Neurology

Epistemonikos EDT is a viable, cost‑free RCT source for migraine network meta‑analyses.

In a case study of pharmacological migraine RCTs, single‑database recall ranged 98.3–99.4%, and combinations reached 99.4–100% compared to a reference standard. Different search sets produced similar network estimates and identical certainty‑of‑evidence ratings for low/moderate risk‑of‑bias trials. Specialized RCT databases (EDT, CENTRAL) reduced screening workload versus MEDLINE/Embase, despite simpler export and documentation features in EDT. The pilot EDT offered reproducible, cost‑free searching suitable for systematic reviews of migraine pharmacotherapy. 1

Early cognitive gains in MS often reflect measurement bias; re‑baseline improves prognostic accuracy.

In 148 pwMS assessed at baseline, ~1 year (re‑baseline), and ~6 years, many early cognitive improvements were seen after accounting for practice effects. About 40% of participants classified as cognitively impaired at baseline reverted to cognitively preserved at re‑baseline. Cognitively preserved participants remained stable, with conversion rates to impairment below 1% over follow‑up. Authors recommend routine re‑baseline assessment before assigning long‑term cognitive prognosis in MS. 2

Real‑world data: gepants improve 24‑hour pain relief versus triptans; 2‑hour outcomes similar.

In a US survey of 1,570 acute monotherapy users (567 gepant, 1,003 triptan), gepants had higher odds of 24‑hour pain relief (adjusted OR 1.36, 95% CI 1.09–1.71). There was no significant difference between classes for 2‑hour pain freedom. Higher symptom severity, attack frequency, disability, and preventive treatment use predicted poorer acute outcomes across both drug classes. Findings support considering gepants when extended symptom control matters, while awaiting randomized head‑to‑head trials. 3