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2. Calcitonin Gene–Related Peptide Monoclonal Antibody Use for the Preventive Treatment of Refractory Headache Disorders in Adolescents

Author

Greene, Kaitlin A, Gentile, Carlyn P, Szperka, Christina L, Yonker, Marcy, Gelfand, Amy A, Grimes, Barbara, and Irwin, Samantha L

Subjects
Pain Research, Chronic Pain, Biotechnology, Clinical Research, Prevention, Headaches, Migraines, Adolescent, Antibodies, Monoclonal, Antibodies, Monoclonal, Humanized, Calcitonin Gene-Related Peptide, Calcitonin Gene-Related Peptide Receptor Antagonists, Child, Female, Follow-Up Studies, Headache Disorders, Humans, Male, Migraine Disorders, Outcome Assessment, Health Care, Retrospective Studies, Migraine, Chronic migraine, Post-traumatic headache, New daily persistent headache, Refractory headache, CGRP monoclonal antibodies, Pediatric, Neurosciences, Paediatrics and Reproductive Medicine, Neurology & Neurosurgery
Abstract

BackgroundMonoclonal antibodies to calcitonin gene-related peptide or its receptor have clinical trial evidence in adults with headache, but data are lacking in adolescents. The objective of this study was to describe the safety and efficacy of calcitonin gene-related peptide monoclonal antibody treatment in adolescents with chronic headache disorders.MethodsWe performed a retrospective multisite cohort study of patients less than 18 years of age who received a calcitonin gene-related peptide monoclonal antibody for headache prevention. Demographics, baseline headache characteristics, efficacy, and side effect data were collected.ResultsThe study population comprised 112 adolescents who received at least one dose of a calcitonin gene-related peptide monoclonal antibody. Mean (S.D.; range) age at first dose was 15.9 years (1.4; 10.3 to 17.8). Ninety-four patients (83.9%) had chronic migraine, 12 (10.7%) had new daily persistent headache, and six (5.4%) had persistent post-traumatic headache. At baseline, the mean (S.D.) number of headache days per month was 26.9 (6.1) (n = 109) and headache was continuous in 75 of 111 (67.6%). At first follow-up visit there was a significant reduction in headache frequency compared with baseline (-2.0 days; 95% confidence interval, -0.8 to -3.2). Significant benefit was perceived by 29.5% of patients at first follow-up visit (n = 33/112) and 30.1% (n = 22/73) at second follow-up visit. A significant functional improvement was perceived by 31% of patients (n = 31/94) at the first follow-up visit and 22.4% (n = 15/67) at the second follow-up visit. The most common side effects were injection site reactions in 17.0% (n = 19) and constipation in 8.0% (n = 9). Five patients (4.5%) discontinued because of side effects.ConclusionsSide effects with calcitonin gene-related peptide monoclonal antibody treatment in adolescents were similar to those reported in adult trials. Calcitonin gene-related peptide monoclonal antibody treatment appears to benefit a proportion of adolescents with chronic refractory headache disorders.

Published
2021

5. List of contributors

Author

Babineau, Shannon, primary, Barmherzig, Rebecca, additional, Berenson, Frank R., additional, Bickel, Jennifer, additional, Blume, Heidi K., additional, Brand, Andrea, additional, Buse, Dawn C., additional, Candee, Meghan S., additional, Chadehumbe, Madeline, additional, Dougherty, Carrie O., additional, Gautreaux, Jessica R., additional, Gelfand, Amy A., additional, Gerson, Trevor, additional, Gladstein, Jack, additional, Greene, Kaitlin, additional, Hall, Amanda, additional, Hershey, Andrew D., additional, Hranilovich, Jennifer, additional, Irwin, Samantha Lee, additional, Kabbouche, Marielle, additional, Karvounides, Dina, additional, Kedia, Sita, additional, Kessel, Shirley, additional, Lagman-Bartolome, Ana Marissa, additional, Marzouk, Maya, additional, Neely, Rachel, additional, O’Brien, Hope, additional, Orr, Serena L., additional, Pakalnis, Ann, additional, Patniyot, Irene, additional, Patterson Gentile, Carlyn, additional, Pietris, Nicholas, additional, Powers, Scott, additional, Qaiser, Sharoon, additional, Qubty, William, additional, Rastogi, Reena, additional, Recober, Ana, additional, Rende, Elizabeth K., additional, Ross, Alexandra C., additional, Seng, Elizabeth, additional, Szperka, Christina L., additional, Turner, Scott B., additional, VanderPluym, Juliana, additional, Victorio, M. Cristina, additional, Waung, Maggie, additional, Weber, Kevin, additional, Yonker, Marcy, additional, Young, William, additional, and Ziplow, Jason L., additional

