NeurologyLive® Year in Review 2022: Top Stories in Headache and Migraine

In 2022, 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, a field that saw a number of therapeutic hopefuls move through the pipeline in the past 12 months, among other progress. Although major news items—like migraine's relationship with COVID-19—often appear among the top pieces our team produces, sometimes smaller stories reach those heights for other reasons—clinical impact and interest, or concerns about the small- or big-picture parts of care, for example. 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 2022.

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

1. COVID-19 Headache Positively Associated With Mortality, Meta-Analysis Suggests

Findings from a large-scale, systematic search conducted by Patricia Pozo-Rosich, MD, PhD, and colleagues and published in Headache showed a significantly higher survival rate among inpatients with COVID-19 who reported headache as a symptom vs those without headache, with the data pointing toward the idea that headache arising secondary to infection is not a “nonspecific” symptom, but rather potentially a marker of enhanced likelihood of survival.

2. Rimegepant Proves Safe in Phase 1 Study of Lactating Women

Data from a phase 1 study published in Breastfeeding Medicine by Robert Croop, MD, et al showed that excretion of rimegepant (Nurtec ODT; Biohaven) into human milk was very low and the therapeutic was safe and well tolerated by lactating women, a significant finding, as more than 30 women in America are impacted by migraine and is the most common cause of disability among women of reproductive age.

3. Headache Identified as Common Symptom in COVID-19 Variants, Mainly Delta

The findings of a cross-sectional cohort study of unvaccinated individuals hospitalized for COVID-19 caused by the Wuhan, Alpha, or Delta SARS-CoV-2 variants by Lars Arendt-Nielsen, PhD, and colleagues showed that headache is common in both the acute and post-COVID stages, with the prevalence of this symptom higher in those affected with the Delta variant, with data published in Headache.

4. CHALLENGE-MIG Aims to Optimize Newly Approved CGRP Preventives

Announced in July 2021, the CHALLENGE-MIG study (NCT05127486) is the first head-to-head clinical trial comparing 2 medications targeting CGRP—galcanezumab, a monoclonal antibody that binds to the CGRP protein, preventing it from attaching to the CGRP receptors; and rimegepant, which blocks the receptor for this protein. The effort is being led by Shivang Joshi, MD, MPH, RPH, and colleagues.

5. New Treatments in Migraine: An In-Depth Review

Although new treatments and innovations are a sign of growth in migraine care, it is important to realize that growth comes with a certain amount of pain. Jessica Ailani, MD, and Arathi Nandyala, MD, write about how in clinical practice, choosing the right treatment option for patients during a time-limited visit is often a dilemma.

6. Dose-Dependent Weight Reductions Observed With Atogepant

Atogepant (Qulipta; AbbVie), an oral, calcitonin gene-related peptide receptor antagonist FDA-approved for the prevention of migraine, was found to be associated with dose-dependent decreases in body weight, according to post-hoc data from the phase 3 ADVANCE study (NCT02848326) presented by David W. Dodick, MD, at the 2022 American Headache Society (AHS) Annual Meeting.

7. IND Application Accepted for Phase 2b Trial of NOE-101 in Trigeminal Neuralgia

In spring, the FDA authorized an investigational new drug application for the initiation of a phase 2b clinical trial of the mGLuR5 inhibitor NOE-101 in trigeminal neuralgia from Noema Pharma, with the study set to evaluate the efficacy of the treatment for pain management associated with the disorder.

8. Acute Long-Term as Needed Rimegepant Reduces Monthly Migraine Days

Data published in Cephalagia Reports by Gil L’Italien, PhD, et al showed that rimegepant (Nurtec ODT; Biohaven Pharmaceuticals), an FDA-approved calcitonin gene-related peptide receptor antagonist, was shown to provide effective acute treatment of migraine over a 52-week period in patients presenting with more than 6 monthly migraine days per month.

9. Migraine Frequency and Aura Impacts Sensory Organization

After undergoing a comprehensive evaluation protocol that included the Sensory Organization Test and otoneurological examination, newly published data in Headache from Gabriela F. Carvalho, PT, PhD, and colleagues suggest the presence of aura and greater migraine severity are related to falls and balance impairments. No otoneurological alterations were detected among the cohort, and the diagnosis of vestibular migraine did not influence balance performance.

10. CGRP Monoclonal Antibodies Show No Significant Impact on Persistent Headaches in Idiopathic Intracranial Hypertension

Despite the common occurrence of headaches in patients with idiopathic intracranial hypertension, new data presented at the 2022 American Headache Society Annual Meeting, showed that treatment with calcitonin gene-related peptide monoclonal antibodies did not yield significant reductions of at least 50% in monthly headache days compared with placebo, with the effort led by Lindsay Frerichs, MD.