Acute Treatment of Migraine: Expert Consensus Statements from the United Arab Emirates (UAE).
Acute migraine
CGRP-based therapy
Consensus statements
Gepants
Recommendations
Journal
Neurology and therapy
ISSN: 2193-8253
Titre abrégé: Neurol Ther
Pays: New Zealand
ID NLM: 101637818
Informations de publication
Date de publication:
Apr 2024
Apr 2024
Historique:
received:
17
11
2023
accepted:
22
12
2023
pubmed:
19
1
2024
medline:
19
1
2024
entrez:
19
1
2024
Statut:
ppublish
Résumé
Migraine, characterized by recurrent headaches and often accompanied by other symptoms like nausea, vomiting, and sensitivity to light and sound, significantly impacts patients' quality of life (QoL) and daily functioning. The global burden of migraines is reflected not only in terms of reduced QoL but also in the form of increased healthcare costs and missed work or school days. While UAE (United Arab Emirates)-specific consensus-based recommendations for the effective use of preventive calcitonin gene-related peptide (CGRP)-based migraine therapies have been published previously, an absence of such regional guidance on the management of acute migraine represents a gap that needs to be urgently addressed. A task force of eight neurologists from the UAE with expertise in migraine management conducted a comprehensive literature search and developed a set of expert statements on the management of acute migraine that were specific to the UAE context. To ensure diverse perspectives are considered, a Delphi panel comprising 16 neurologists plus the task force members was set up. Consensus was achieved using a modified Delphi survey method. Consensus was predefined as a median rating of 7 or higher without discordance (if > 25% of the Delphi panelists rate an expert statement as 3 or lower on the Likert scale). Expert statements achieving consensus were adopted. The Modified Delphi method was used successfully to achieve consensus on all nine expert statements drafted by the task force. These consensus statements aim to provide a comprehensive guide for UAE healthcare professionals in treating acute migraine. The statements cover all aspects of acute migraine treatment, including what goals to set, the timing of treatment, treatment strategy to use in case of inadequate response to triptans, safety aspects of combining gepants for acute attacks with preventive CGRP-based therapies, special population (pregnant and pediatric patients) considerations, and the management of the most bothersome symptoms (MBS). Adopting these consensus statements on the treatment of acute migraine can help enhance patient care, improve outcomes, and standardize treatment practices in the UAE. The collaborative effort of experts with diverse experiences in developing these consensus statements will strengthen the credibility and applicability of these statements to various healthcare settings in the country.
Identifiants
pubmed: 38240944
doi: 10.1007/s40120-023-00576-4
pii: 10.1007/s40120-023-00576-4
doi:
Types de publication
Journal Article
Langues
eng
Pagination
257-281Informations de copyright
© 2024. The Author(s).
Références
Pescador RM, De Jesus O. Migraine Headache. Treasure Island (FL): StatPearls; 2023 Jan. https://www.ncbi.nlm.nih.gov/books/NBK560787/ . Accessed 3 Oct 2023
The Institute for Health Metrics and Evaluation. Global Health Metrics: Migraine—Level 4 cause. https://www.healthdata.org/results/gbd_summaries/2019/migraine-level-4-cause . Accessed 3 Oct 2023
Steiner TJ, Stovner LJ. Global epidemiology of migraine and its implications for public health and health policy. Nat Rev Neurol. 2023;19(2):109–17. https://doi.org/10.1038/s41582-022-00763-1 .
doi: 10.1038/s41582-022-00763-1
pubmed: 36693999
Battista S, Lazzaretti A, Coppola I, Falsiroli Maistrello L, Rania N, Testa M. Living with migraine: a meta-synthesis of qualitative studies. Front Psychol. 2023. https://doi.org/10.3389/fpsyg.2023.1129926 .
doi: 10.3389/fpsyg.2023.1129926
pubmed: 37701866
pmcid: 10494980
Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018;38(1):1–211. https://doi.org/10.1177/0333102417738202 .
