Efficacy and Safety of Erenumab for Nonopioid Medication Overuse Headache in Chronic Migraine: A Phase 4, Randomized, Placebo-Controlled Trial.

Importance: Patients with chronic migraine and medication overuse headaches (CM-MOH) represent a particularly burdened subpopulation. This trial provides first, to our knowledge, American Academy of Neurology class I evidence for a preventive therapy in CM-MOH.

Objective: To assess erenumab efficacy and safety in patients with nonopioid CM-MOH.

Post hoc analysis of clinical trial data and pharmacokinetic data to assess wearing-off of erenumab within monthly treatment cycle.

Background: Treatment wearing-off has been reported for calcitonin gene-related peptide-pathway monoclonal antibodies, including erenumab, specifically in the last week of the monthly dosing cycle.

Objective: We sought to determine the consistency of erenumab effect throughout the monthly treatment cycle.

Methods: In this post hoc analysis of four pivotal double-blind, randomized controlled studies of erenumab in episodic and chronic migraine, we assessed wearing-off based on change in weekly migraine days at week 4 versus average over weeks 1-3 in each monthly dosing cycle.

Safety and tolerability of erenumab in individuals with episodic or chronic migraine across age groups: a pooled analysis of placebo-controlled trials.

Background: Erenumab, a fully human monoclonal antibody that targets the calcitonin gene-related peptide receptor, has demonstrated efficacy and safety in the prevention of episodic and chronic migraine. There exists an unmet need to establish the safety of erenumab in older individuals, in view of existing multiple comorbidities, polypharmacy, and age-related physiological changes. This pooled analysis of five large migraine-prevention studies examined the safety of erenumab stratified across age groups, particularly in older populations.

Telemedicine in neurology: Telemedicine Work Group of the American Academy of Neurology update.

Purpose: While there is strong evidence supporting the importance of telemedicine in stroke, its role in other areas of neurology is not as clear. The goal of this review is to provide an overview of evidence-based data on the role of teleneurology in the care of patients with neurologic disorders other than stroke.

Recent Findings: Studies across multiple specialties report noninferiority of evaluations by telemedicine compared with traditional, in-person evaluations in terms of patient and caregiver satisfaction.

Pulse cyclophosphamide therapy in chronic inflammatory demyelinating polyneuropathy.

Fifteen patients with chronic inflammatory demyelinating neuropathy (CIDP) were treated with pulse intravenous cyclophosphamide (IVCY) monthly for up to 6 months. Eleven patients reached a complete remission; only one patient worsened. Complications included nausea, vomiting, anemia, and hair loss.

Subarachnoid hemorrhage in a patient with Lyme disease.

Neuroborreliosis can cause a wide variety of seemingly unrelated neurologic abnormalities. Although the epidemiology, etiology, and pathology of this infection have been well documented, the pathogenesis and diagnosis continue to be problematic. In the current study we report a case of Lyme disease in which subarachnoid hemorrhage was the presenting feature of a patient with polyradiculoneuropathy and encephalopathy.

Oral methotrexate and alternate-day prednisone for low-risk Langerhans cell histiocytosis.

Many treatments for low-risk Langerhans cell histiocytosis (LCH) involve unpleasant side-effects or risks of late effects. To provide treatment with minimal toxicity and no known risk of late effects, we have used oral alternate-day prednisone (PDN, 40 mg/sq.m.