New Delhi: After 14 years, doctors in the US have updated the guidelines to treat migraine attacks. The new recommendations include treatments that did not exist in the past decade.
“My hope is that this guideline helps clinicians feel more comfortable prescribing preventive treatments for people with migraine,” Rebecca Burch, a headache medicine specialist at the University of Vermont Medical Center in Burlington, said during a news briefing.
These recommendations include drugs that target calcitonin-gene-related peptide (CGRP), a protein that is involved in migraines. CGRP levels rise during a migraine attack and then fall back to normal eventually. Some of the new drugs targeting the CGRP protein have proven to reduce migraines by nearly 70 per cent in the long run.
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Amaal Starling, a neurologist specialising in headaches at the Mayo Clinic in Phoenix told Science News that the biggest difference in migraine treatments today, compared to 10 years ago, is the stress on migraine prevention.
“For the first time, we have disease-specific, mechanism-based, targeted treatment options for migraine prevention, and these are the CGRP-targeted treatment options. These medications … have high rates of efficacy and high rates of tolerability meaning very minimal side effects,” Starling said.
While the new recommendations highlighted drugs like Aimovig and Ajvoy, it did not completely dismiss older drugs. Many of the older drugs remain cheaper options for patients who prefer medicines with a longer track record.
“This practice guideline provides updated evidence-based recommendations regarding the use of pharmacologic migraine prevention in adults,” read the updated recommendations from the American Academy of Neurology and the American Headache Society, published on 31 August in Neurology.
The guidelines have also highlighted people who should not be consuming any of the drugs.
“Drugs taken during pregnancy have the potential to harm the fetus. As randomized controlled trials (RCTs) of drug safety during pregnancy are not ethically possible, no drug can be declared completely safe when taken during pregnancy,” the recommendations added.