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Background: Alopecia is associated with erenumab post-marketing, but no cases have been described. Methods: We describe two patients that reported temporary hair loss and review the FDA Adverse Event Reporting System (FAERS). Results: The first patient experienced alopecia within three months of starting erenumab, which did not improve with ongoing use or transition to fremanezumab. The second patient reported alopecia within two weeks of starting erenumab, which continued after transition to galcanezumab; months later, there was also recurrent hair loss within one month of starting fremanzeumab. According to FAERS (last accessed 18 August 2022), alopecia was reported most with erenumab (1158), followed by galcanezumab (554), fremanezumab (175), eptinezumab (23), rimegepant (26), ubrogepant (4), and atogepant (3). Conclusion: Most events were reported in women and non-serious. The potential mechanism of alopecia with drugs targeting calcitonin gene-related peptide or its receptor possibly includes disruptions in the microvascular circulation and other homeostatic mechanisms. [ABSTRACT FROM AUTHOR]

Objective: To assess the characteristics and associated disability of headache as an adverse event following vaccination. Background: According to clinical trials and post‐licensure surveillance, headache is a common symptom of vaccines, yet systematic investigations of post‐licensure reports of this adverse event are lacking. Methods: This was a retrospective database analysis study. We searched the Vaccine Adverse Events Reporting System (VAERS) database completed from July 1990 to June 2020 (a 30‐year period prior to the start of COVID‐19 pandemic) to identify reports of headache. We evaluated epidemiological features, including event characteristics, patient demographics, and vaccine type. Results: In those aged 3 years or older, headache was the fifth most reported adverse symptom, present in 8.1% (43,218/536,120) of all reports. Of headache reports, 96.3% (41,635/43,218) included the code "headache" not further specified. Migraine was coded in 1973 cases, although almost one‐third (12,467/41,808; 29.8%) of headache reports without a migraine code mention nausea or vomiting. The onset of symptoms was within 1 day of vaccination in over two‐thirds of cases. The majority of reports were classified as not serious; about one‐third involved emergency room or office visits. Of the 43,218 total headache reports, only a minority involved hospitalizations (2624; 6.1%) or permanent disability (1091; 2.5%), females accounted for 68.9% (29,771) and males for 29.5% (12,725), patients aged 6 to 59 years represented 67.3% (29,112), and over one‐third of cases were reported after herpes zoster (8665; 20.1%) and influenza (6748; 15.6%) vaccinations. Conclusion: In a national surveillance system, headache was a commonly reported post‐vaccination adverse event; a small subset of reports was considered serious. The development of standardized vaccine‐related case definitions could be useful for better evaluating headache as an adverse event during vaccine development, and may reduce vaccine hesitancy especially in headache‐prone individuals. [ABSTRACT FROM AUTHOR]

This document published by the International Headache Society provides practical recommendations for the preventive pharmacological treatment of migraines. The recommendations are categorized into two levels: Optimal and Essential, based on medication availability in different regions. The document includes a table listing drugs with evidence of efficacy for migraine prevention and their availability in the World Health Organization Model List of Essential Medicines. The recommendations aim to establish essential standards of migraine management worldwide and provide guidance on evaluating treatment effectiveness, switching medications, combination therapy, and duration of treatment. The document also discusses comorbidities, specific medications for chronic migraine, preventive treatment in different populations, and managing medication overuse headache. [Extracted from the article]

Background: In an effort to improve migraine management around the world, the International Headache Society (IHS) has here developed a list of practical recommendations for the acute pharmacological treatment of migraine. The recommendations are categorized into optimal and essential, in order to provide treatment options for all possible settings, including those with limited access to migraine medications. Methods: An IHS steering committee developed a list of clinical questions based on practical issues in the management of migraine. A selected group of international senior and junior headache experts developed the recommendations, following expert consensus and the review of available national and international headache guidelines and guidance documents. Following the initial search, a bibliography of twenty-one national and international guidelines was created and reviewed by the working group. Results: A total of seventeen questions addressing different aspects of acute migraine treatment have been outlined. For each of them we provide an optimal recommendation, to be used whenever possible, and an essential recommendation to be used when the optimal level cannot be attained. Conclusion: Adoption of these international recommendations will improve the quality of acute migraine treatment around the world, even where pharmacological options remain limited. [ABSTRACT FROM AUTHOR]