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The American Headache Society Consensus Statement: Update on integrating new migraine treatments into clinical practice.
Headache. 2021 07; 61(7):1021-1039.H

Abstract

OBJECTIVE

To incorporate recent research findings, expert consensus, and patient perspectives into updated guidance on the use of new acute and preventive treatments for migraine in adults.

BACKGROUND

The American Headache Society previously published a Consensus Statement on the use of newly introduced treatments for adults with migraine. This update, which is based on the expanded evidence base and emerging expert consensus concerning postapproval usage, provides practical recommendations in the absence of a formal guideline.

METHODS

This update involved four steps: (1) review of data about the efficacy, safety, and clinical use of migraine treatments introduced since the previous Statement was published; (2) incorporation of these data into a proposed update; (3) review and commentary by the Board of Directors of the American Headache Society and patients and advocates associated with the American Migraine Foundation; (4) consideration of these collective insights and integration into an updated Consensus Statement.

RESULTS

Since the last Consensus Statement, no evidence has emerged to alter the established principles of either acute or preventive treatment. Newly introduced acute treatments include two small-molecule calcitonin gene-related peptide (CGRP) receptor antagonists (ubrogepant, rimegepant); a serotonin (5-HT1F) agonist (lasmiditan); a nonsteroidal anti-inflammatory drug (celecoxib oral solution); and a neuromodulatory device (remote electrical neuromodulation). New preventive treatments include an intravenous anti-CGRP ligand monoclonal antibody (eptinezumab). Several modalities, including neuromodulation (electrical trigeminal nerve stimulation, noninvasive vagus nerve stimulation, single-pulse transcranial magnetic stimulation) and biobehavioral therapy (cognitive behavioral therapy, biofeedback, relaxation therapies, mindfulness-based therapies, acceptance and commitment therapy) may be appropriate for either acute and/or preventive treatment; a neuromodulation device may be appropriate for acute migraine treatment only (remote electrical neuromodulation).

CONCLUSIONS

The integration of new treatments into clinical practice should be informed by the potential for benefit relative to established therapies, as well as by the characteristics and preferences of individual patients.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Ailani J
Department of Neurology, Medstar Georgetown University Hospital, Washington, DC, USA.
Burch RC
Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Robbins MS
Department of Neurology, Weill Cornell Medicine, New York, NY, USA.
Board of Directors of the American Headache Society
American Headache Society, Mt Royal, NJ, USA.

MeSH

Antibodies, Monoclonal, HumanizedBehavior TherapyCalcitonin Gene-Related PeptideCalcitonin Gene-Related Peptide Receptor AntagonistsConsensusElectric Stimulation TherapyHumansMigraine DisordersPeptide FragmentsPractice Guidelines as TopicReceptors, SerotoninSerotonin Receptor AgonistsSocieties, MedicalTranscranial Magnetic StimulationUnited States

Pub Type(s)

Journal Article

Language

eng

PubMed ID

34160823

Clinical Trial Links

Predictive Role of MIDAS Reduction at 3 Months for Erenumab Treatment

Citation

Ailani, Jessica, et al. "The American Headache Society Consensus Statement: Update On Integrating New Migraine Treatments Into Clinical Practice." Headache, vol. 61, no. 7, 2021, pp. 1021-1039.
Ailani J, Burch RC, Robbins MS, et al. The American Headache Society Consensus Statement: Update on integrating new migraine treatments into clinical practice. Headache. 2021;61(7):1021-1039.
Ailani, J., Burch, R. C., & Robbins, M. S. (2021). The American Headache Society Consensus Statement: Update on integrating new migraine treatments into clinical practice. Headache, 61(7), 1021-1039. https://doi.org/10.1111/head.14153
Ailani J, et al. The American Headache Society Consensus Statement: Update On Integrating New Migraine Treatments Into Clinical Practice. Headache. 2021;61(7):1021-1039. PubMed PMID: 34160823.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The American Headache Society Consensus Statement: Update on integrating new migraine treatments into clinical practice. AU - Ailani,Jessica, AU - Burch,Rebecca C, AU - Robbins,Matthew S, AU - ,, Y1 - 2021/06/23/ PY - 2021/05/04/revised PY - 2021/03/16/received PY - 2021/05/09/accepted PY - 2021/6/24/pubmed PY - 2022/2/15/medline PY - 2021/6/23/entrez KW - acute KW - consensus KW - migraine KW - preventive KW - principles KW - treatment SP - 1021 EP - 1039 JF - Headache JO - Headache VL - 61 IS - 7 N2 - OBJECTIVE: To incorporate recent research findings, expert consensus, and patient perspectives into updated guidance on the use of new acute and preventive treatments for migraine in adults. BACKGROUND: The American Headache Society previously published a Consensus Statement on the use of newly introduced treatments for adults with migraine. This update, which is based on the expanded evidence base and emerging expert consensus concerning postapproval usage, provides practical recommendations in the absence of a formal guideline. METHODS: This update involved four steps: (1) review of data about the efficacy, safety, and clinical use of migraine treatments introduced since the previous Statement was published; (2) incorporation of these data into a proposed update; (3) review and commentary by the Board of Directors of the American Headache Society and patients and advocates associated with the American Migraine Foundation; (4) consideration of these collective insights and integration into an updated Consensus Statement. RESULTS: Since the last Consensus Statement, no evidence has emerged to alter the established principles of either acute or preventive treatment. Newly introduced acute treatments include two small-molecule calcitonin gene-related peptide (CGRP) receptor antagonists (ubrogepant, rimegepant); a serotonin (5-HT1F) agonist (lasmiditan); a nonsteroidal anti-inflammatory drug (celecoxib oral solution); and a neuromodulatory device (remote electrical neuromodulation). New preventive treatments include an intravenous anti-CGRP ligand monoclonal antibody (eptinezumab). Several modalities, including neuromodulation (electrical trigeminal nerve stimulation, noninvasive vagus nerve stimulation, single-pulse transcranial magnetic stimulation) and biobehavioral therapy (cognitive behavioral therapy, biofeedback, relaxation therapies, mindfulness-based therapies, acceptance and commitment therapy) may be appropriate for either acute and/or preventive treatment; a neuromodulation device may be appropriate for acute migraine treatment only (remote electrical neuromodulation). CONCLUSIONS: The integration of new treatments into clinical practice should be informed by the potential for benefit relative to established therapies, as well as by the characteristics and preferences of individual patients. SN - 1526-4610 UR - https://www.unboundmedicine.com/medline/citation/34160823/The_American_Headache_Society_Consensus_Statement:_Update_on_integrating_new_migraine_treatments_into_clinical_practice_ DB - PRIME DP - Unbound Medicine ER -