The Journal of Headache and Pain

Official Journal of the "European Headache Federation" and of "Lifting The Burden - The Global Campaign against Headache"

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Volume 15 Supplement 1

Abstracts from the 4th European Headache and Migraine Trust International Congress: EHMTIC 2014

Open Access

EHMTI-0080. How migraine is affected by therapies for multiple sclerosis

  • C Condello1,
  • L Pinessi1 and
  • L Savi1
The Journal of Headache and Pain201415(Suppl 1):D11

Published: 18 September 2014


Multiple SclerosisMigraineMitoxantroneNatalizumabGlatiramer Acetate


There are a number of available disease-modifying therapies for Multiple Sclerosis (MS). Prevalence of migraine is higher in SM patients than in the general population, so possible effects of these preventive treatments on migraine should be monitored. A review of the literature on the subject is presented.


PubMed, Ovid and Google Scholar searches were conducted looking for Migraine combined with Beta-Interferon (bIFN), Glatiramer Acetate (GA), Natalizumab, Fingolimod, Laquinimod, Teriflunomide, Azathioprine, Methotrexate, Mitoxantrone and Ciclofosfamide.


Use of bIFN-1a was related to worsening of previously diagnosed migraine (37,5-41%, p<0.05) and to high percentage of de novo headache presentation (41-44%, p=0.05, ¼ of which with migraine features).

GA was associated with only 11% of worsening of migraine, and a direct comparison with bIFN showed the latter as much more migraine-inducing.

Effects of Natalizumab on migraine were evaluated in a small sample, but a significant reduction in migraine frequency and MIDAS scores was detected.

Only spurious cases of worsening of migraine were reported with use of Fingolimod.


Of all disease-modifying therapies used in MS, bIFN is the only one which showed a clear association with worsening of previous migraine. Interpretation of data is difficult on increased incidence of migraine after starting a disease-modifying treatment, due to uneasy distinction between facilitation of a true migraine and secondary headache, attributable to medications.

Migraine should always be carefully assessed in patients affected by MS, in particular if treated with disease-modifying medications, to evaluate eventual modification of migraine itself.

No conflict of interest.

Authors’ Affiliations

Headache Center, Città della salute e della scienza, Torino, Italy


© Condello et al; licensee Springer. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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