Published
2022
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9. Efficacy of IV Valproic Acid and Oral Valproic Acid Tapers for the Treatment of Pediatric Headaches in the Emergency Department

Author

Rosenthal, Scott, primary, Mazzio, Emma, additional, Wellman Gilbert, Hannah, additional, Guistolisi, Sarah, additional, Marks, Jill, additional, Jewell, Jerry, additional, Straley, Megan, additional, Silveira, Lori, additional, Messer, Ricka, additional, Martin, Jan, additional, Mistry, Rakesh, additional, Yonker, Marcy E., additional, and Press, Craig A., additional

Published
2023
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11. Practice guideline update summary: Pharmacologic treatment for pediatric migraine prevention: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the American Headache Society

Author

Oskoui, Maryam, Pringsheim, Tamara, Billinghurst, Lori, Potrebic, Sonja, Gersz, Elaine M., Gloss, David, Holler-Managan, Yolanda, Leininger, Emily, Licking, Nicole, Mack, Kenneth, Powers, Scott W., Sowell, Michael, Victorio, M. Cristina, Yonker, Marcy, Zanitsch, Heather, and Hershey, Andrew D.

Published
2019
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12. Practice guideline update summary: Acute treatment of migraine in children and adolescents: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the American Headache Society

Author

Oskoui, Maryam, Pringsheim, Tamara, Holler-Managan, Yolanda, Potrebic, Sonja, Billinghurst, Lori, Gloss, David, Hershey, Andrew D., Licking, Nicole, Sowell, Michael, Victorio, M. Cristina, Gersz, Elaine M., Leininger, Emily, Zanitsch, Heather, Yonker, Marcy, and Mack, Kenneth

Published
2019
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14. Dots and spots: A retrospective review of T2‐hyperintense white matter lesions in pediatric patients with and without headache.

Author

Ackley, Elizabeth, Asamoah, Philip, Mirsky, David, White, Christina, Maloney, John, Stence, Nicholas, Silveira, Lori, Yonker, Marcy, and Neuberger, Ilana

Subjects
BRAIN, CONFIDENCE intervals, CROSS-sectional method, MAGNETIC resonance imaging, PEDIATRICS, RETROSPECTIVE studies, DISEASE incidence, WHITE matter (Nerve tissue), DISEASE prevalence, HEADACHE, ELECTRONIC health records, CHILDREN
Abstract

Objective: We aimed to determine if T2‐weighted hyperintense white matter lesions (WMLs) on brain magnetic resonance imaging (MRI) occur more frequently in pediatric patients with migraine and other primary headache disorders compared to the general pediatric population. Background: Small foci of T2 hyperintensity in the white matter are frequently identified on brain MRI during the workup of pediatric headache. Such lesions have been reported to be more common among adults with migraine versus adults without migraine; however, this association has not been well established in the pediatric population. Methods: We performed a retrospective cross‐sectional single‐center study of electronic medical records and radiologic studies, examining pediatric patients from 3 to 18 years old who underwent brain MRI between 2016 and 2021. Patients with existing intracranial disease or abnormalities were excluded. Patients with reports of headache were categorized. Imaging was reviewed to determine the number and location of WMLs. Headache‐associated disability scores (Pediatric Migraine Disability Assessment) were noted, when available. Results: Brain MRI of 248 patients with a diagnosis of headache (144 with migraine, 42 with non‐migraine primary headache, and 62 with headache that could not be further classified) and 490 controls were reviewed. WMLs were encountered commonly among all study participants, with a prevalence of 40.5% (17/42) to 54.1% (265/490). There was no statistically significant difference comparing the number of lesions between each of the headache groups and the control group: migraine group versus control group median [interquartile range (IQR)], 0 [0–3] versus 1 [0–4], incidence rate ratio [95% confidence interval (CI)], 0.99 [0.69–1.44], p = 0.989, non‐migraine headache group versus control group median [IQR], 0 [0–3] versus 1 [0–4], 0.71 [0.46–1.31], p = 0.156, headache not otherwise specified group versus control group median [IQR], 0 [0–4] versus 1 [0–4], 0.77 [0.45–1.31], p = 0.291. There was no significant correlation between headache‐associated disability and the number of WMLs (0.07 [−0.30 to 0.17], rho [95% CI]). Conclusion: T2 hyperintense WMLs are common within the pediatric population and are not encountered more frequently in pediatric patients with migraine or other primary headache disorders. Thus, such lesions are presumably incidental and unlikely related to headache history. [ABSTRACT FROM AUTHOR]

