The Role of Preventive Therapy in the Photofobia associated with Migraine

Abstract

Introduction: Migraine associated symptoms, such as photophobia and phonophobia can be debilitating for migraine patients, deeply affecting their quality of life. We aimed to evaluate how the novel treatment with antibodies targeting the calcitonin gene-related peptide (anti-CGRP) affected photophobia. Methods: We conducted a prospective observational study including patients with refractory migraine treated with anti-CGRP antibodies at a Portuguese hospital. Patients completed the Headache Impact Test-6 (HIT-6) and the Utah Photophobia Symptom Impact Scale-version 2 (UPSIS-2) questionnaires before and after 3 months of treatment. Additional data was collected from clinical records. Results: Of the 22 female patients, 14 were included in this study (median age 38 years), 8 had a diagnosis of episodic migraine and 6 of chronic migraine. All patients had refractory migraine, with a median of 5 prior treatments. The baseline median and IQR25-75 for HIT-6 score was 68 (62-74) and for the UPSIS-2 was 34 (29,6-46,8).All patients were treated with fremanezumab or erenumab. The 3-month questionnaire revealed a median HIT-6 of 61 (57-66) and UPSIS-2 of 35,9 (25,8-46,5). A statistically significant difference is found in the HIT-6 (p=0.025). No statistically significant difference has been observed in the UPSIS-2 global score (p = 0.780) or individual questions. Conclusion: Anti-CGRP antibodies statistically improve the quality of life of our patients. Their impact in photophobia was not enlightening but it should be noted that the small sample size may have limited the capacity to show improvement in photophobia.