Galcanezumab for Cluster Headache, a Link Between Carotid Webs and Stroke, Managing Migraine Patient Relationships

This week, Neurology News Network covered the breakthrough therapy designation awarded to Eli Lilly's galcanezumab (Emgailty) by the FDA for episodic cluster headache, as well as the linkage between carotid webs and ischemic strokes. We also covered an interview with Jessica Ailani, MD, at the American Headache Society’s 2018 Scottsdale Headache Symposium, as she stressed building a culture of teaching patients to be their own advocates and to build the relationship with the patient to better manage their migraines. (Transcript below.)

Matt:

Welcome to Neurology News Network. I’m Matt Hoffman.

Jenna:

And I’m Jenna Payesko. Let’s get into the news from this week.

Eli Lilly and Company announced that the FDA granted breakthrough therapy designation to galcanezumab-gnlm, marketed as Emgality, for episodic cluster headache and intends to submit a supplemental biologics license application by the end of the year.

A phase 3 trial, one of the first placebo-controlled studies performed in cluster headache, demonstrated that monthly injections of galcanezumab, a CGRP inhibitor, led to a significant reduction in the frequency of cluster headache attacks within the first 3 weeks. The group treated with 300-mg galcanezumab reported a statistically significant difference in the reduction of weekly cluster headache attacks compared to placebo.

Matt:

Recent research has explored the linkage between carotid webs and ischemic strokes, and although the clinical data is limited, it suggests that these vascular entities have an increased prevalence in cerebral ischemic events among patients younger than 60 years. As such, a group of investigators from the Department of Neurology at Emory University Hospital and the Marcus Stroke and Neuroscience Center at Grady Memorial Hospital, sought to expand upon the current understanding of and gaps in research for carotid webs in ischemic strokes.

Ultimately, they found that treatment options in carotid webs with ischemic strokes have not been extensively investigated, and multicenter observational studies evaluating the natural history of them are warranted.

Jenna:

At the American Headache Society’s 2018 Scottsdale Headache Symposium, Jessica Ailani, MD, the director of the MedStar Georgetown University Hospital Headache Center, sat with NeurologyLive to discuss the importance of ensuring physicians are taking the time to ask just 1 more question during visits. By delving into their current status, and not taking “I’m fine” at face value, it can make all the difference for a patient’s care.

Ailani stressed building a culture of teaching patients to be their own advocates and to build the relationship with the patient to better manage their migraines. Let’s take a look.

Matt:

For more direct access to expert insight, head to neurologylive.com. This has been Neurology News Network. Thanks for watching.