Evidence map›Paper›PMID 40275185›Full record

Trial reportThe journal of headache and pain2025

Plasma SuPAR and therapeutic response to erenumab in migraine: a REFORM study.

William K Karlsson, Rune H Christensen, Haidar M Al-Khazali, Thomas Kallemose, Baker N Jawad, Ove Andersen, Messoud Ashina, Håkan Ashina

2 registry-linked trialsAbstract readClinical Trial, Phase IV
In one paragraph

Trial report in The journal of headache and pain, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04603976 phase4unknown statusnot on this map

Registry for Migraine - Clinical Core

TypeinterventionalSponsorDanish Headache CenterRan2020 to 2022Enrolled1,000ConditionsMigraineArmsErenumab
NCT04674020 phase4unknown statusnot on this map

Registry for Migraine - Structural and Functional Magnetic Resonance Imaging Before and After Erenumab Treatment

TypeinterventionalSponsorDanish Headache CenterRan2020 to 2025Enrolled250ConditionsMigraine, HeadacheArmsErenumab
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

William K KarlssonDepartment of Neurology, Danish Headache Center, Copenhagen University Hospital- Rigshospitalet, Copenhagen, Denmark.
Rune H ChristensenDepartment of Neurology, Danish Headache Center, Copenhagen University Hospital- Rigshospitalet, Copenhagen, Denmark.
Haidar M Al-KhazaliDepartment of Neurology, Danish Headache Center, Copenhagen University Hospital- Rigshospitalet, Copenhagen, Denmark.
Thomas KallemoseDepartment of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark.
Baker N JawadDepartment of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark.
Ove AndersenDepartment of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Messoud AshinaDepartment of Neurology, Danish Headache Center, Copenhagen University Hospital- Rigshospitalet, Copenhagen, Denmark.
Håkan AshinaDepartment of Neurology, Danish Headache Center, Copenhagen University Hospital- Rigshospitalet, Copenhagen, Denmark. haakan.ashina@regionh.dk.

Funding

Lundbeck Foundation R310-2018-3711Lundbeck Foundation R403-2022-1352
6 · The paper itself

Abstract

backgroundSoluble urokinase-plasminogen activator receptor (suPAR) is a biomarker of systemic inflammation and elevated in plasma of individuals with migraine with aura. As inflammatory cytokines can upregulate calcitonin gene-related peptide (CGRP), suPAR levels might be linked to response to CGRP-targeting therapies. Therefore, we investigated whether plasma suPAR levels are associated with response to the CGRP-receptor antagonist erenumab.

methodsIn this single-center, prospective study, adults with ≥ 4 monthly migraine days received 140 mg erenumab subcutaneously every 4 weeks for 24 weeks. Blood samples were collected at baseline, Week 24 (end of treatment), and Week 48 (24 weeks post-treatment). Responders were defined as achieving a ≥ 50% reduction in monthly migraine days from baseline to weeks 13-24. Associations between baseline suPAR and treatment response were analyzed using logistic and linear regression. Longitudinal changes in suPAR were assessed using linear mixed models.

resultsThe study included 623 participants with migraine (mean age 44.1 ± 12.3 years; 90.4% female) and 154 healthy controls. Among participants, 183 (29.4%) had migraine with aura, and 406 (65.2%) had chronic migraine. Baseline plasma suPAR levels were not associated with response to erenumab in the total migraine population (odds ratio [OR] 0.83, 95% confidence interval [CI] 0.64 to 1.07; p = 0.14) or in the aura subgroup (OR 0.73, 95% CI 0.48 to 1.10; p = 0.14). Plasma suPAR levels were significantly higher in non-responders compared to responders at Week 48 (7.5% higher, 95% CI 3.3 to 11.5%; p = 0.005). Non-responders with aura had higher suPAR concentrations than controls at baseline (difference 10.1%; 95% CI 3.0 to 17.8%; p = 0.023) and Week 24 (8.7%; 95% CI 1.6 to 16.2%; p = 0.047). These differences persisted at Week 48 (12.4%; 95% CI 4.6 to 20.7%; p = 0.013). No longitudinal changes in suPAR concentrations were observed.

conclusionsWe did not find an association between baseline plasma suPAR levels and response to erenumab. Plasma suPAR concentrations remained stable, even among participants with aura. These findings suggest that systemic low-grade inflammation, as measured by suPAR, does not influence treatment efficacy.

trial registrationPre-registered on ClinicalTrials.gov (NCT04603976 and NCT04674020).

Indexed as

Antibodies, Monoclonal, HumanizedCalcitonin Gene-Related Peptide Receptor AntagonistsMigraine DisordersReceptors, Urokinase Plasminogen ActivatorAdultBiomarkersFemaleHumansMaleMiddle AgedProspective StudiesTreatment OutcomeAntibodies, Monoclonal, HumanizedBiomarkersCalcitonin Gene-Related Peptide Receptor AntagonistserenumabPLAUR protein, humanReceptors, Urokinase Plasminogen ActivatorBiomarkerBloodCGRPEfficacyInflammationPredictors

Identifiers

PMID40275185
PMCPMC12020035

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.