Published
2023
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16. Efficacy of Intravenous Valproic Acid and Oral Valproic Acid Tapers for Treatment of Pediatric Headaches in the Emergency Department (P15-2.001)

Author

Rosenthal, Scott, primary, Mazzio, Emma, additional, Gilbert, Hannah Wellman, additional, Marks, Jill, additional, Jewell, Jerry, additional, Guistolisi, Sarah, additional, Martin, Jan, additional, Messer, Ricka, additional, Mistry, Rakesh, additional, Yonker, Marcy, additional, and Press, Craig, additional

Published
2022
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23. The Development of the Medical Transfer Packet for Transition of Care of the Pediatric Patient with Headache

Author

Orr, Serena L., primary, Gelfand, Amy A., additional, Hranilovich, Jennifer, additional, Irwin, Samantha L., additional, Kabbouche, Marielle, additional, Lagman‐Bartolome, Anna Marissa, additional, Lavell, Cheryl, additional, O’Brien, Hope L., additional, Rajapakse, Thilinie, additional, Rao, Rashmi, additional, Szperka, Christina, additional, Werner, Klaus, additional, VanderPluym, Juliana, additional, Yonker, Marcy, additional, and Hershey, Andrew, additional

Published
2020
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25. Pediatric Migraine Action Plan (PedMAP)

Author

Turner, Scott B., primary, Rende, Elizabeth K., additional, Pezzuto, Tara, additional, Weaver, Samantha, additional, Henderlong‐Kropp, Annmarie, additional, Greene, Kaitlin A., additional, Bicknese, Alma R., additional, Dilts, Jennifer J., additional, Gautreaux, Jessica R., additional, Victorio, M. Cristina C., additional, Strauss, Lauren D., additional, Lagman‐Bartolome, Ana Marissa, additional, Szperka, Christina L., additional, Yonker, Marcy, additional, Hershey, Andrew D., additional, and Gelfand, Amy A., additional

Published
2019
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28. New Guidelines: Interpretation, Application and the Future

Author

Hershey, Andrew D., primary, Oskoui, Maryam, additional, Pringsheim, Tamara, additional, Holler‐Managan, Yolanda, additional, Potrebic, Sonja, additional, Billinghurst, Lori, additional, Gloss, David, additional, Licking, Nicole, additional, Sowell, Michael, additional, Victorio, M. Cristina, additional, Gersz, Elaine, additional, Vrijsen, Emily, additional, Zanitsch, Heather, additional, Yonker, Marcy, additional, Mack, Kenneth, additional, Gelfand, Amy A., additional, Szperka, Christina L., additional, and Powers, Scott W., additional

Published
2019
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29. Practice guideline update summary: Acute treatment of migraine in children and adolescents

Author

Oskoui, Maryam, primary, Pringsheim, Tamara, additional, Holler‐Managan, Yolanda, additional, Potrebic, Sonja, additional, Billinghurst, Lori, additional, Gloss, David, additional, Hershey, Andrew D., additional, Licking, Nicole, additional, Sowell, Michael, additional, Victorio, M. Cristina, additional, Gersz, Elaine M., additional, Leininger, Emily, additional, Zanitsch, Heather, additional, Yonker, Marcy, additional, and Mack, Kenneth, additional

Published
2019
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30. Practice guideline update summary: Pharmacologic treatment for pediatric migraine prevention

Author

Oskoui, Maryam, primary, Pringsheim, Tamara, additional, Billinghurst, Lori, additional, Potrebic, Sonja, additional, Gersz, Elaine M., additional, Gloss, David, additional, Holler‐Managan, Yolanda, additional, Leininger, Emily, additional, Licking, Nicole, additional, Mack, Kenneth, additional, Powers, Scott W., additional, Sowell, Michael, additional, Cristina Victorio, M., additional, Yonker, Marcy, additional, Zanitsch, Heather, additional, and Hershey, Andrew D., additional

