PMC:7507645 / 28291-30022 JSONTXT

{"project":"TEST0","denotations":[{"id":"32958075-199-204-1506683","span":{"begin":199,"end":200},"obj":"[\"30003412\"]"},{"id":"32958075-232-237-1506684","span":{"begin":435,"end":436},"obj":"[\"30003412\"]"},{"id":"32958075-235-240-1506685","span":{"begin":438,"end":439},"obj":"[\"25083264\"]"},{"id":"32958075-230-236-1506686","span":{"begin":441,"end":443},"obj":"[\"30793412\"]"},{"id":"32958075-236-241-1506687","span":{"begin":733,"end":734},"obj":"[\"25083264\"]"},{"id":"32958075-231-237-1506688","span":{"begin":736,"end":738},"obj":"[\"29381924\"]"},{"id":"32958075-235-241-1506689","span":{"begin":740,"end":742},"obj":"[\"21834901\"]"},{"id":"32958075-162-168-1506690","span":{"begin":907,"end":909},"obj":"[\"26122645\"]"},{"id":"32958075-138-144-1506691","span":{"begin":1050,"end":1052},"obj":"[\"26122645\"]"}],"text":"In this study, patients with MO saw improvements in the measured outcomes without undergoing withdrawal therapy or so-called “detoxification,” which is often believed to be important in managing MO [2]. Several strategies are available for detoxification, including early abrupt withdrawal, restricted intake, discontinuation therapy with rescue medication (different analgesic than the overused medication), or intravenous hydration [2, 3, 25]. During detoxification, most patients experience an initial worsening of headaches and additional withdrawal symptoms such as nausea, vomiting, hypotension, tachycardia, sleep disturbances, restlessness, and anxiety, which typically last up to 10 days, but may persist for up to 4 weeks [3, 26, 27]. Studies have demonstrated variable rates of success in discontinuing medications, with percentages of patients achieving detoxification ranging from 57% to 100% [28]. Even after successful discontinuation of overused medication, 17% to 43% of patients relapse back to MO just 1 year after detoxification [28]. Our results suggest that patients treated with fremanezumab do not need to discontinue overused drugs to experience the benefit of preventive treatment and achieve reduced acute medication use. Fremanezumab treatment resulted in 58% of patients reverting from MO to no MO, compared with 46% for patients given placebo, suggesting that patients receiving fremanezumab may achieve reversion from MO, avoid detoxification and its associated symptoms, and still achieve fewer headache days and migraine days. Together, this suggests the potential for a paradigm shift to an effective and more humane approach for treating CM with MO: prevent first and detoxify later if necessary."}

{"project":"2_test","denotations":[{"id":"32958075-30003412-60560890","span":{"begin":199,"end":200},"obj":"30003412"},{"id":"32958075-30003412-60560891","span":{"begin":435,"end":436},"obj":"30003412"},{"id":"32958075-25083264-60560892","span":{"begin":438,"end":439},"obj":"25083264"},{"id":"32958075-30793412-60560893","span":{"begin":441,"end":443},"obj":"30793412"},{"id":"32958075-25083264-60560894","span":{"begin":733,"end":734},"obj":"25083264"},{"id":"32958075-29381924-60560895","span":{"begin":736,"end":738},"obj":"29381924"},{"id":"32958075-21834901-60560896","span":{"begin":740,"end":742},"obj":"21834901"},{"id":"32958075-26122645-60560897","span":{"begin":907,"end":909},"obj":"26122645"},{"id":"32958075-26122645-60560898","span":{"begin":1050,"end":1052},"obj":"26122645"}],"text":"In this study, patients with MO saw improvements in the measured outcomes without undergoing withdrawal therapy or so-called “detoxification,” which is often believed to be important in managing MO [2]. Several strategies are available for detoxification, including early abrupt withdrawal, restricted intake, discontinuation therapy with rescue medication (different analgesic than the overused medication), or intravenous hydration [2, 3, 25]. During detoxification, most patients experience an initial worsening of headaches and additional withdrawal symptoms such as nausea, vomiting, hypotension, tachycardia, sleep disturbances, restlessness, and anxiety, which typically last up to 10 days, but may persist for up to 4 weeks [3, 26, 27]. Studies have demonstrated variable rates of success in discontinuing medications, with percentages of patients achieving detoxification ranging from 57% to 100% [28]. Even after successful discontinuation of overused medication, 17% to 43% of patients relapse back to MO just 1 year after detoxification [28]. Our results suggest that patients treated with fremanezumab do not need to discontinue overused drugs to experience the benefit of preventive treatment and achieve reduced acute medication use. Fremanezumab treatment resulted in 58% of patients reverting from MO to no MO, compared with 46% for patients given placebo, suggesting that patients receiving fremanezumab may achieve reversion from MO, avoid detoxification and its associated symptoms, and still achieve fewer headache days and migraine days. Together, this suggests the potential for a paradigm shift to an effective and more humane approach for treating CM with MO: prevent first and detoxify later if necessary."}