Assessment of drug-related migraine in a real-world large-scale database

BackgroundDrug-induced migraine represents a clinically significant yet under-investigated subtype of migraine. This study aims to evaluate the risk of drug-related migraine based on real-world data from the FDA Adverse Event Reporting System (FAERS).MethodsA retrospective pharmacovigilance analysis...

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Main Authors: Fan Wu, Ao Liu, Zhenyuan Jiang, Zhonglin Wang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Pharmacology
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Online Access:https://www.frontiersin.org/articles/10.3389/fphar.2025.1647088/full
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author Fan Wu
Ao Liu
Zhenyuan Jiang
Zhonglin Wang
author_facet Fan Wu
Ao Liu
Zhenyuan Jiang
Zhonglin Wang
author_sort Fan Wu
collection DOAJ
description BackgroundDrug-induced migraine represents a clinically significant yet under-investigated subtype of migraine. This study aims to evaluate the risk of drug-related migraine based on real-world data from the FDA Adverse Event Reporting System (FAERS).MethodsA retrospective pharmacovigilance analysis was conducted using FAERS data from Q1 2004 to Q4 2024. Migraine cases were identified via standardized MedDRA (The Medical Dictionary for Regulatory Activities) terms. Only primary suspect drugs were included. Disproportionality analyses were performed using four algorithms: ROR, PRR, MGPS, and BCPNN. Drugs were classified by therapeutic indication and mechanism of action, and stratified by BCPNN values to assess risk levels.ResultsA total of 20,886 migraine-related adverse events were identified, predominantly among females (77.4%) with a mean age of 45.7 years. Sixty-six drugs yielded positive signals, and after exclusion criteria, 39 remained for further analysis. The highest-risk agents included lorcaserin (BCPNN = 3.33), tasimelteon (3.20), and botulinum toxin type A (3.06). High-risk therapeutic classes included immunosuppressants, estrogens/progestogens, and sedative-hypnotics.ConclusionThis large-scale analysis identifies key drug categories and compounds associated with an elevated risk of migraine, providing actionable insights for clinicians. Especially lorcaserin, tasimelteon, and botulinum toxin as potential risk factors for migraine. Given the public health burden of migraine, pharmacovigilance efforts should incorporate such findings to mitigate iatrogenic risks. Further prospective studies are warranted to establish causal mechanisms and optimize therapeutic decision-making.
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spelling doaj-art-75b424b2bf2d40138a6fccf1dac900302025-08-20T03:32:11ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122025-07-011610.3389/fphar.2025.16470881647088Assessment of drug-related migraine in a real-world large-scale databaseFan Wu0Ao Liu1Zhenyuan Jiang2Zhonglin Wang3Shandong University of Traditional Chinese Medicine, Jinan, Shandong, ChinaShanghai Academy of Social Sciences, Shanghai, ChinaAffiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, ChinaShandong University of Traditional Chinese Medicine, Jinan, Shandong, ChinaBackgroundDrug-induced migraine represents a clinically significant yet under-investigated subtype of migraine. This study aims to evaluate the risk of drug-related migraine based on real-world data from the FDA Adverse Event Reporting System (FAERS).MethodsA retrospective pharmacovigilance analysis was conducted using FAERS data from Q1 2004 to Q4 2024. Migraine cases were identified via standardized MedDRA (The Medical Dictionary for Regulatory Activities) terms. Only primary suspect drugs were included. Disproportionality analyses were performed using four algorithms: ROR, PRR, MGPS, and BCPNN. Drugs were classified by therapeutic indication and mechanism of action, and stratified by BCPNN values to assess risk levels.ResultsA total of 20,886 migraine-related adverse events were identified, predominantly among females (77.4%) with a mean age of 45.7 years. Sixty-six drugs yielded positive signals, and after exclusion criteria, 39 remained for further analysis. The highest-risk agents included lorcaserin (BCPNN = 3.33), tasimelteon (3.20), and botulinum toxin type A (3.06). High-risk therapeutic classes included immunosuppressants, estrogens/progestogens, and sedative-hypnotics.ConclusionThis large-scale analysis identifies key drug categories and compounds associated with an elevated risk of migraine, providing actionable insights for clinicians. Especially lorcaserin, tasimelteon, and botulinum toxin as potential risk factors for migraine. Given the public health burden of migraine, pharmacovigilance efforts should incorporate such findings to mitigate iatrogenic risks. Further prospective studies are warranted to establish causal mechanisms and optimize therapeutic decision-making.https://www.frontiersin.org/articles/10.3389/fphar.2025.1647088/fullmigrainedrug-induced headacheFAERSpharmacovigilancedisproportionality analysisBCPNN
spellingShingle Fan Wu
Ao Liu
Zhenyuan Jiang
Zhonglin Wang
Assessment of drug-related migraine in a real-world large-scale database
Frontiers in Pharmacology
migraine
drug-induced headache
FAERS
pharmacovigilance
disproportionality analysis
BCPNN
title Assessment of drug-related migraine in a real-world large-scale database
title_full Assessment of drug-related migraine in a real-world large-scale database
title_fullStr Assessment of drug-related migraine in a real-world large-scale database
title_full_unstemmed Assessment of drug-related migraine in a real-world large-scale database
title_short Assessment of drug-related migraine in a real-world large-scale database
title_sort assessment of drug related migraine in a real world large scale database
topic migraine
drug-induced headache
FAERS
pharmacovigilance
disproportionality analysis
BCPNN
url https://www.frontiersin.org/articles/10.3389/fphar.2025.1647088/full
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