive migraine treatment in this patient age group

3. Satsuma Resubmits NDA Over STS101 Nasal Powder for Acute Migraine Treatment

After the FDA issued a complete response letter (CRL) in January, Satsuma Pharmaceuticals has resubmitted its new drug application (NDA) for its investigational candidate STS101, a dihydroergotamine (DHE) nasal powder, for the treatment of patients with acute migraine with or without aura. Following a positive Type A meeting, Satsuma and its corporate parent, Shin Nippon Biomedical Laboratories, believes the NDA resubmission will address all outcomes in the CRL.

4. FDA Accepts Resubmitted New Drug Application for Migraine Treatment AXS-07

The FDA has accepted Axsome Therapeutics’ resubmitted new drug application (NDA) for its novel agent AXS-07 as a treatment for acute migraine. The agency has given the oral, rapidly absorbed, multi-mechanistic investigational medicine a Prescription Drug User Fee Act (PDUFA) action goal date of January 31, 2025.

5. Digital Therapeutic CT-132 Meets Primary End Point in Phase 3 Study of Preventive Migraine

CT-132 (Click Therapeutics), an investigational prescription digital therapeutic, met its primary end point in the phase 3 ReMMi-D randomized trial (NCT05853900) of patients with episodic migraine, with results revealing a significant reduction in monthly migraine days (MMDs) among treated patients over a 12-week treatment period.

6. Sumatriptan Demonstrates Therapeutic Potential in Post-Traumatic Headache in Phase 2 Pilot Study

Preliminary data published from a single-arm, prospective, non-randomized phase 2 trial (NCT01854385) revealed that sumatriptan, a migraine-specific medication, may alleviate the symptom burden for patients with post-traumatic headache (PTH). Investigators concluded that future studies, such as a phase 3 trial with a larger sample size, are needed to better understand the efficacy of sumatriptan in this patient population.

7. Phase 2 HOPE Study of PACAP-Targeting Treatment Lu AG09222 Published in New England Journal of Medicine

Recently, investigators published pivotal data from the phase 2 HOPE trial (NCT05133323) assessing Lundbeck’s pituitary adenylate cyclase-activating polypeptide (PACAP)-targeting therapy, Lu AG09222, in the New England Journal of Medicine. All told, results revealed that treatment with a single intravenous infusion of 750 mg of Lu AG09222 was superior over placebo in reducing migraine frequency over a 4-week period, further supporting its development as an alternative treatment for migraine.

8. Atogepant Effective in Treating Chronic Migraine With Medication Overuse

Recently published post-hoc data from the phase 3 PROGRESS trial (NCT03855137) revealed that atogepant (Qulipta; AbbVie), an FDA-approved medication for chronic and episode migraine, was effective in patients with and without acute medication overuse.

9. Essentials for Treating Headache as a General Neurologist

Susan W. Broner, MD, medical director of the Weill Cornell Medicine Headache Program, discussed the key diagnostic criteria and treatment recommendations for migraine and trigeminal autonomic cephalalgias. She also talked about how early diagnosis and treatment can impact the long-term outcomes of patients with post-traumatic headache. Furthermore, she spoke about central sensitization and how it can affect the prognosis of headache disorders, particularly in patients with mild traumatic brain injury.

10. Surveying the Effect of Cannabis Use for Migraine and Headache Management

Allison Verhaak, PhD, a clinical psychologist from Ayer Neuroscience Institute at Hartford Healthcare Headache Center, discussed the reported benefits of cannabis-based products for headache management based on responses from the survey. She also talked about how stigma and perception may influence the use of cannabis among patients who experience migraine. Additionally, Verhaak spoke about the key challenges faced by patients in selecting and dosing cannabis products for migraine relief.