Published
2019
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31. Recommendations on the Use of Anti-CGRP Monoclonal Antibodies in Children and Adolescents

Author

Szperka, Christina L., primary, VanderPluym, Juliana, additional, Orr, Serena L., additional, Oakley, Christopher B., additional, Qubty, William, additional, Patniyot, Irene, additional, Lagman-Bartolome, Ana Marissa, additional, Morris, Cynthia, additional, Gautreaux, Jessica, additional, Victorio, M. Cristina, additional, Hagler, Suzanne, additional, Narula, Sona, additional, Candee, Meghan S., additional, Cleves-Bayon, Catalina, additional, Rao, Rashmi, additional, Fryer, Robert H., additional, Bicknese, Alma R., additional, Yonker, Marcy, additional, Hershey, Andrew D., additional, Powers, Scott W., additional, Goadsby, Peter J., additional, and Gelfand, Amy A., additional

Published
2018
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33. In Memoriam: Donald W. Lewis, MD (1951–2012)

Author

Hershey, Andrew D., primary, Winner, Paul, additional, Linder, Steve, additional, Gladstein, Jack, additional, Yonker, Marcy, additional, Mack, Kenneth, additional, Pearlman, Eric, additional, and Rothner, A. David, additional

Published
2012
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36. Contributors

Author

Adams, Elizabeth E., Adams, R. Jason, Allen, Marilee C., Alouf, Benjamin, Amoroso, Gina, Andersen, Tara, Anderson, Marsha S., Attia, Magdy W., Aveta, Jacquelyn M., Bartoshesky, Louis E., Beers, Sara L., Bennett, Amanda E., Bhatti, Faizah N., Blum, Nathan J., Bonafide, Christopher P., Bonner, Robert L., Jr., Bratcher, Denise, Byck, Hal C., Calaman, Sharon, Casey, Rosemary, Chase, Lindsay, Chidekel, Aaron S., Chopra, Arun, Clapp, Edelveis R.M., Consolini, Deborah M., Crowell, Kathryn Rausch, Cruz, Mario, Daly, Ashley, Daugherty, Reza J., DeLago, Cynthia, DeWolfe, Craig C., Dodge, Rachel A.B., Doughty, Cara B., Dycoco, Maria C., Eppes, Stephen C., Farkouh, Christiana R., Fendrick, Gerald M., Frank, Gary, Frizzola, Meg A., Fronheiser, Kate L., Garofalo, Cara, Gartner Jr., John Carlton, Gibson, Cynthia, Goyal, Nilufer R., Green, Nicole A., Haines, Christopher J., Hassink, Sandra Gibson, Hetzler, Theresa, Howard, John M., Hsu, Deborah, Humphrey, Lisa, Kapklein, Matthew J., Kessel, Aaron D., Killinger, James S., Knapp, Jane F., Krishnamurthy, Ganga, Kruszewski, Patrice, Kuo, Dennis Z., Lane, J. Lindsey, LaTerra, Robert, Lee, Jane S., Lee-Jayaram, Jannet, Leite, Kelly R., Loiselle, John M., Lynn, Justin F., Mann, Barry D., Mann, Keith J., Mayforth, Ruth D., McCullough, Jennifer L., McIntosh, Cynthia, McMahon, Maureen C., Meduri, Anne M., Mendez, Suzanne Swanson, Milana, Carolyn, Miller, Jennifer R., Morris, Marilyn C., Newland, Jason, O’Brien, Kathleen B., Palermo, Robert, Raab, Christopher P., Randis, Tara M., Rappaport, David I., Ratner, Veniamin, Roemer, Deena K., Rosen, Carolyn M., Rosenthal, Jennifer R., Ross, Jody, Ross, Sara L.P., Sacks, Linda M., Sas, David J., Scharbach, Marilyn, Schlichting, Christine M., Selbst, Steven M., Senn, Kathleen, Shankar, Venkat R., Shore, Paul M., Singer, Lewis P., Singh, Sabina B., Stephan, Maria, Stryjewski, Glenn R., Sweberg, Todd, Tauber, Danna, Tchopev, Nik, Tenney-Soeiro, Rebecca, Towers, Helen M., Turow, Judith A., Walmsley, Daniel, Williams, Kristi, Willis, English, Friedberg, Rachel Wohlberg, Woolf, Paul K., Yonker, Marcy E., Zinn, Matthew, and Zomorrodi, Arezoo

Published
2012
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