New and Old Migraine Treatments Highlight American Headache Society Meeting

New and Old Migraine Treatments Highlight American Headache Society Meeting

While study results for new treatments for migraine headaches continue to inspire hope for the 36 million Americans suffering from migraines, today’s current treatments also came in for scrutiny at the American Headache Society 57th Annual Scientific Meeting in Washington, D.C.

More on the new treatments in a moment – first, let’s discuss what’s happening right now.

A study suggests that inappropriate prescribing of opioids and barbiturates for the treatment of migraine is common.

Despite several specialty societies recommending caution against indiscriminate use of opioids and barbiturates as treatment for migraines, results of a survey indicate that about 20% of patients who presented at a headache center reported use of one or both of these treatments.

The study is the first to examine recent statistics on opioid and barbiturate – containing medication use in patients presenting to a headache center, said Mina T. Minen, MD, MPH, director of Headache Services and assistant professor in the Department of Neurology at New York University Langone Medical Center.

The majority of patients (83.9%) were diagnosed with migraine, with more than half of patients reported being prescribed an opioid (55.6%) or a barbiturate (56.7%). Furthermore, one in five was on opioids (19.4%) and barbiturates (20.8%) at the time of completing the survey.

Overall, 63% of patients prescribed an opioid found it effective and 64.2% of patients given a barbiturate-containing medication found it effective.

The American Academy of Neurology’s position paper on opioid use says that no substantial evidence supports long-term use of opioids and that it incurs serious risk of overdose, dependence, or addiction.

“We found it surprising that despite guidelines stating that these medications are not recommended as first-line treatments for primary headache disorders, [they] are still in use by a substantial number of patients,”  Dr Minen told  Medscape Medical News.

Meanwhile, as we reported earlier this week, study results on a new class of anti-calcitonin gene-related peptide (CGRP) monoclonal antibodies to fight migraine highlighted the meeting. Big players like Lilly (NYSE:LLY), Teva (NYSE:TEVA) and Amgen (NASDAQ:AMGN) along with high flying start up Alder Biopharmaceuticals (NASDAQ:ALDR) are in various stages of drug development. CGRP modulates transmission of pain and dilation of blood vessels.

“This development is a transformative moment in migraine treatment,” said Peter J. Goadsby, MD, PhD, who is chair of the scientific program of the American Headache Society’s annual Scientific Meeting.  Dr. Goadsby is Chief of the UCSF Headache Center, and one of the world’s leading headache treatment experts and researchers. (Here’s the release from the American Headache Society)

More than 36 million Americans suffer from migraine attacks, more than have asthma or diabetes combined. About four million have Chronic Migraine or experience more than 15 migraine days a month. High-Frequency Episodic Migraine is defined as 10-14 headache days per month, while episodic migraine (EM) is characterized by those with migraine who have 0 to 14 headache days per month. Migraine can be extremely disabling and costly, accounting for more than $20 billion in direct (e.g. doctor visits, medications) and indirect (e.g. missed work, lost productivity) expenses each year in the United States.


Authored by: Ed Coghlan