In June 2022, the American Headache Society hosted its 64th Annual Scientific Meeting in Colorado.  Every year, neurologists, headache specialists and researchers gather and present new data on the treatment of headache disorders.  This year, a number of new treatments were discussed, as well as new information regarding medications and treatments for migraine.  

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Novel Device for Migraine - Relivion

Many doctors and patients have searched for effective non-medical treatments for migraine - supplements, therapies and devices.  A study presented by Dr. Roni Sharon reviewed the use of a new neurostimulation device called Relivion, specifically in a population of chronic or high frequency episodic migraine patients.  These are patients that have a very high frequency of migraine attacks and need multiple kinds of treatments together to improve their headaches.  

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The Relivion device uses transcutaneous stimulation of superficial nerves around the head to decrease pain signaling and headache.  It targets branches of the occipital nerve in the back of the head and the supraorbital and supratrochlear nerves in the forehead areas above the eyebrows.  38 patients used this device for 3 months as part of a preventive regimen. 85% of patients on this regimen decreased their monthly migraine days by 50% or greater, which is a very meaningful improvement. They also showed that these patients needed fewer medications for migraine and had improvement in severity. 

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Weight loss with Nurtec

An abstract by Dr. David Dodick, presented by Dr. Jessica Ailani, reviewed long term safety from a cohort of patients using Nurtec for the acute and preventive treatment of migraine for over a year.  This review showed an unanticipated benefit for people who consistently use Nurtec for their migraines: the average patient using Nurtec experiences about a 7% loss in body weight over the first 6 months of treatment.  This loss was only noted about 3 months after starting the medication, and it appeared to stabilize in the 6-9 month period. 

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The majority of patients did not continue to lose weight if they remained on the medication longer, however patients did appear to stabilize at this new body weight over time.  It remains to be seen if other CGRP blocking medications also have this benefit, and precisely how Nurtec leads to weight loss. 

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Tolerance with frequent Nurtec use

Dr. Richard Lipton virtually presented data on the long term use of Nurtec - specifically, if it safe for patients to take more than 15 tablets of Nurtec over the course of a month.  Nurtec was initially approved for the acute treatment of migraine attacks, in later 2021, the FDA approved it for prevention to be used every other day.  One question that many providers have is whether there are any potential side effects or complications when Nurtec is used for both prevention and acute treatment - potentially using more than the initial 16 tablets per month than were recommended.  

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This study revealed no significant tolerance issues or other concerns for patients that were instructed to take Nurtec every other day in addition to using it for exacerbations of migraine on the days Nurtec was not already taken. Nurtec was not taken more than once daily.  The majority of patients in this study did not actually take Nurtec every other day even though this was the recommendation, and the average days of use per month was 14.  This does put some of the presented data in question, as we still are not completely confident that the use of Nurtec more than 16 days per month truly is without side effect.  

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Want to learn more about the latest developments in headache medicine, including newtreatments that are appropriate for your case? Schedule an appointment with one of Neura's headache specialists today! 

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