Intravenous DHE demonstrates cardiac safety among patients with refractory migraine

A recent found the safety and efficacy of repetitive intravenous Dihydroergotamine (DHE) for migraine patients with cardiovascular risk factors, but without ischemic heart disease or coronary vasospasm. This research aimed to address the uncertainty surrounding DHE's application and the findings were published in Headache: The Journal of Head and Face Pain.

This single-center retrospective cohort analysis, examined patients suffering from refractory chronic migraines who underwent intravenous DHE treatment between January 2019 and October 2019. The primary objectives included assessing the safety, tolerability, and effectiveness of the treatment in individuals with atherosclerotic cardiovascular disease risk factors, categorized as either low (<5.0%) or elevated (≥5.0%).

The research encompassed 347 patients, mainly women (80.1%), with a median age of 46. Among these, 227 had calculable risk scores, with 28.2% classified as having elevated cardiovascular risk. Impressively, there were no significant electrocardiogram abnormalities or cardiovascular adverse events reported during the study.

The median hospital stay for these patients was six days. A noteworthy discovery was that patients with elevated cardiovascular risk experienced higher levels of nausea but received similar initial DHE doses as those with lower risk. However, they did receive lower final DHE doses and reported slightly less reduction in pain severity after admission compared to the low-risk group.