Lipton RB, Buse DC, Nahas SJ, et al. Risk factors for migraine disease progression: a narrative review for a patient-centered approach. J Neurol. 2023. https://doi.org/10.1007/s00415-023-11880-2 .
doi: 10.1007/s00415-023-11880-2
pubmed: 37615752
pmcid: 10632231
Puledda F, Silva EM, Suwanlaong K, Goadsby PJ. Migraine: from pathophysiology to treatment. J Neurol. 2023;270(7):3654–66. https://doi.org/10.1007/s00415-023-11706-1 .
doi: 10.1007/s00415-023-11706-1
pubmed: 37029836
pmcid: 10267278
Labastida-Ramírez A, Caronna E, Gollion C, et al. Mode and site of action of therapies targeting CGRP signaling. J Headache Pain. 2023;24(1):125. https://doi.org/10.1186/s10194-023-01644-8 .
doi: 10.1186/s10194-023-01644-8
pubmed: 37691118
pmcid: 10494408
Ryvlin P, Skorobogatykh K, Negro A, et al. Current clinical practice in disabling and chronic migraine in the primary care setting: results from the European My-LIFE anamnesis survey. BMC Neurol. 2021;21(1):1. https://doi.org/10.1186/s12883-020-02014-6 .
doi: 10.1186/s12883-020-02014-6
pubmed: 33390161
pmcid: 7780632
Katsarava Z, Mania M, Lampl C, Herberhold J, Steiner TJ. Poor medical care for people with migraine in Europe—evidence from the Eurolight study. J Headache Pain. 2018;19(1):10. https://doi.org/10.1186/s10194-018-0839-1 .
doi: 10.1186/s10194-018-0839-1
pubmed: 29392600
pmcid: 5794675
Eigenbrodt AK, Ashina H, Khan S, et al. Diagnosis and management of migraine in ten steps. Nat Rev Neurol. 2021;17(8):501–14. https://doi.org/10.1038/s41582-021-00509-5 .
doi: 10.1038/s41582-021-00509-5
pubmed: 34145431
pmcid: 8321897
Ailani J, Burch RC, Robbins MS. The American Headache Society consensus statement: update on integrating new migraine treatments into clinical practice. Headache J Head Face Pain. 2021;61(7):1021–39. https://doi.org/10.1111/head.14153 .
doi: 10.1111/head.14153
Alsaadi T, Kayed DM, Al-Madani A, et al. Consensus-based recommendations on the use of CGRP-based therapies for migraine prevention in the UAE. Neurol Ther. 2023. https://doi.org/10.1007/s40120-023-00550-0 .
doi: 10.1007/s40120-023-00550-0
pubmed: 37792218
pmcid: 10444733
Ferrari MD, Goadsby PJ, Burstein R, et al. Migraine. Nat Rev Dis Primers. 2022;8(1):2. https://doi.org/10.1038/s41572-021-00328-4 .
doi: 10.1038/s41572-021-00328-4
pubmed: 35027572
Malone C, Wachholtz A, Bhowmick A. Migraine: treatments, comorbidities, and quality of life, in the USA. J Pain Res. 2015. https://doi.org/10.2147/JPR.S88207 .
doi: 10.2147/JPR.S88207
pubmed: 26316804
pmcid: 4540217
Amiri P, Kazeminasab S, Nejadghaderi SA, et al. Migraine: a review on its history, global epidemiology, risk factors, and comorbidities. Front Neurol. 2022. https://doi.org/10.3389/fneur.2021.800605 .
doi: 10.3389/fneur.2021.800605
pubmed: 36686533
pmcid: 9226565
Gago-Veiga A, Huhn JI, Latysheva N, et al. InterMiG: international differences in the therapeutic approach to migraine patients in specialized headache centers. J Headache Pain. 2021;22(1):43. https://doi.org/10.1186/s10194-021-01258-y .
doi: 10.1186/s10194-021-01258-y
pubmed: 34030634
pmcid: 8142511
Diener HC, Tassorelli C, Dodick DW, et al. Guidelines of the International Headache Society for controlled trials of acute treatment of migraine attacks in adults: fourth edition. Cephalalgia. 2019;39(6):687–710. https://doi.org/10.1177/0333102419828967 .
doi: 10.1177/0333102419828967
pubmed: 30806518
pmcid: 6501455
Goadsby P, Zanchin G, Geraud G, et al. Early vs. non-early intervention in acute migraine—‘Act When Mild (AwM)’. a double-blind, placebo-controlled trial of almotriptan. Cephalalgia. 2008;28(4):383–91. https://doi.org/10.1111/j.1468-2982.2008.01546.x .
doi: 10.1111/j.1468-2982.2008.01546.x
pubmed: 18294251
Lantéri-Minet M, Mick G, Allaf B. Early dosing and efficacy of triptans in acute migraine treatment: the TEMPO study. Cephalalgia. 2012;32(3):226–35. https://doi.org/10.1177/0333102411433042 .
