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Laura Hall, Venkatesh Brahma, Robert L. Lesser, Adeniyi Fisayo, Martin Wand, Christopher Teng; The Effect of Topical Prostaglandins on Migraine Headaches. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5131.
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Migraine headaches are a major health burden and cause of disability. Many suffer without adequate short-term treatment and/or long-term control. We observed that treatment with topical prostaglandin analogues decreased the frequency, severity and duration of migraines. We surveyed patients about their migraine symptoms before and after treatment to learn about the changes potentially related prostaglandin use.
We conducted retrospective surveys on 12 patients (4 males, overall average age 58.2 years). Participants were migraine sufferers treated with prostaglandin analogues either in their eyes (1 drop in both eyes as indicated for the treatment of elevated intraocular pressure) or on the fingernail bed (1 drop applied nightly to the lunula of four to six nails and allowed to dry). We collected data on their migraine history and symptoms before and after treatment with prostaglandins using expanded Migraine Disability Assessment (MIDAS) questionnaires. The Wilcoxon Signed-Rank Test was used to calculate the change in migraine frequency, severity, duration and modified MIDAS scores with prostaglandin treatment.
Two subjects used prostaglandin eye drops in their eyes (average length of treatment 79.5 months) and 9 subjects used them on their nails (average length of treatment 8.2 months). There was a decrease in the number of headache days from the 3-month period before treatment (mean 25.8 headache days) to the 3-month period following treatment (mean 7.7 headache days) (p≤ 0.05). There was also a decrease in headache severity from 5.8 to 3.5 (scale of 0-10) (p≤ 0.05) and headache duration from 3-12 hours to 1-3 hours (p≤ 0.05). The MIDAS score also reduced from 18.4 to 2.8 (p≤ 0.05). No adverse effects were reported with fingernail application however it was noted that fingernail growth accelerated.
Prostaglandin analogues are FDA approved for the treatment of elevated intraocular pressure applied to the eye. When used in patients with migraine headaches, there was improvement in the frequency, duration and severity of migraine headaches. Prostaglandin analogues could prove to be a novel treatment modality for the management of migraine headaches.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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