electroCore, Inc. announced two clinical studies focused on expanding the use of non-invasive vagus nerve stimulation (nVNS) for the acute and preventive treatment of migraine, and a recent publication of a real-world retrospective analysis which supports the use of nVNS as an effective therapeutic option for patients with cluster headache. Clinical developments featuring nVNS in migraine and cluster headache include: nVNS for the treatment of cluster headache: early UK clinical experience: This real-world retrospective analysis, published in theJournal of Headache and Pain examined data in chronic and episodic cluster headache patients (n=29 and n=1, respectively) who did not respond to or were intolerant of multiple preventive and/or acute treatments. Patients analyzed over an average of three to six months experienced a decrease in the frequency of cluster headache attacks, from 26.6 attacks per week to 9.5 attacks per week following initiation of nVNS, a mean difference of 17.1 (p<0.01). Average cluster headache attack duration decreased from 51.9 minutes to 29.4 minutes following the initiation of nVNS, a mean difference of 22.5 (p<0.01), and average cluster headache attack severity (rated on a 10-point scale) decreased from 7.8 to 6.0, a mean difference of 1.8 (p<0.01). Adverse events were mild and transient, and consistent with previous studies. These results extend the findings of registration trials of nVNS in cluster headache patients including the PREVA (PREVention and Acute treatment of chronic cluster headache) pivotal study, a prospective, open-label, controlled, randomized clinical trial that demonstrated the safety and effectiveness of gammaCore as an adjunctive therapy for the preventive treatment of cluster headache. Initiation and first patient enrolled in the PREMIUM II study in the United States: PREMIUM II, a multicenter, prospective, double-blind, randomized, sham-controlled study, will evaluate the efficacy and safety of nVNS for the preventive treatment of migraine. The study will enroll up to 500 patients in 35 sites in the United States, with an anticipated duration of 18 months. Real-world study on the practical utility of gammaCore in the treatment of patients in migraine, consistent with the PREVA study: This study will be initiated in the EU shortly, to support the role of nVNS for the prevention or treatment of migraine compared with the patient’s current therapy.