Pharmacy Daily | Call to raise migraine target

NEW migraine treatment recommendations suggest raising the target reduction of migraine days from the current standard of 50% reduction to 90-100%.

If adopted, the new four-level framework for assessing migraine control proposed by the International Headache Society (IHS) has the potential to improve the lives of millions of Australians affected by migraine.

"It was time for new recommendations that will bring us closer to managing migraine as a disease that can be controlled in a similar way to epilepsy, multiple sclerosis and other chronic conditions," commented Dr Faraidoon Haghdoost from the George Institute for Global Health, who was one of the contributors to the IHS Position Statement.

"The consistency of new agents in multiple clinical trials and real-world studies to achieve effective and sustained migraine prevention, means we can offer more hope for eliminating disability from migraine and for sufferers to be able to live free from constant worry about the next attack, the debilitating pain, and the frustration of not being taken seriously," said Dr Haghdoost.

Traditionally, a 50% reduction in migraine days per month - or a 30% reduction for those with chronic or harder-to-treat symptoms - was the benchmark for a successful response to therapies.

But this translates to many days still impacted by migraine.

"We can now strive for much better results through personalised treatment, whether that's combination therapy or using the new agents," said Dr Haghdoost.

"The recommendations from the IHS encourage clinicians to make ongoing efforts to further reduce headache frequency and improve quality of life, rather than settling for a predefined reduction target."

In Australia, patients need to record at least 15 headache days per month to qualify for PBS reimbursement of eptinezumab (Vyepti), one of the newer agents for the prevention of migraines.

"Expanding the criteria to capture those with fewer than 15 headache days would lead to better results in line with new recommended international practice, and reduce the burden on patients and the healthcare system," suggested DrHaghdoost.

Pharmacists play an important role in managing patients with migraines and headaches and the PSA has several resources to help pharmacists stay informed about treatment options - see HERE. KB