Theranica, a neuromodulation therapeutics company advancing migraine care through its proprietary Remote Electrical Neuromodulation (REN) technology, announced results from the largest and longest-running real-world evidence study of migraine treatment in the U.S. veteran population published to date. The peer-reviewed study, published in Military Medicine, the official journal of AMSUS – the Society of Federal Health Professionals, found that Nerivio, the company's FDA-cleared REN wearable, gave veterans consistent, patient-centered relief from migraine while reducing their reliance on prescribed migraine medications.
The prospective real-world evidence study, conducted in accordance with the FDA's Real-World Evidence framework, followed 466 veterans cared for by the Veterans Health Administration (VHA) across 28,274 REN treatments between November 2020 and February 2026. It was co-authored by neurologists from VHA Headache Centers of Excellence in Nashville, TN and Chicago, IL, the Central Virginia VA Health Care System and Virginia Commonwealth University, and the VA Connecticut Healthcare System, alongside Theranica’s medical information and research team. The study’s multi-site authorship reflects REN’s existing clinical integration across several VHA Headache Centers of Excellence nationwide.
In 77 per cent of REN treatments, veterans avoided prescribed medication entirely for acute migraine care — using REN as a stand-alone therapy in 61 per cent of treatments and pairing it with an over-the-counter option in 16 per cent.
Efficacy results were consistent with previous randomized controlled trials and real-world evidence studies with REN:
Post 2-hour pain relief was achieved by 66.7 per cent of patients, and post 2-hour pain freedom in 26.6 per cent of patients;
Post 2-hour relief from functional disability was achieved by 69.3 per cent of patients, and complete freedom from functional disability by 33.3 per cent;
Post 2-hour freedom from associated migraine symptoms - sensitivity to light and sound, nausea/vomiting - in 56.5 per cent of the patients.
Timing proved critical to outcomes: Veterans who began treatment within one hour of their migraine onset saw significantly greater benefit than those who treated later, including up to 28 percentage points higher functional disability relief and double the likelihood of achieving functional disability freedom (2.0x).
As expected, safety findings were very favorable: only 2 of 466 patients (0.4 per cent) reported device-related adverse events, both local, mild and non-serious.
“This large, peer-reviewed study provides important evidence supporting the role of non-pharmacologic approaches in the treatment of migraine, particularly for patients with complex medical needs,” said Dr. David Shulkin, former U.S. Secretary of Veterans Affairs. “Many veterans manage multiple chronic conditions and already face significant medication burdens. Findings such as these highlight the potential value of safe, evidence-based, drug-free treatment options as part of a comprehensive approach to migraine care.”
Alon Ironi, CEO and Co-Founder of Theranica said, “Nerivio can be prescribed to eligible patients by any certified clinician, not just neurologists. That means shorter access time for patients in need, as they do not need to wait for a neurologist appointment.”
Migraine and other headache disorders are especially common among U.S. veterans, who frequently manage them alongside service-related conditions such as PTSD, traumatic brain injury, depression, anxiety, and chronic musculoskeletal pain. This complex clinical picture often limits the use of standard migraine medications because of contraindications or the risks of polypharmacy — a challenge the study's authors identify as a key reason for expanding access to well-tolerated, non-pharmacological options like REN within veteran care. This aligns directly with the VHA’s own Opioid Safety Initiative and its institutional priority to expand non-pharmacological, non-opioid options for veteran pain management.
“Veterans with migraine are among the most clinically complex patients we treat, often managing multiple service-related conditions alongside their headache disorder,” said Dr. Alan R. Towne, a neurologist at the Central Virginia VA Health Care System in Richmond, Virginia, Director of its Headache Center of Excellence, Professor of Neurology Virginia Commonwealth University, and a co-author of the study. “What stood out to me was how consistently veterans were able to manage their migraine attacks with Nerivio alone, without reaching for additional medication. For a population where polypharmacy is a real and constant concern, having an effective, non-drug option we can build into a treatment plan is enormously valuable.”
