Influence of Metabolic State and Body Composition on the Action of Pharmacological Treatment of Migraine

Overview

Journal J Headache Pain

Publisher Biomed Central

Date 2024 Feb 12

PMID 38347465

Authors

Noor Bruijn

Romy van Lohuizen

Malgorzata Boron

Mira Fitzek

Francesca Gabriele

Giada Giuliani

Laura Melgarejo

Pavel Rehulka

Gabriele Sebastianelli

Paul Triller

Simone Vigneri

Behiye Ozcan

Antoinette Maassen Van Den Brink

Affiliations

Soon will be listed here.

Abstract

Migraine is a disabling neurovascular disorder among people of all ages, with the highest prevalence in the fertile years, and in women. Migraine impacts the quality of life of affected individuals tremendously and, in addition, it is associated with highly prevalent metabolic diseases, such as obesity, diabetes mellitus and thyroid dysfunction. Also, the clinical response to drugs might be affected in patients with metabolic disease due to body composition and metabolic change. Therefore, the efficacy of antimigraine drugs could be altered in patients with both migraine and metabolic disease. However, knowledge of the pharmacology and the related clinical effects of antimigraine drugs in patients with metabolic disease are limited. Therefore, and given the clinical relevance, this article provides a comprehensive overview of the current research and hypotheses related to the influence of metabolic state and body composition on the action of antimigraine drugs. In addition, the influence of antimigraine drugs on metabolic functioning and, vice versa, the influence of metabolic diseases and its hormonal modulating medication on migraine activity is outlined. Future exploration on personalizing migraine treatment to individual characteristics is necessary to enhance therapeutic strategies, especially given its increasing significance in recent decades.

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References

Al-Hassany L, Haas J, Piccininni M, Kurth T, Brink A, Rohmann J . Giving Researchers a Headache - Sex and Gender Differences in Migraine. Front Neurol. 2020; 11:549038. PMC: 7642465. DOI: 10.3389/fneur.2020.549038. View

. Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018; 38(1):1-211. DOI: 10.1177/0333102417738202. View

Thomas F, Caldwell J, Greenberger N . Steatorrhea in thyrotoxicosis. Relation to hypermotility and excessive dietary fat. Ann Intern Med. 1973; 78(5):669-75. DOI: 10.7326/0003-4819-78-5-669. View

Nosadini R, de Kreutzenberg S, Duner E, Iori E, Avogaro A, Trevisan R . Porcine and human insulin absorption from subcutaneous tissues in normal and insulin-dependent diabetic subjects: a deconvolution-based approach. J Clin Endocrinol Metab. 1988; 67(3):551-9. DOI: 10.1210/jcem-67-3-551. View

Afshinmajd S, Davati A, Akbari F . The effects of body mass index on the treatment of the patients with migraine headaches. Iran J Neurol. 2013; 10(3-4):35-8. PMC: 3829225. View

Yoshinari K, Takagi S, Yoshimasa T, Sugatani J, Miwa M . Hepatic CYP3A expression is attenuated in obese mice fed a high-fat diet. Pharm Res. 2006; 23(6):1188-200. DOI: 10.1007/s11095-006-0071-6. View

Lupi C, Benemei S, Guerzoni S, Pellesi L, Negro A . Pharmacokinetics and pharmacodynamics of new acute treatments for migraine. Expert Opin Drug Metab Toxicol. 2019; 15(3):189-198. DOI: 10.1080/17425255.2019.1578749. View

van der Schoor L, Verkade H, Kuipers F, Jonker J . New insights in the biology of ABC transporters ABCC2 and ABCC3: impact on drug disposition. Expert Opin Drug Metab Toxicol. 2014; 11(2):273-93. DOI: 10.1517/17425255.2015.981152. View

Oliveira de Souza C, Sun X, Oh D . Metabolic Functions of G Protein-Coupled Receptors and β-Arrestin-Mediated Signaling Pathways in the Pathophysiology of Type 2 Diabetes and Obesity. Front Endocrinol (Lausanne). 2021; 12:715877. PMC: 8419444. DOI: 10.3389/fendo.2021.715877. View

10.

Mills G, Horn J . Beta-blockers and glucose control. Drug Intell Clin Pharm. 1985; 19(4):246-51. DOI: 10.1177/106002808501900401. View

11.

Garnett W . Clinical pharmacology of topiramate: a review. Epilepsia. 2000; 41(S1):61-5. DOI: 10.1111/j.1528-1157.2000.tb02174.x. View

12.

Takahashi N, Inui N, Morita H, Takeuchi K, Uchida S, Watanabe H . Effect of thyroid hormone on the activity of CYP3A enzyme in humans. J Clin Pharmacol. 2009; 50(1):88-93. DOI: 10.1177/0091270009344336. View

13.

Roberts B, Susano I, Gipson D, Trachtman H, Joy M . Contribution of renal and non-renal clearance on increased total clearance of adalimumab in glomerular disease. J Clin Pharmacol. 2013; 53(9):919-24. DOI: 10.1002/jcph.121. View

14.

Vargas F, Manuel Moreno J, Rodriguez-Gomez I, Wangensteen R, Osuna A, Alvarez-Guerra M . Vascular and renal function in experimental thyroid disorders. Eur J Endocrinol. 2006; 154(2):197-212. DOI: 10.1530/eje.1.02093. View

15.

Hsu W, Hsiao P, Lin P, Chen S, Lee M, Shin S . Effect of metformin on kidney function in patients with type 2 diabetes mellitus and moderate chronic kidney disease. Oncotarget. 2018; 9(4):5416-5423. PMC: 5797060. DOI: 10.18632/oncotarget.23387. View

16.

Bonadonna R, Groop L, Kraemer N, Ferrannini E, Del Prato S, DeFronzo R . Obesity and insulin resistance in humans: a dose-response study. Metabolism. 1990; 39(5):452-9. DOI: 10.1016/0026-0495(90)90002-t. View

17.

Rainero I, Limone P, Ferrero M, Valfre W, Pelissetto C, Rubino E . Insulin sensitivity is impaired in patients with migraine. Cephalalgia. 2005; 25(8):593-7. DOI: 10.1111/j.1468-2982.2005.00928.x. View

18.

Dev P, Favas T, Jaiswal R, Cyriac M, Mishra V, Pathak A . The effect of low dose thyroid replacement therapy in patients with episodic migraine and subclinical hypothyroidism: A randomised placebo-controlled trial. Cephalalgia. 2023; 43(10):3331024231182684. DOI: 10.1177/03331024231182684. View

19.

Moreno-Ajona D, Villar-Martinez M, Goadsby P . New Generation Gepants: Migraine Acute and Preventive Medications. J Clin Med. 2022; 11(6). PMC: 8953732. DOI: 10.3390/jcm11061656. View

20.

Akerman S, Romero-Reyes M . Insights into the pharmacological targeting of the trigeminocervical complex in the context of treatments of migraine. Expert Rev Neurother. 2013; 13(9):1041-59. DOI: 10.1586/14737175.2013.827472. View