Effects of anticoagulation in patients with device-detected atrial fibrillation and multiple stroke risk factors: a win ratio analysis of the NOAH-AFNET 6 trial.

Aims: Patients with device-detected atrial fibrillation (DDAF) have a lower stroke risk than those with ECG-diagnosed AF, requiring careful evaluation of oral anticoagulation benefits vs. its inherent bleeding risk.

Methods And Results: An unmatched win ratio analysis was performed of the NOAH-AFNET 6 trial dataset, using components of the primary efficacy and safety outcomes of the trial.

[Prevalence and incidence of migraine in general practice. A survey of general practitioners in North Rhine-Westphalia, Germany].

Background: Headaches are one of the most common symptoms worldwide. The majority of patients suffer from migraine. The prevalence of migraine is about 14% in the general population in industrialized countries.

[Education for medication overuse headache : Results of a systematic literature review].

Background: Medication overuse headache (MOH) is often found in patients with chronic migraine as a result of worsening migraine accompanied by increasing amounts of acute medications. MOH is a relevant problem in clinical practice and the current German guideline on MOH recommends educational intervention to guide patients to reduce acute medication use.

Objectives: The aim was to investigate published approaches for education in MO (medication overuse) and MOH.

PACAP and migraine.

A number of neuropeptides, including pituitary adenylate cyclase-activating polypeptide (PACAP), play an important role in the pathophysiology of migraine. Infusions of PACAP in patients with migraine can provoke migraine attacks. A placebo-controlled study with a monoclonal antibody directed against the PACAP-receptor failed to show efficacy.

Disrupting Migraine Dynamics: A Narrative Review of the Consequences of Modern Anti-CGRP Monoclonal Antibody Therapies.

This article provides an overview of a symposium held as part of the proceedings at the 10th European Academy of Neurology Congress in Helsinki, Finland, on 2 July 2024. Migraine is a common neurological disease and a leading cause of disability worldwide. Anti-calcitonin gene-related peptide (CGRP) therapies are the first to be specifically developed for migraine prevention and are recommended as a first-line option by the American Headache Society and European Headache Federation.

Evidence-based guidelines for the pharmacological treatment of migraine, summary version.

We here present evidence-based guidelines for the pharmacological treatment of migraine. These guidelines, created by the Italian Society for the Study of Headache and the International Headache Society, aim to offer clear, actionable recommendations to healthcare professionals. They incorporate evidence-based recommendations from randomized controlled trials and expert-based opinions.

Evidence-based guidelines for the pharmacological treatment of migraine.

We here present evidence-based guidelines for the pharmacological treatment of migraine. These guidelines, created by the Italian Society for the Study of Headache and the International Headache Society, aim to offer clear, actionable recommendations to healthcare professionals. They incorporate evidence-based recommendations from randomized controlled trials and expert-based opinions.

Guidelines of the International Headache Society for Real-World Evidence studies in migraine and cluster headache.

Real-world evidence studies are an important tool for investigating the effectiveness, safety and tolerability of treatments for headache disorders in clinical practice. These studies use data generated from routine clinical practice from a variety of sources and can help to identify unmet needs in headache care and guide new therapies, including populations not always included in randomized clinical trials of different ages, comorbidities, and concomitant stable treatments. Real-world evidence pertains to the clinical evidence surrounding the utilization, as well as the potential advantages or drawbacks of treatment, which is extracted through an analysis of real-world data.

Setting higher standards for migraine prevention: A position statement of the International Headache Society.

Migraine is one of the most prevalent and disabling neurological diseases, significantly affecting quality of life and productivity, as well as contributing to substantial societal costs. Recent innovations, including calcitonin gene-related peptide (CGRP) pathway inhibitors and onabotulinumtoxinA, have transformed migraine prevention by offering high efficacy and excellent tolerability, thus improving adherence. Clinical trials and real-world studies show that significant reductions in migraine frequency and, in some cases, complete migraine freedom is achievable.

Shift from chronic to episodic migraine frequency in a long-term phase 3 study of galcanezumab.

Background: Chronic migraine (CM) is a highly disabling form of migraine in which patients have ≥ 15 headache days per month, of which at least 8 have the features of migraine. Galcanezumab is a monoclonal antibody to calcitonin gene-related peptide which is approved for the preventive treatment of migraine. Ability to convert patients from chronic migraine frequency to episodic migraine (EM) frequency is a clinically relevant and desirable outcome when prescribing preventive treatments to patients with CM.

Prior Anticoagulation and Risk of Hemorrhagic Transformation in Acute Stroke: A Post Hoc Analysis of the PRODAST Study.

Background: Oral anticoagulation is highly effective in preventing ischemic events in patients with atrial fibrillation. Still, a considerable number of patients have an acute ischemic stroke or transient ischemic attack despite anticoagulation. In this study, we investigated the association of prior antithrombotic regimens with stroke severity, volume, and hemorrhagic transformation.

Andexanet alfa in patients with factor Xa inhibitor-associated intracranial hemorrhage: The prospective observational multicenter ASTRO-DE study.

Background: Hematoma expansion after intracranial hemorrhage (ICH) in anticoagulated patients significantly influences clinical outcomes and mortality, emphasizing the need for effective reversal agents. Andexanet alfa is a specific reversal agent for factor Xa-associated major bleeding.

Aims: The Andexanet alfa: non-interventional study at STROke centers in Germany (Deutschland, DE) (ASTRO-DE) study collected real-world evidence on the effect of andexanet alfa on mitigating hematoma expansion and altering prognosis in rivaroxaban- or apixaban-treated patients with ICH.

Characteristics of Patients With Asymptomatic Atrial Fibrillation and Ischemic Stroke-Insights From the GLORIA-AF Registry (Phase 2).

Background: Asymptomatic nonvalvular atrial fibrillation is often suspected in patients with cryptogenic stroke which constitute 20%-30% of ischemic strokes. Detection of atrial fibrillation (AF) and treatment with anticoagulation can reduce the risk of stroke. We sought to investigate the prevalence of asymptomatic atrial fibrillation (aAF) in patients with a history of stroke or an acute stroke on admission.

Comparative effects of drug interventions for the acute management of migraine episodes in adults: systematic review and network meta-analysis.

Objective: To compare all licensed drug interventions as oral monotherapy for the acute treatment of migraine episodes in adults.

Design: Systematic review and network meta-analysis.

Data Sources: Cochrane Central Register of Controlled Trials, Medline, Embase, ClinicalTrials.