TY - JOUR
T1 - Migraine progression in subgroups of migraine based on comorbidities
T2 - Results of the CaMEO Study
AU - Lipton, Richard B.
AU - Fanning, Kristina M.
AU - Buse, Dawn C.
AU - Martin, Vincent T.
AU - Hohaia, Lee B.
AU - Adams, Aubrey Manack
AU - Reed, Michael L.
AU - Goadsby, Peter J.
N1 - Funding Information:
The Article Processing Charge was funded by the Allergan plc.
Funding Information:
Writing and editorial support was provided by Lisa Feder, PhD, of Peloton Advantage, LLC, an OPEN Health company (Parsippany, NJ), and Gerard P. Johnson, PhD, of CHC Group, LLC (North Wales, PA), an ICON plc company, and was funded by Allergan plc, Dublin, Ireland.
Funding Information:
This study was funded by Allergan plc, Dublin, Ireland. The Article Processing Charge was funded by Allergan plc.
Funding Information:
Cephalalgia and as senior advisor to Headache; has received research support from the NIH; receives support from the Migraine Research Foundation and the National Headache Foundation; has reviewed for the NIA and NINDS; serves as consultant, advisory board member, or has received honoraria from Alder, Allergan, Amgen, Autonomic Technologies, Ava-nir, Biohaven, Biovision, Boston Scientific, Dr. Reddy’s Laboratories, Electrocore, Eli Lilly, eNeura Therapeutics, GlaxoSmithKline, Merck, Novartis, Pernix, Pfizer, Supernus, Teva, Vector, and Vedanta; receives royalties from Wolff’s Headache (8th Edition, Oxford University Press), Informa, and Wiley; and holds stock options in eNeura Therapeutics and Biohaven. K. Fanning is an employee of Vedanta Research, which has received support funded by Allergan, Amgen, Promius, Eli Lilly, GlaxoSmithKline, and Merck & Co., Inc., via grants to the National Headache Foundation. D. Buse has received grant support and honoraria from Allergan, Avanir, Amgen, Eli Lilly and Company, Teva, and Promius; and is on the editorial board of Current Pain and Headache Reports. V. Martin has been a consultant for Allergan, Amgen, Alder, Avanir, Biohaven, Promius, Supernus, Eli Lilly, and Teva, and a speaker for Allergan, Amgen, Avanir, Eli Lilly, Depomed, and Pfizer. L. Hohaia is an employee of CHC Group, LLC, an ICON plc company, which has received funding from Allergan for manuscript development. A. Manack Adams is a full-time employee of Allergan plc and owns stock in the company. M. Reed is Managing Director of Vedanta Research, which has received research funding from Allergan, Amgen, Promius, Eli Lilly, GlaxoSmithKline, and Merck & Co., Inc., via grants to the National Headache Foundation. Vedanta Research has received funding directly from Allergan for work on the CaMEO Study. P. Goadsby reports personal fees from Alder Bio-pharmaceuticals, Autonomic Technologies Inc., Biohaven Pharmaceuticals Inc., Dr. Reddy’s Laboratories, Electrocore LLC, Novartis, Scion, Teva Pharmaceuticals, Trigemina Inc., MedicoLegal work, Massachusetts Medical Society, Up-to-Date, Oxford University Press, and Wolters Kluwer outside the submitted work; grants and personal fees from Amgen, Eli Lilly and Company, and eNeura Inc.; and has a patent for magnetic stimulation for headache assigned to eNeura without fee. Go to Neurology.org/N for full disclosures.
Publisher Copyright:
© 2019 American Academy of Neurology.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2019/12/10
Y1 - 2019/12/10
N2 - ObjectiveTo test the hypothesis that statistically defined subgroups of migraine (based on constellations of comorbidities and concomitant conditions; henceforth comorbidities), previously identified using Chronic Migraine Epidemiology and Outcomes (CaMEO) Study data, differ in prognosis, as measured by rates of progression from episodic migraine (EM) to chronic migraine (CM).MethodsThe onset of CM was assessed up to 4 times over 12 months in individuals with EM and ≥1 comorbidity at baseline, based on constellations of comorbidities (comorbidity classes). The "fewest comorbidities" class served as reference. Individuals completing ≥1 follow-up survey from the web-based CaMEO Study were included. Covariates included sociodemographic variables and headache characteristics. Sex, income, cutaneous allodynia, and medication overuse were modeled as binary variables; age, body mass index, headache-related disability (Migraine Disability Assessment [MIDAS]), and Migraine Symptom Severity Scale as continuous variables. CM onset was assessed using discrete time analysis.ResultsIn the final sociodemographic model, all comorbidity classes had significantly elevated hazard ratios (HRs) for risk of progression to CM from EM, relative to fewest comorbidities. HRs for CM onset ranged from 5.34 (95% confidence interval [CI] 3.89-7.33; p ≤ 0.001) for most comorbidities to 1.53 (95% CI 1.17-2.01; p < 0.05) for the respiratory class. After adjusting for headache covariates independently, each comorbidity class significantly predicted CM onset, although HRs were attenuated.ConclusionsSubgroups of migraine identified by comorbidity classes at cross-section predicted progression from EM (with ≥1 comorbidity at baseline) to CM. The relationship of comorbidity group to CM onset remained after adjusting for indicators of migraine severity, such as MIDAS.Clinicaltrials.gov identifierNCT01648530.
AB - ObjectiveTo test the hypothesis that statistically defined subgroups of migraine (based on constellations of comorbidities and concomitant conditions; henceforth comorbidities), previously identified using Chronic Migraine Epidemiology and Outcomes (CaMEO) Study data, differ in prognosis, as measured by rates of progression from episodic migraine (EM) to chronic migraine (CM).MethodsThe onset of CM was assessed up to 4 times over 12 months in individuals with EM and ≥1 comorbidity at baseline, based on constellations of comorbidities (comorbidity classes). The "fewest comorbidities" class served as reference. Individuals completing ≥1 follow-up survey from the web-based CaMEO Study were included. Covariates included sociodemographic variables and headache characteristics. Sex, income, cutaneous allodynia, and medication overuse were modeled as binary variables; age, body mass index, headache-related disability (Migraine Disability Assessment [MIDAS]), and Migraine Symptom Severity Scale as continuous variables. CM onset was assessed using discrete time analysis.ResultsIn the final sociodemographic model, all comorbidity classes had significantly elevated hazard ratios (HRs) for risk of progression to CM from EM, relative to fewest comorbidities. HRs for CM onset ranged from 5.34 (95% confidence interval [CI] 3.89-7.33; p ≤ 0.001) for most comorbidities to 1.53 (95% CI 1.17-2.01; p < 0.05) for the respiratory class. After adjusting for headache covariates independently, each comorbidity class significantly predicted CM onset, although HRs were attenuated.ConclusionsSubgroups of migraine identified by comorbidity classes at cross-section predicted progression from EM (with ≥1 comorbidity at baseline) to CM. The relationship of comorbidity group to CM onset remained after adjusting for indicators of migraine severity, such as MIDAS.Clinicaltrials.gov identifierNCT01648530.
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U2 - 10.1212/WNL.0000000000008589
DO - 10.1212/WNL.0000000000008589
M3 - Article
C2 - 31690685
AN - SCOPUS:85076325446
VL - 93
SP - E2224-E2236
JO - Neurology
JF - Neurology
SN - 0028-3878
IS - 24
ER -