doi: 10.1177/0333102411433042
pubmed: 22234883
Mínguez-Olaondo A, Quintas S, Morollón Sánchez-Mateos N, et al. Cutaneous allodynia in migraine: a narrative review. Front Neurol. 2022. https://doi.org/10.3389/fneur.2021.831035 .
doi: 10.3389/fneur.2021.831035
pubmed: 35720084
pmcid: 9198643
Burstein R, Jakubowski M. Analgesic triptan action in an animal model of intracranial pain: a race against the development of central sensitization. Ann Neurol. 2004;55(1):27–36. https://doi.org/10.1002/ana.10785 .
doi: 10.1002/ana.10785
pubmed: 14705109
Lipton RB, Dodick DW, Goadsby PJ, et al. Efficacy of ubrogepant in the acute treatment of migraine with mild pain vs moderate or severe pain. Neurology. 2022;99(17):e1905–15. https://doi.org/10.1212/WNL.0000000000201031 .
doi: 10.1212/WNL.0000000000201031
pubmed: 35977836
pmcid: 9620813
Dodick DW, Goadsby PJ, Schwedt TJ, et al. Ubrogepant for the acute treatment of migraine when administered during the prodrome (premonitory phase): results from a phase 3, randomized, double-blind, placebo-controlled, crossover study (S47.001). In: Thursday, April 27. Lippincott Williams & Wilkins; 2023:1666. https://doi.org/10.1212/WNL.0000000000202043 .
Schwedt TJ, Lipton RB, Goadsby PJ, et al. Characterizing prodrome (premonitory phase) in migraine: results from the PRODROME Trial Screening Period (S41.009). In: Wednesday, April 26. Lippincott Williams & Wilkins; 2023:1669. https://doi.org/10.1212/WNL.0000000000202046 .
Goadsby PJ, Ailani J, Dodick DW, et al. Efficacy of ubrogepant for the treatment of migraine symptoms during the prodrome (premonitory phase): results from the PRODROME Trial (S47.002). In: Thursday, April 27. Lippincott Williams & Wilkins; 2023:1670. https://doi.org/10.1212/WNL.0000000000202047 .
Lipton RB, Stewart WF, Stone AM, Láinez MJA, Sawyer JPC. Stratified care vs step care strategies for migraine. JAMA. 2000;284(20):2599. https://doi.org/10.1001/jama.284.20.2599 .
doi: 10.1001/jama.284.20.2599
pubmed: 11086366
Bahra A, Walsh M, Menon S, Goadsby PJ. Does chronic daily headache arise de novo in association with regular use of analgesics? Headache J Head Face Pain. 2003;43(3):179–90. https://doi.org/10.1046/j.1526-4610.2003.03041.x .
doi: 10.1046/j.1526-4610.2003.03041.x
Williams P, Dowson AJ, Rapoport AM, Sawyer J. The cost effectiveness of stratified care in the management of migraine. Pharmacoeconomics. 2001;19(8):819–29. https://doi.org/10.2165/00019053-200119080-00004 .
doi: 10.2165/00019053-200119080-00004
pubmed: 11596834
Altamura C, Brunelli N, Marcosano M, Fofi L, Vernieri F. Gepants—a long way to cure: a narrative review. Neurol Sci. 2022;43(9):5697–708. https://doi.org/10.1007/s10072-022-06184-8 .
doi: 10.1007/s10072-022-06184-8
pubmed: 35650458
pmcid: 9159895
Amara SG, Jonas V, Rosenfeld MG, Ong ES, Evans RM. Alternative RNA processing in calcitonin gene expression generates mRNAs encoding different polypeptide products. Nature. 1982;298(5871):240–4. https://doi.org/10.1038/298240a0 .
doi: 10.1038/298240a0
pubmed: 6283379
Lipton RB, Dodick DW, Ailani J, et al. Effect of ubrogepant vs placebo on pain and the most bothersome associated symptom in the acute treatment of migraine. JAMA. 2019;322(19):1887. https://doi.org/10.1001/jama.2019.16711 .
doi: 10.1001/jama.2019.16711
pubmed: 31742631
pmcid: 6865323
Lipton RB, Croop R, Stock EG, et al. Rimegepant, an oral calcitonin gene-related peptide receptor antagonist, for migraine. N Engl J Med. 2019;381(2):142–9. https://doi.org/10.1056/NEJMoa1811090 .
doi: 10.1056/NEJMoa1811090
pubmed: 31291516
Clemow DB, Johnson KW, Hochstetler HM, Ossipov MH, Hake AM, Blumenfeld AM. Lasmiditan mechanism of action—review of a selective 5-HT1F agonist. J Headache Pain. 2020;21(1):71. https://doi.org/10.1186/s10194-020-01132-3 .
