GLP-1 drugs show promise in managing chronic migraines

GLP-1 drugs, including Novo Nordisk's Wegovy and Ozempic, could also help people who have chronic migraines, a real-world observational study suggests.

Chronic migraine patients who took certain GLP-1 receptor agonists, which are most commonly used to treat metabolic conditions like obesity and diabetes, were associated with fewer acute care events and a reduced use of additional migraine treatments after a year than those who took topiramate, a standard first-line migraine preventative, according to the American Academy of Neurology.

"People with chronic migraines often end up in the emergency room, or they need to try several preventive medications before finding one that can work for them," study author Vitoria Acar, MD, University of Sao Paulo in Brazil, said.

"Seeing these patterns of lower use of emergency care and lower use of drugs to stop migraines or trying additional drugs to prevent migraines among people taking GLP-1 drugs for other conditions suggests that these therapies may help stabilize the disease burden in ways that we haven't fully appreciated yet," Acar added.

People who started using GLP-1 drugs, including liraglutide, semaglutide, dulaglutide, exenatide, lixisenatide or albiglutide, were about 10% less likely to make an emergency department (ED) visit in the following year than those who started topiramate, data shows.

The study used TriNetX, a large healthcare database, to identify nearly 11,000 adults with chronic migraine who began taking a GLP-1 therapy. Each patient was paired with a clinically similar individual who began taking topiramate, and both groups were followed for 12 months.

The analysis, based on electronic health data, shows that ED visits over the following year were 2.7 percentage points lower among patients who started GLP-1 drugs than those who began topiramate. GLP-1 users were also about 14% less likely to be hospitalized for any reason over the course of the year.

In the observational study, people who began taking GLP-1s were also about 13% less likely to have a nerve-blocking procedure or to get a prescription for an antimigraine triptan medication over the following year, compared with those in the topiramate group.

Early research is exploring whether the anti-inflammatory and neurovascular effects of GLP-1 drugs could contribute to migraine treatment, according to Acar.

Researchers plan to present their findings from the preliminary study at the upcoming AAN meeting in Chicago next month, the organization says.

Although the findings suggest that GLP-1 therapies may offer benefits beyond weight loss, liraglutide is the only GLP-1 receptor agonist evaluated in the clinic for migraine treatment. Still, the results were encouraging.

In a small exploratory trial published last year, liraglutide reduced monthly migraine episodes by half in migraine patients with obesity. It also significantly lowered headache occurrences in patients who did not respond well to standard treatments available on the market. Notably, the participants did not lose much weight during the trial, suggesting that the decrease in headaches was not associated with weight loss.

As of now, no drugmaker has an early-stage migraine-specific GLP-1 drug program, according to publicly available information.

Alivia Kaylor is a scientist and the senior site editor of Pharma Life Sciences.