Effectiveness and tolerability of liraglutide as add-on treatment in patients with obesity and high-frequency or chronic migraine: A prospective pilot study
Abstract
OBJECTIVE: To assess whether glucagon-like-peptide-1 receptor (GLP-1R) agonists could serve as a novel prophylactic treatment for migraine in patients with obesity.
BACKGROUND: Increased intracranial pressure (ICP) is speculated to play a role in migraine mechanisms, as chronic migraine and idiopathic intracranial hypertension without papilledema (IIWHOP) are often clinically indistinguishable. These striking similarities suggest a deep pathogenetic link between the two conditions posing the hypothesis that control of ICP may be helpful in migraine treatment. The GLP-1R agonists have been shown to greatly reduce ICP. Notably, they have also been demonstrated to decrease calcitonin gene-related peptide expression in chronic migraine models.
METHODS: This was a prospective, interventional, open-label, pilot cohort study, evaluating the effectiveness of liraglutide as an add-on treatment of unresponsive migraine in patients with obesity. We consecutively enrolled patients with high-frequency or chronic migraine and a body mass index (BMI) of >30 kg/m2, and unresponsive to at least two preventive treatments. We excluded patients with papilledema, sixth nerve palsy, or pulsatile tinnitus, to rule out patients in which idiopathic intracranial hypertension could be clinically suspected. Liraglutide was administered 1.2 mg daily. The study was conducted from January to July 2024, with a 12-week follow-up period. The primary outcome of this study was the reduction of monthly days…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 31 participants or records.
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