New drugs, treatments, studies and clinical guidelines, summarised in plain language with a link to the original source.
New drugsTreatments
FDA grants De Novo authorization to Avulux lenses for migraine photophobia
The FDA authorized Avulux optical filter lenses to reduce the impact of light sensitivity in patients aged 12 and older with episodic migraine. This over-the-counter device blocks specific wavelengths (480 nm and 590 nm) without replacing acute or preventive treatments. The decision was based on randomized studies and real-world data, although the announcement did not detail efficacy or safety figures. For the patient, it represents a non-invasive and regulator-recognized option to manage photophobia as a complementary symptom.
Efficacy and safety of eptinezumab in adults with chronic migraine and medication-overuse headache who also received patient education: 24-week results from the RESOLUTION randomized trial
This phase 4 multinational clinical trial evaluated eptinezumab in 608 adults with chronic migraine and medication-overuse headache (MOH). After receiving education about MOH, patients treated with this monoclonal antibody showed sustained reductions in migraine frequency and days of acute medication use through week 24. The results indicate that the initial improvements in disease burden and quality of life are maintained after a second dose, resulting in many patients no longer meeting the diagnostic criteria for chronic migraine and MOH with a good safety profile.
Emgality, a medication for chronic migraine, is leaving the Brazilian market
The pharmaceutical company Libbs announced that the monoclonal antibody Emgality (galcanezumab) will stop being sold in Brazil starting June 2026 due to a portfolio update. This monthly injectable drug, approved in 2019, is a key ally for patients with chronic migraine and cluster headache who do not respond to other treatments. The withdrawal worries doctors and patients because of the difficulty in finding substitutes with the same efficacy and lower rate of side effects, directly impacting the quality of life of those who depend on this preventive.
Safety, tolerability, and efficacy of atogepant added to onabotulinumtoxinA for the preventive treatment of chronic migraine: a phase 3, multicenter, 24-week, open-label study
This phase 3 study evaluated adding 60 mg of daily atogepant to 75 adult patients with chronic migraine who were already receiving onabotulinumtoxinA. The results showed a reduction of 7.2 migraine days per month after 24 weeks, and 61.9% of participants managed to reduce their attacks by half. Although there were side effects such as constipation and nausea, the treatment was safe and well-tolerated. For the patient, this validates combining two different preventive therapies to achieve superior disease control.
How much aerobic exercise is needed to reduce migraine? A dose-response meta-analysis on pain intensity and frequency
This meta-analysis of 15 studies with 253 patients analyzed the impact of aerobic exercise on migraine. The results show that exercise significantly reduces both pain intensity and frequency. For a moderate effect, at least 200 total minutes of activity are required, reaching the maximum benefit between 900 and 950 cumulative minutes during the program. For the patient, this translates into a preliminary recommendation to perform 3 weekly sessions of 30 minutes for about 10 or 11 weeks to optimize improvement.
Comparative efficacy and safety of preventive treatments for vestibular migraine: a systematic review and network meta-analysis
This network meta-analysis analyzed 5 clinical trials with 419 patients to compare preventive drugs against vertigo in vestibular migraine. The results show that all evaluated treatments significantly reduced monthly attacks. Propranolol stood out with the largest theoretical reduction (-7.04 attacks/month), followed by valproic acid and venlafaxine. However, galcanezumab presented the best balance between efficacy, quality of evidence, and tolerability with no dropouts. For the patient, this validates classic and new options to decrease the frequency of vertigo and improve their quality of life.
Greater occipital nerve block for migraine treatment: an overview, systematic review, and meta-analysis
This meta-analysis and review of 16 clinical trials evaluated the efficacy of the greater occipital nerve block (GONB) in 930 patients. The results show that the use of local anesthetic reduces pain intensity in acute attacks after 30 minutes. In chronic migraine, weekly injections reduced pain and monthly migraine days by 4.46 days after one month. For the patient, this confirms that it is a safe and useful procedure for rapid relief, although evidence on long-term benefits or steroid use is still limited.
Early and sustained change in headache day frequency after eptinezumab treatment in adults with migraine in whom 2 to 4 prior preventive treatments failed: a post hoc analysis of the DELIVER randomized trial
This analysis of the DELIVER trial evaluated the use of intravenous eptinezumab in adults with migraine who did not respond to 2-4 prior preventives. The results show that 23% of patients reduced their headache days to fewer than 4 per month in the first 12 weeks, a figure that rose to 47% by the end of the study (weeks 61-72). Furthermore, 9% achieved zero days of pain after the last dose. For the patient, this represents a sustained improvement in pain intensity and disease burden, even in difficult-to-treat cases.
OnabotulinumtoxinA for the preventive treatment of episodic migraine: Results from the phase 3, multicenter, randomized, double-blind, placebo-controlled PRECLUDE trial
This phase 3 clinical trial conducted at multiple centers evaluated the efficacy of onabotulinumtoxinA in 775 adult patients with episodic migraine. The results showed that, although there was a reduction in monthly migraine days, there was no statistically significant difference between the 155 U or 195 U doses compared to placebo. Secondary objectives in reducing acute medication were also not met. For the patient, this confirms that Botox is not more effective than placebo in cases of episodic migraine, unlike its proven use in chronic migraine.
Adjunctive occipital nerve block for the emergency treatment of acute migraine: A randomized controlled trial
This randomized trial in adults evaluated the efficacy of adding a greater occipital nerve block (methylprednisolone and lidocaine) to standard intravenous triple therapy in the emergency department. Results showed that 95.2% of patients with the block achieved a 50% pain reduction within two hours, compared to 47.6% in the control group. At 30 days, patients reported fewer migraine days and more pain-free days. For the patient, this procedure offers rapid and lasting relief in cases of severe or refractory attacks.