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Background: Galcanezumab has shown efficacy and effectiveness in the treatment of episodic and chronic migraine (CM), however, the population represented in randomized clinical trials (RCTs) differs from the population observed in real-world setting. To describe the long-term effectiveness and tolerability of galcanezumab in clinical practice in patients excluded from RCTs.
Methods: Multicenter prospective cohort study of consecutive patients with chronic and high-frequency episodic migraine (HFEM) with prior failure to three or more migraine preventive drugs, treated with galcanezumab and followed up for 12 months.
Results: We enrolled 1055 patients, aged 50 (IQR: 42-58), 82.9% female, 76.4% chronic migraine, 69% with at least one exclusion criteria for RCTs, including age > 65 (n = 121), concomitant use of onabotulinumtoxinA (n = 185), daily headache at baseline (n = 347), chronic painful syndromes (n = 206), fibromyalgia (n = 101) or treatment resistance (n = 957). The median number of prior preventive treatments was 4 (IQR: 3-5). The retention rate was 90.8%, 76.8% and 71.4% at 3, 6 and 12 months. The main reasons for treatment discontinuation were lack of effectiveness (21.1%) and inadequate tolerability (6.6%). The 30%, 50% and 75% responder rates were 62.6%, 49.8% and 24.2% between weeks 8-12; 60.9%, 48.8% and 24.6% between weeks 20-24; and 59.7%, 48.3% and 24.6% between weeks 44-48. Daily headache at baseline (OR: 0.619; 95%CI: 0.469-0.817) and patient's age (OR: 1.016; 95%CI: 1.005-1.026) were associated with 50% response at weeks 20-24. The variables that were associated with a higher reduction of headache days between weeks 20-24 were patient's age (0.068; 95% CI: 0.018-0.119) and headache days per month at baseline (0.451; 95% CI: 0.319-0.583), while psychiatric comorbidity (-1.587; 95% CI: -2.626-0.538) and daily headache at baseline (-2.718; 95% CI: -4.58-0.869) were associated with fewer reduction in the number of headache days between weeks 20-24.
Conclusion: This study provides class III evidence of effectiveness and tolerability of galcanezumab in patients with HFEM and CM with comorbidities that would result in exclusion of the pivotal RCTs. Nonetheless, the clinical results over a 12-month period were similar to the efficacy observed in randomized controlled trials. Few patients discontinued the drug due to inadequate tolerability.
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http://dx.doi.org/10.1186/s10194-023-01690-2 | DOI Listing |
Inorg Chem
December 2024
Department of Chemistry, University of California Riverside, Riverside, California 92521, United States.
In the 1970s Hawthorne reported an electrochemical dehydrocoupling reaction of the -carborane anion [HCBH] to form the biscarborane [CBH] . In this Communication we show that the said "Hawthorne Reaction" can be achieved thermally and that it tolerates C-butylation. The new compound was fully characterized by B, H, and C NMR spectroscopies, high-resolution mass spectrometry, and single-crystal X-ray diffraction.
View Article and Find Full Text PDFCan J Ophthalmol
December 2024
Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada.
Objective: To conduct a pilot study to evaluate and compare the 24-hour habitual intraocular pressure (IOP) and ocular perfusion pressure (OPP) fluctuation in glaucoma patients treated with medical therapy, selective laser trabeculoplasty (SLT) or trabeculectomy.
Design: Pilot study.
Participants: Criteria for inclusion were patients aged 18 years or older with well-controlled IOP with either maximum tolerated medical therapy, previous SLT, or previous trabeculectomy.
Vopr Kurortol Fizioter Lech Fiz Kult
December 2024
Saint-Petersburg State Pediatric Medical University, Saint-Petersburg, Russia.
Unlabelled: Dystrophinopathies - a group of hereditary X-linked neuromuscular diseases characterized by worsening fibrofatty degeneration of skeletal muscles, muscular weakness, low exercise tolerance, as well as orthopedic, cardiovascular and respiratory complications. Study of the effectiveness of physical medical rehabilitation in patients with neuromuscular diseases, evaluation of the influence of external and internal factors on functional capabilities and effectiveness of the conducted rehabilitation are highly relevant.
Objective: To evaluate the effectiveness of physical medical rehabilitation of patients with dystrophinopathies at the outpatient stages of the disease's course and the influence of anthropometric characteristics and functional status of patients' motor capabilities.
Lung India
January 2025
Department of Pulmonary and Critical Care Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India.
Background And Objective: Obstructive sleep apnea (OSA) is a common condition, featured by repetitive upper airway collapse during sleep manifested with poor quality of life and co-morbidities. Although continuous positive airway pressure (CPAP) is the recommended therapy, lack of patient compliance and persistent symptoms often preclude its success. The present study evaluates the effect of acetazolamide in combination with CPAP, and compares this treatment strategy to single therapy using CPAP in moderate to severe OSA.
View Article and Find Full Text PDFACS Appl Bio Mater
December 2024
Polymers & Functional Materials Division, CSIR- Indian Institute of Chemical Technology, Hyderabad 500007, India.
Neurological disorders impact global health by affecting both central and peripheral nervous systems. Understanding the neurogenic processes, i.e.
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