Background Chronic migraine (CM) and episodic migraine (EM) are associated with substantial headache-related disability, poor quality of life and global societal burden. In this subgroup analysis from the CONQUER study, we report efficacy outcomes from a pre-specified analysis of galcanezumab versus placebo in patients with CM or EM and 3–4 prior preventive medication category failures due to inadequate efficacy (after at least 2 months at maximum tolerated dose), or safety or tolerability reasons. The patient population is of particular interest due to evidence of decreased quality of life and increased economic burden among patients with migraine that is inadequately managed and is of interest to decision-makers globally. Methods Key outcomes included overall mean change from baseline in monthly migraine headache days and proportions of patients achieving ≥30% (CM), ≥50%, and ≥ 75% reduction (response rates) in monthly migraine headache days across Months 1–3. Patient functioning and disability were evaluated at Month 3. Results Of the 462 randomized patients, 186 (40.3%) had a history of 3–4 preventive category failures. Galcanezumab versus placebo resulted in significantly (P ≤ .001) larger overall mean reduction in monthly migraine headache days (total: − 5.49 versus − 1.03; CM: − 6.70 versus − 1.56; EM: − 3.64 versus − 0.65). Similarly, the ≥50% response rate was significantly (P ≤ .001) higher with galcanezumab versus placebo (total: 41.0 versus 12.7; CM: 41.5 versus 8.4; EM: 41.1 versus 16.5). In the CM group, the ≥30% response rate was significantly higher in the galcanezumab group than the placebo group (CM, 57.5 versus 19.8, P ≤ .0001) as was the ≥75% response rate (13.3 versus 2.6, P ≤ .05). Galcanezumab also resulted in significant (P < .0001) improvements in patient functioning and reductions in disability. Conclusions Galcanezumab was effective in a difficult-to-treat population of patients with CM or EM who had failed 3–4 prior preventive medication categories. Trial registration CONQUER. Clinicaltrials.gov identifier: NCT03559257.

The affiliation of the first author, Rose I. Okonkwo, was incorrectly stated as ''

Background: Currently in Nigeria, prescription only medicines are supposed to be dispensed only with a prescription. The study aimed to reveal the prevalence of prescription only medicine without a prescription and the perception of community pharmacist in Makurdi, Benue State Nigeria towards the phenomenon. Method: The study was carried out between February–April 2019 using simulated patient approach and administration of questionnaire on the pharmacists. Result: Forty pharmacies were surveyed and 100% (29) of the respondents were willing to dispense prescription only medicines without a prescription. Among the respondents, 93% (27) said they do see up to an estimated 30% of POMs without a prescription daily. While 19.2% (5) of the pharmacists do dispense POM without a prescription, 42.3% (11) said they do so depend on the level of education or prior exposure of the client to the medication. Only 38.5% (10) said they will not dispense a POM without a prescription. Most of the pharmacists, 93% (27) agreed that dispensing POM without with a prescription holds potentials for drug abuse, drug misuse, drug dependence with attendant economic consequences. Conclusion: A vast majority of practicing community pharmacists in Nigeria are willing and do dispense prescription-only medications without a valid prescription; for a variety of reasons. This is against existing Nigerian pharmacy laws and the national drug policy.

No abstract

BACKGROUND: The use of complimentary and alternative medicines has risen globally. We therefore, explored the prevalence and predictors of use of complementary and alternative medicines among healthcare workers. METHODS: This was a cross-sectional study that was conducted between 1st June and 31st August 2018 on the use of complementary and alternative medicines among health workers in Federal Medical Center Makurdi and Benue State University Teaching Hospital, Makurdi in Benue State. Questionnaire was used to collect data from respondents and data analysed using logistic binary regression models. RESULT: Response rate for the study was 80.2% out of which females were 196 (58.2%) with 215 (65.7%) in the age bracket of 31 &ndash; 60 years. Married respondents were 244 (72.4%) while Medical Doctors followed by Nurses were 87 (25.8%) and 84 (24.9%) respectively. Majority of the respondents, 113 (33.8%) have a monthly salary of above N100,000 (277.8 USD @ exchange rate of N360) while health workers of Tiv ethnic extraction had the highest number of 202 (60.7%) followed by those of Idoma extraction, 95 (28.5%). Those with years of work experience between (0 -15) were 268 (87.9%). The most used CAM was spiritual therapy, 230 (68.2%) while whole-body therapy was the least with 84 (24.9%). Use of biological therapy and manipulative therapy were 182 (54%) and 207 (61.4%) respectively. The odds of a female health worker using spiritual therapy was more than twice that of their male counterpart, (AOR: 2.218, 95% CI: 1.391 &ndash; 3.538). The odds of a Community Health Extension Worker and a medical doctor using a biological therapy among the study population were four times and almost thrice respectively compared to a pharmacist (AOR: 4.117, 95% CI: 1.690 &ndash; 10.030) and (AOR: 2.541, 95% CI: 1.095 &ndash; 5.896). The odds of an Idoma health worker using a manipulative and body-based therapy was thrice that of a Tiv health worker (AOR: 3.00, 95% CI: 1.318 &ndash; 6.829). While the odds of a Tiv health worker using whole-body therapy was seven times that of Idoma (AOR: 7.420, 95% CI: 2.186 &ndash; 25.188. CONCLUSION: There was high prevalence of CAM use by health workers and this has potentials to influence integration of CAM with conventional medicines.