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The Impact of Interferon Beta and Natalizumab on Comorbid Migraine in Multiple Sclerosis

Authors

  • Veronica Villani MD,

    Corresponding author
    1. From Neurological Headache Centre, S. Andrea Hospital, Rome, Italy (V. Villani and G. Sette); Department of Neurology and Psychiatry, Sapienza University, Rome, Italy (V. Villani, L. Prosperini, and C. Pozzilli); Department of Psychology, Sapienza University, Rome, Italy (L. De Giglio); Centre for Experimental Neurological Therapies (CENTERS), S. Andrea Hospital, Rome, Italy (M. Salvetti).
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  • Luca Prosperini MD,

    1. From Neurological Headache Centre, S. Andrea Hospital, Rome, Italy (V. Villani and G. Sette); Department of Neurology and Psychiatry, Sapienza University, Rome, Italy (V. Villani, L. Prosperini, and C. Pozzilli); Department of Psychology, Sapienza University, Rome, Italy (L. De Giglio); Centre for Experimental Neurological Therapies (CENTERS), S. Andrea Hospital, Rome, Italy (M. Salvetti).
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  • Laura De Giglio MD,

    1. From Neurological Headache Centre, S. Andrea Hospital, Rome, Italy (V. Villani and G. Sette); Department of Neurology and Psychiatry, Sapienza University, Rome, Italy (V. Villani, L. Prosperini, and C. Pozzilli); Department of Psychology, Sapienza University, Rome, Italy (L. De Giglio); Centre for Experimental Neurological Therapies (CENTERS), S. Andrea Hospital, Rome, Italy (M. Salvetti).
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  • Carlo Pozzilli MD, PhD,

    1. From Neurological Headache Centre, S. Andrea Hospital, Rome, Italy (V. Villani and G. Sette); Department of Neurology and Psychiatry, Sapienza University, Rome, Italy (V. Villani, L. Prosperini, and C. Pozzilli); Department of Psychology, Sapienza University, Rome, Italy (L. De Giglio); Centre for Experimental Neurological Therapies (CENTERS), S. Andrea Hospital, Rome, Italy (M. Salvetti).
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  • Marco Salvetti MD, PhD,

    1. From Neurological Headache Centre, S. Andrea Hospital, Rome, Italy (V. Villani and G. Sette); Department of Neurology and Psychiatry, Sapienza University, Rome, Italy (V. Villani, L. Prosperini, and C. Pozzilli); Department of Psychology, Sapienza University, Rome, Italy (L. De Giglio); Centre for Experimental Neurological Therapies (CENTERS), S. Andrea Hospital, Rome, Italy (M. Salvetti).
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  • Giuliano Sette MD, PhD

    1. From Neurological Headache Centre, S. Andrea Hospital, Rome, Italy (V. Villani and G. Sette); Department of Neurology and Psychiatry, Sapienza University, Rome, Italy (V. Villani, L. Prosperini, and C. Pozzilli); Department of Psychology, Sapienza University, Rome, Italy (L. De Giglio); Centre for Experimental Neurological Therapies (CENTERS), S. Andrea Hospital, Rome, Italy (M. Salvetti).
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  • Conflict of Interest: None. Funding: This research was carried out using information collected during normal patient care, and extra time spent in data analysis and interpretation was part of educational programs within the University (V.V., L.P., L.D.G.).

  • Financial disclosures : Prof. Pozzilli has received honoraria for consultancy or speaking from Sanofi-Aventis, Biogen Idec, Bayer Schering, Merck Serono, and Novartis, and has received research grants from Sanofi-Aventis, Merck Serono, and Bayer Schering. Prof. Salvetti has received research grants from Sanofi-Aventis, Merck Serono, and Bayer Schering. Drs. Villani, Prosperini, De Giglio, Sette do not have any disclosures to report.

V. Villani, Neurology Unit, S. Andrea Hospital, Sapienza University, Via di Grottarossa, 1035-00189 Rome, Italy, email: veronicavillani@hotmail.it

Abstract

Background.— Some multiple sclerosis (MS)-specific therapies may exacerbate a comorbid migraine. Whereas data regarding the impact of interferon beta (IFNB) on this comorbidity have been reported, studies on the role of natalizumab (NTZ) are still lacking.

Purpose.— Our aim was to compare the impact of IFNB and NTZ on the frequency and disability of comorbid migraine in MS patients.

Methods.— We performed a longitudinal evaluation on MS patients with comorbid migraine previously assessed at our center and retested for the present study, by comparing data from 33 patients originally treated with IFNB and thereafter switched to NTZ vs 30 patients continued currently to receive IFNB.

Results.— Longitudinal analysis showed a significant reduction of migraine frequency (from a mean value of 8.4 to 5.1 days per month; P = .034) and Migraine Disability Assessment Scale (MIDAS) score (from a mean value of 14.2 to 10.5; P = .045) in the subgroup patients switched from IFNB to NTZ but not in those remaining in the IFNB recipient, irrespective of level of fatigue, trait anxiety, depression, alexithymia, or other clinical variables.

Conclusions.— Our findings suggest that NTZ did not exacerbate comorbid migraine in MS patients and support the hypothesis that IFNB might represent an important trigger for migraine worsening.

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