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oai:recercat.cat:11351/124402025-10-24T10:36:52Zcom_2072_378070com_2072_378040col_2072_378092

Resistant and refractory migraine – two different entities with different comorbidities? Results from the REFINE study Rosignoli, Chiara Caponnetto, Valeria Onofri, Agnese Avaltroni, S. Braschinsky, Mark Ornello, Raffaele Pozo-Rosich, Patricia Muñoz-Vendrell, Albert Institut Català de la Salut [Rosignoli C, Ornello R, Onofri A, Avaltroni S] Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy. [Caponnetto V] Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy. [Braschinsky M] Department of Neurology and Neurosurgery, Institute of Clinical Medicine, Faculty of Medicine, University of Tartu, Tartu, Estonia. [Pozo-Rosich P, Muñoz-Vendrell A] Unitat de Cefalees, Servei de Neurologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain Vall d'Hebron Barcelona Hospital Campus Resistència als medicaments Migranya - Tractament Comorbiditat DISEASES::Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Headache Disorders::Headache Disorders, Primary::Migraine Disorders HEALTH CARE::Health Care Quality, Access, and Evaluation::Quality of Health Care::Epidemiologic Factors::Comorbidity PHENOMENA AND PROCESSES::Physiological Phenomena::Pharmacological and Toxicological Phenomena::Pharmacological Phenomena::Drug Resistance ENFERMEDADES::enfermedades del sistema nervioso::enfermedades del sistema nervioso central::enfermedades cerebrales::trastornos con cefaleas::cefaleas primarias::trastornos migrañosos ATENCIÓN DE SALUD::calidad, acceso y evaluación de la atención sanitaria::calidad de la atención sanitaria::factores epidemiológicos::comorbilidad FENÓMENOS Y PROCESOS::fenómenos fisiológicos::fenómenos farmacológicos y toxicológicos::fenómenos farmacológicos::resistencia a medicamentos Comorbidities; Refractory migraine; Resistant migraine Comorbilidades; Migraña refractaria; Migraña resistente Comorbiditats; migranya refractària; Migranya resistent Background Resistant and refractory migraine are commonly encountered in specialized headache centers. Several comorbidities, mostly psychiatric conditions, have been linked to migraine worsening; however, there is little knowledge of the comorbidity profile of individuals with resistant and refractory migraine. Methods REFINE is a prospective observational multicenter international study involving individuals with migraine from 15 headache centers. Participants were categorized into three groups based on the European Headache Federation criteria: non-resistant and non-refractory (NRNRM), resistant (ResM), and refractory (RefM). We explored the prevalence of 20 comorbidities at baseline in the three groups. Results Of the 689 included patients (82.8% women), 262 (38.0%) had ResM, 73 (10.4%) had RefM and 354 (51.4%) NRNRM. A higher prevalence of psychiatric comorbidities, trigger points, temporomandibular joint disorders, thyroiditis, and cerebrovascular diseases was observed in the RefM group, followed by ResM and NRNRM. Multiple comorbidities were more common in the RefM group, followed by the ResM group and by the NRNRM group (41.6% vs. 24.5% vs. 14.1% respectively; p < 0.001). At the sensitivity analysis, exploring participants with chronic migraine, significant differences among the NRNRM, ResM, and RefM groups were found in the prevalence of anxiety (p < 0.001), asthma and rhinitis (p = 0.013), bipolar and other psychiatric disorders (p = 0.049), cerebrovascular diseases (p < 0.001), depression (p < 0.001), obesity (p = 0.002), thyroiditis (p < 0.001), and trigger points (p = 0.008). Conclusion REFINE data indicate that individuals with ResM and RefM have a higher burden of comorbidities than those with NRNRM. It can be postulated that those comorbidities may have an impact on the progression of migraine from a form that is easy to treat to a form that is resistant or refractory to treatments. Longitudinal studies are needed to understand the direction of the association between ResM or RefM and those comorbidities and if proper treatment of comorbidities might help overcome treatment resistance or refractoriness. This study will be funded by intramural DISCAB GRANT 2021 (Project ID 07_DG_2024_10) awarded by the Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila. 2025-01-20T11:04:06Z 2025-01-20T11:04:06Z 2024-12-03 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Rosignoli C, Ornello R, Caponnetto V, Onofri A, Avaltroni S, Braschinsky M, et al. Resistant and refractory migraine – two different entities with different comorbidities? Results from the REFINE study. J Headache Pain. 2024 Dec 3;25:212. 1129-2377 https://hdl.handle.net/11351/12440 10.1186/s10194-024-01910-3 39627727 001369713100001 http://hdl.handle.net/11351/12440 eng The Journal of Headache and Pain;25 https://doi.org/10.1186/s10194-024-01910-3 Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess application/pdf BMC Scientia