Recently published Abstract on Acthar for Migraines. Sorry if this has already been posted.
Objective: The goal of this study was to examine the effects of ACTH gel in chronic migraine patients who had failed multiple preventative treatments. Background: Despite the availability of many therapies for migraine prevention, there remain a significant number of patients whose migraines are refractory to treatment. Adrenocorticotropic hormone (ACTH) causes the release of glucocorticoids and has anti-inflammatory effects though melanocortin signaling, suggesting it might serve as a novel treatment for migraine prevention. Methods: This was a four center, two-arm, open-label study with 30 randomized subjects. All subjects met ICHD-IIR criteria for a diagnosis of chronic migraine and previously had failed at least two oral migraine preventatives as well as onabotulinumtoxinA. Following a 30-day baseline data collection period, subjects were randomized to receive either 40 IU or 80 IU of subcutaneous ACTH for 4 weeks. After the treatment phase subjects were followed for an additional 6 months. Results: When comparing baseline to treatment phase for all patients, we found a significant decrease in headache days (-2.2, p = .01) and migraine days (-2.2, p = .03). This reduction in headache days was greater for those receiving 80 IU than 40 IU, with those receiving 80 IU reporting a significant reduction in headache days (-2.6, p = .01) while the 40IU group had no significant change is headache days (-1.8, p = .21). A significant reduction in monthly headache days continued throughout the 6 month follow-up phase of the study F (7, 22) = .91, p = .03. Conclusions: Data from this pilot study suggest ACTH may be effective in reducing headache frequency in previously treatment-refractory patients with chronic migraine. Further investigation involving a larger subject population and double-blind methodology is needed to confirm this preliminary result.