Migraine Subgroups Indentified Based on Comorbidity Profiles

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Asthma, cardiovascular disease, anxiety and depression, chronic pain conditions, arthritis are a few comorbidities associated with migraine.
Asthma, cardiovascular disease, anxiety and depression, chronic pain conditions, arthritis are a few comorbidities associated with migraine.

Latent class analysis modeling identifies 8 natural subgroups of migraine through comorbidity profiles, according to a study published in Headache: The Journal of Head and Face Pain.

The web-based Chronic Migraine Epidemiology and Outcomes (CaMEO) study included 11,837 individuals with chronic migraine or episodic migraine and at least 1 comorbidity, and all participants were volunteers.

Of the 11,837 participants, 76% were women, 9.1% had chronic migraine, and 90.9% had episodic migraine. Following latent class analysis and clinical judgment, researchers selected an 8-class model using 22 comorbidities, each with a unique pattern. The subgroups are: Class 1, Most Comorbidities (n=676; 5.7%); Class 2, Respiratory/Psychiatric (n=1332; 11.3%); Class 3, Respiratory/Pain (n=913; 7.7%); Class 4, Respiratory (n=2355; 19.9%); Class 5, Psychiatric (n=898; 7.6%); Class 6, Cardiovascular (n=917; 7.7%); Class 7, Pain (n=720; 6.1%); Class 8, Fewest Comorbidities (n=4026; 34.0%).

Individuals classified in Class 1 had the most severe phenotype of migraine, with the greatest proportion with MIDAS grade IV (“severe disability”, 48.1% vs 22.3% of overall individuals).  In addition, there were higher rates of cutaneous allodynia, acute medication overuse, chronic migraine, and aura compared with overall individuals (67.6% vs 47.0%;, 36.4% vs 15.0%; 23.1% vs 9.1%; 40.1% vs 28.8%; respectively).

Researchers concluded that all participants matched the criteria for 1 of the 8 classes, but one-third of individuals were classified under group 8. The intention of the CaMEO Study was to distinguish the course of migraine disease and correlated comorbidities, look at demographic issues, compile the data to improve diagnosis, and identify natural subgroups of migraine. Researchers suggest that, “subsequent research will assess prognostic and biologic differences among the classes.”

This study was supported by Allergan plc (Dublin, Ireland). Please see reference for a complete list of authors' disclosures.

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Reference

Lipton RB, Fanning KM, Buse DC, et el. Identifying natural subgroups of migraine based on comorbidity and concomitant condition profiles: Results of the Chronic Migraine Epidemiology and Outcomes (CaMEO) Study [published online July 19, 2018]. Headache. doi: 10.1111/head.13342

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