February 8, 2021 Gianna
Melillo
Migraine is a potential risk factor for asthma and asthma is a
potential risk indicator for migraine, authors of a systematic review and
meta-analysis concluded.
Migraine is a potential risk factor
for asthma and asthma is a potential risk
indicator for migraine, authors of a systematic review and meta-analysis
concluded.
Approximately 7% to 18% of the world’s population suffers from
asthma. Although this condition can be alleviated via inhaled corticosteroid
(ICS) or long-acting β-agonists (LABAs), no specific drug that can permanently
prevent the recurrence of asthma attacks exists.
It is estimated that 1.04 billion individuals suffer from
migraine globally and incidence is frequently comorbid with asthma. This
condition has been termed as "acephalic migraine" and "pulmonary
migraine."
Common pathophysiologic mechanisms of inflammation and immune
dysfunction, shared triggering and environmental factors, and emotional stress
or psychological distress could all contribute to the bidirectional association
between the 2 conditions.
To better understand the strength of the comorbid relationship
between migraine and asthma, researchers conducted a systematic review and
meta-analysis of population-based evidence. Articles listed in PubMed, Web of
Science, and SCOPUS, including text words and medical subject headings terms
"headache" or "migraine" and "asthma" until March
of 2020 were reviewed for inclusion in the analysis.
All articles in the review (n = 14) were population-based
cohort, case controlled, cross-sectional investigations, included an exposed
group of individuals with migraine or asthma and a healthy control group, and
reported outcomes in odds ratio (OR), relative risk (RR) or HR. Selection was
not restricted based on language of publication.
The 14 articles comprised 1,188,780 subjects, and 1 article
reported 2 cohort studies, for a total of 15 studies analyzed. Of the 15 studies,
3 were case-control, 6 were cross-sectional, and 6 were cohort. Articles
included studies from the United Kingdom, the United States, Korea, China,
Denmark, Norway, Israel, and Sweden. “Five studies relied upon questionnaire or
medical records to identify cases of migraine and/or asthma, while 9 relied
upon validated International Classification of Headache Disorders (ICHD)
or International Classification of Diseases (ICD)
codes,” the authors wrote.
Pooled analyses revealed:
·
Migraine was
associated with a significant increase of prevalent asthma (OR, 1.54; 95% CI,
1.34-1.77)
·
Patients with asthma
had a significantly increased risk for migraine (RR, 1.42; 95% CI, 1.26-1.60)
·
Migraine was
associated with a significant increase of prevalent asthma (OR, 1.45; 95% CI,
1.22-1.72)
·
Patients with asthma
had a significantly increased risk for migraine (HR, 1.47; 95% CI, 1.41-1.52)
“Migraine was associated with 54% increased prevalence and 42%
greater risk of asthma, and vice versa, asthma associated with 45%
increased prevalence and 47% greater risk of migraine,” researchers wrote.
Because only 1 case-control study was primarily of adolescents
and 5 of 6 cohort studies were conducted in Asia, results may not be
generalizable, marking a limitation to the review.
Future studies with large samples and different age groups ought
to be conducted to clarify the bidirectional relationship between the 2
conditions.
“The bidirectional relationship we found might aid in preventing
or identifying people with these 2 diseases. It is necessary to get further
information about potential overlapping pathways in pathogenesis, which may
facilitate the development of new treatment strategies for migraine and
asthma,” the authors concluded.
Reference
Wang L, Deng Z, Zu M, Zhang J, Wang Y. The comorbid relationship
between migraine and asthma: a systematic review and meta-analysis of
population-based studies. Front Med (Lausanne). Published
online January 13, 2021. doi:10.3389/fmed.2020.609528
https://www.ajmc.com/view/review-highlights-bidirectional-relationship-between-migraine-asthma
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