doi: 10.1186/s10194-020-01132-3
pubmed: 32522164
pmcid: 7288483
Goadsby PJ, Wietecha LA, Dennehy EB, et al. Phase 3 randomized, placebo-controlled, double-blind study of lasmiditan for acute treatment of migraine. Brain. 2019;142(7):1894–904. https://doi.org/10.1093/brain/awz134 .
doi: 10.1093/brain/awz134
pubmed: 31132795
pmcid: 6620826
Leroux E, Buchanan A, Lombard L, et al. Evaluation of patients with insufficient efficacy and/or tolerability to triptans for the acute treatment of migraine: a systematic literature review. Adv Ther. 2020;37(12):4765–96. https://doi.org/10.1007/s12325-020-01494-9 .
doi: 10.1007/s12325-020-01494-9
pubmed: 32990921
pmcid: 7595976
Sacco S, Lampl C, Amin FM, et al. European Headache Federation (EHF) consensus on the definition of effective treatment of a migraine attack and of triptan failure. J Headache Pain. 2022;23(1):133. https://doi.org/10.1186/s10194-022-01502-z .
doi: 10.1186/s10194-022-01502-z
pubmed: 36224519
pmcid: 9555163
Shah T, Bedrin K, Tinsley A. Calcitonin gene relating peptide inhibitors in combination for migraine treatment: a mini-review. Front Pain Res. 2023. https://doi.org/10.3389/fpain.2023.1130239 .
doi: 10.3389/fpain.2023.1130239
Jakate A, Blumenfeld AM, Boinpally R, et al. Pharmacokinetics and safety of ubrogepant when coadministered with calcitonin gene-related peptide-targeted monoclonal antibody migraine preventives in participants with migraine: a randomized phase 1b drug–drug interaction study. Headache J Head Face Pain. 2021;61(4):642–52. https://doi.org/10.1111/head.14095 .
doi: 10.1111/head.14095
Lipton RB, Contreras-De Lama J, Serrano D, et al. COmbining UbRogepAnt and Preventives for MiGrainE (COURAGE) study using the migraine buddy application: a novel, entirely remote design for collecting real-world evidence. Headache. 2021;61(SUPPL 1):1–178.
Freitag FG, Tolebeyan A, Sivakumar D. 63rd Annual Scientific Meeting American Headache Society®. Headache J Head Face Pain. 2021;61(S1):1–178. https://doi.org/10.1111/head.14130 .
doi: 10.1111/head.14130
Ferrari A, Baraldi C, Licata M, Rustichelli C. Polypharmacy among headache patients: a cross-sectional study. CNS Drugs. 2018;32(6):567–78. https://doi.org/10.1007/s40263-018-0522-8 .
doi: 10.1007/s40263-018-0522-8
pubmed: 29752625
pmcid: 6061427
Negro A, Delaruelle Z, Ivanova TA, et al. Headache and pregnancy: a systematic review. J Headache Pain. 2017;18(1):106. https://doi.org/10.1186/s10194-017-0816-0 .
doi: 10.1186/s10194-017-0816-0
pubmed: 29052046
pmcid: 5648730
Aegidius K, Zwart J, Hagen K, Stovner L. The effect of pregnancy and parity on headache prevalence: the Head-HUNT Study. Headache J Head Face Pain. 2009;49(6):851–9. https://doi.org/10.1111/j.1526-4610.2009.01438.x .
doi: 10.1111/j.1526-4610.2009.01438.x
Amundsen S, Nordeng H, Nezvalová-Henriksen K, Stovner LJ, Spigset O. Pharmacological treatment of migraine during pregnancy and breastfeeding. Nat Rev Neurol. 2015;11(4):209–19. https://doi.org/10.1038/nrneurol.2015.29 .
doi: 10.1038/nrneurol.2015.29
pubmed: 25776823
Barnes NP. Migraine headache in children. BMJ Clin Evid. 2015;2015:0318.
