To evaluate the impact of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) on emergency department use, hospitalizations, and preventive therapy escalation in adults with chronic migraine compared to topiramate.
Key Findings:
24% of patients initiating GLP-1 RAs visited the emergency department compared to 26% for topiramate (risk ratio 0.90).
GLP-1 RA initiation was associated with lower hospitalizations (risk ratio 0.86).
Lower risk of nerve block procedures (risk ratio 0.87) and triptan prescriptions (risk ratio 0.87) in GLP-1 RA group.
Patients on GLP-1 RAs were less likely to start additional preventive medications, including valproate (risk ratio 0.52) and CGRP monoclonal antibodies (risk ratio 0.58).
Interpretation:
GLP-1 RAs may help stabilize chronic migraine management, leading to reduced emergency care and lower use of additional preventive medications.
Limitations:
Observational study design does not establish causation.
Unmeasured factors such as weight loss, migraine severity, and lifestyle changes may have influenced outcomes.
Conclusion:
The study suggests potential benefits of GLP-1 RAs in managing chronic migraine, warranting further investigation through randomized controlled trials.
