Lomerizine Prophylaxis for Pediatric Migraine: Efficacy and Predictors of Treatment Response—A Retrospective Cohort Study

Medical Sciences · Published 2026-07-29 · DOI 10.3390/medsci14040447

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Hideki Shimomura, Sachi Tokunaga, Naoko Taniguchi, Eisuke Terasaki, Saeka Yoshitake, Ayuko Usami, Shintaro Iwamoto, Yasuhiro Takeshima

Abstract

<b>Background/Objectives:</b> There is limited evidence supporting the use of lomerizine, a calcium channel blocker approved for migraine prophylaxis in Japan, in children. This study evaluated the prophylactic efficacy of lomerizine in a pediatric population with migraine and identified the baseline factors independently associated with treatment response. <b>Methods:</b> This single-center, retrospective cohort study enrolled 83 patients aged ≤18 years prescribed lomerizine for migraine prophylaxis. The primary outcome was headache improvement, defined as a ≥50% reduction in monthly headache days from baseline, assessed at 3–4 and 6–8 months. Multivariable logistic regression included prespecified comorbidity-based covariates: psychosocial factors, neurodevelopmental disorder, and postural orthostatic tachycardia syndrome. <b>Results:</b> Headache improvement was observed in 34 of 80 (42.5%) patients at 3–4 months, and in 36 of 71 (50.7%) patients at 6–8 months. Response rates at 3–4 months and 6–8 months, respectively, were 57.7% and 67.4% among patients without psychosocial factors and 14.3% and 20.0% among those with psychosocial factors. Psychosocial factors were the only variables independently associated with a lower probability of improvement at both time points (3–4 months: adjusted odds ratio, 0.122; 95% confidence interval, 0.036–0.419; <i>p</i> < 0.001; 6–8 months: adjusted odds ratio, 0.137; 95% confidence interval, 0.041–0.456; <i>p</i> = 0.001). <b>Conclusions:</b> Patients receiving lomerizine experienced clinically meaningful improvement in headache frequency, particularly those without psychosocial comorbidity. Psychosocial comorbidity was the only baseline factor independently associated with a poor treatment response, underscoring the potential importance of routine psychosocial screening and a possible benefit from concurrent psychological interventions; these findings require prospective confirmation.

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Publication details

Year
2026

Citation

Shimomura, H., Tokunaga, S., Taniguchi, N., et al. (2026). Lomerizine Prophylaxis for Pediatric Migraine: Efficacy and Predictors of Treatment Response—A Retrospective Cohort Study. Medical Sciences. https://doi.org/10.3390/medsci14040447

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