Hershey AD. Current approaches to the diagnosis and management of paediatric migraine. Lancet Neurol. 2010;9(2):190–204. https://doi.org/10.1016/S1474-4422(09)70303-5 .
doi: 10.1016/S1474-4422(09)70303-5
pubmed: 20129168
Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the American Headache Society. Practice guideline update summary: acute treatment of migraine in children and adolescents. Neurology. 2020;94(1):50.1-50. https://doi.org/10.1212/WNL.0000000000008728 .
doi: 10.1212/WNL.0000000000008728
Orr SL, Kabbouche MA, O’Brien HL, Kacperski J, Powers SW, Hershey AD. Paediatric migraine: evidence-based management and future directions. Nat Rev Neurol. 2018;14(9):515–27. https://doi.org/10.1038/s41582-018-0042-7 .
doi: 10.1038/s41582-018-0042-7
pubmed: 30038237
Faber AJ, Lagman-Bartolome AM, Rajapakse T. Drugs for the acute treatment of migraine in children and adolescents. Paediatr Child Health. 2017;22(8):454–8. https://doi.org/10.1093/pch/pxx170 .
doi: 10.1093/pch/pxx170
pubmed: 29479263
pmcid: 5804596
U.S. Department of Health and Human Services, Food and Drug Administration, Food and Drug Administration. Migraine: developing drugs for acute treatment-guidance for industry. Published 2018. https://www.fda.gov/downloads/drugs/guidances/ucm419465.pdf . Accessed 19 Oct 2023.
Newman LC. Why triptan treatment can fail: focus on gastrointestinal manifestations of migraine. Headache J Head Face Pain. 2013;53(S1):11–6. https://doi.org/10.1111/head.12111 .
doi: 10.1111/head.12111
Ashina M, Vasudeva R, Jin L, et al. Onset of efficacy following oral treatment with lasmiditan for the acute treatment of migraine: integrated results from 2 randomized double-blind placebo-controlled phase 3 clinical studies. Headache J Head Face Pain. 2019;59(10):1788–801. https://doi.org/10.1111/head.13636 .
doi: 10.1111/head.13636
Brandes J, Kudrow D, Cady R, Tiseo P, Sun W, Sikes C. Eletriptan in the early treatment of acute migraine: influence of pain intensity and time of dosing. Cephalalgia. 2005;25(9):735–42. https://doi.org/10.1111/j.1468-2982.2005.00981.x .
doi: 10.1111/j.1468-2982.2005.00981.x
pubmed: 16109056
Klapper J, Lucas C, Røsjø Ø, Charlesworth B. Benefits of treating highly disabled migraine patients with zolmitriptan while pain is mild. Cephalalgia. 2004;24(11):918–24. https://doi.org/10.1111/j.1468-2982.2004.00735.x .
doi: 10.1111/j.1468-2982.2004.00735.x
pubmed: 15482352
Mathew NT, Kailasam J, Meadors L. Early treatment of migraine with rizatriptan: a placebo-controlled study. Headache J Head Face Pain. 2004;44(7):669–73. https://doi.org/10.1111/j.1526-4610.2004.04125.x .
doi: 10.1111/j.1526-4610.2004.04125.x
Cady RK, Sheftell F, Lipton RB, et al. Effect of early intervention with sumatriptan on migraine pain: Retrospective analyses of data from three clinical trials. Clin Ther. 2000;22(9):1035–48. https://doi.org/10.1016/S0149-2918(00)80083-1 .
doi: 10.1016/S0149-2918(00)80083-1
pubmed: 11048903
Croop R, Goadsby PJ, Stock DA, et al. Efficacy, safety, and tolerability of rimegepant orally disintegrating tablet for the acute treatment of migraine: a randomised, phase 3, double-blind, placebo-controlled trial. Lancet. 2019;394(10200):737–45. https://doi.org/10.1016/S0140-6736(19)31606-X .
doi: 10.1016/S0140-6736(19)31606-X
pubmed: 31311674
Dodick DW, Lipton RB, Ailani J, et al. Ubrogepant for the treatment of migraine. N Engl J Med. 2019;381(23):2230–41. https://doi.org/10.1056/NEJMoa1813049 .
doi: 10.1056/NEJMoa1813049
pubmed: 31800988
Croop R, Madonia J, Stock DA, et al. Zavegepant nasal spray for the acute treatment of migraine: a phase 2/3 double-blind, randomized, placebo-controlled, dose-ranging trial. Headache J Head Face Pain. 2022;62(9):1153–63. https://doi.org/10.1111/head.14389 .
doi: 10.1111/head.14389
Kuca B, Silberstein SD, Wietecha L, Berg PH, Dozier G, Lipton RB. Lasmiditan is an effective acute treatment for migraine. Neurology. 2018;91(24):e2222–32. https://doi.org/10.1212/WNL.0000000000006641 .
doi: 10.1212/WNL.0000000000006641
pubmed: 30446595
pmcid: 6329326