Real-world Experience with Remote Electrical Neuromodulation in the Acute Treatment of Migraine. Issue 12 (16th September 2020)

• Record Type: Journal Article
• Authors: Tepper, Stewart J; Lin, Tamar; Montal, Tal; Ironi, Alon; Dougherty, Carrie
• Is Part Of: Pain medicine. Volume 21:Issue 12(2020)
• Page Start: 3522
• Page End: 3529
• Publication Date: 2020-09-16
• Subjects: Acute Migraine Treatment -- Real-world -- Remote Electrical Neuromodulation -- Functional Disability -- Nonpharmacological Treatment -- Medication Overuse Headache; Pain -- Periodicals; Pain -- Treatment -- Periodicals; Analgesics -- Periodicals; Pain -- Periodicals; Pain Management -- Periodicals; Douleur -- Périodiques; Douleur -- Traitement -- Périodiques; Analgésiques -- Périodiques; Analgésique; Soulagement de la douleur; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.047205
• DOI: 10.1093/pm/pnaa299
• Languages: English
• ISSNs: 1526-2375

Abstract

Abstract: Objective: Remote electrical neuromodulation (REN) is a nonpharmacological acute migraine treatment that stimulates upper-arm peripheral nerves. The aim of this investigation was to evaluate the effectiveness and safety of REN for acute treatment of migraine in a real-world setting. Methods: Real-world data were collected from patients who were using REN (Nerivio ®, Theranica Bio-Electronics Ltd., Israel) between October 1, 2019, and March 31, 2020. Patients recorded their symptoms at baseline, two hours, and 24 hours post-treatment. Patients were stratified based on the type of visit and provider; in-person visits with headache specialists (HS group) or virtual visits with nonheadache specialists (NHS group). Efficacy outcome focused on intra-individual consistency of response across multiple attacks. Results: We found that 58.9% (662/1, 123) of the patients in the HS group and 74.2% (23/31) of the patients in the NHS group experienced pain relief at two hours in at least 50% of their treated attacks and 20.0% (268/1, 339) of the patients in the HS group and 35.6% (16/45) of the patients in the NHS group experienced pain freedom at two hours in at least 50% of their treated attacks. The effects of REN on associated symptoms and improvement in function were also consistent in both groups. The incidence of device-related adverse events was very low (0.5%). Conclusions: Real-world data confirm that REN results in meaningful clinical benefits with minimal side effects. REN may provide an effective drug-free treatment option for achieving consistent relief from migraine symptoms and may reduce the use of acute medications.