Hostname: page-component-8448b6f56d-m8qmq Total loading time: 0 Render date: 2024-04-25T03:57:20.525Z Has data issue: false hasContentIssue false

Current management: migraine headache

Published online by Cambridge University Press:  19 January 2018

Stephen D. Silberstein*
Affiliation:
Jefferson Headache Center, Philadelphia, Pennsylvania, USA
*
*Address for correspondence: Stephen D. Silberstein, Department of Neurology, Thomas Jefferson University, 900 Walnut Street, 2nd Floor, Ste. 200, Philadelphia, PA 19107, USA. (Email: Stephen.Silberstein@jefferson.edu)

Abstract

Migraine varies in its frequency, severity, and impact; treatment should consider these variations and the patient’s needs and goals. Migraine pharmacologic treatment may be acute (abortive) or preventive (prophylactic), and patients often require both. New medication devices are available or in development, including an intracutaneous, microneedle system of zolmitriptan and sumatriptan, and breath-powered powder sumatriptan intranasal treatment. Lasmiditan, a 5-HT1F receptor agonist, is in development for acute treatment, as are small molecule calcitonin gene-related peptide (CGRP) receptor antagonists (Gepants) for acute and preventive treatment. Antibodies to CGRP and its receptor are being developed for migraine prevention. All 4 treatments are effective and have, as of yet, no safety concerns.

Type
CME Review Article
Copyright
© Cambridge University Press 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

This activity is supported by an unrestricted educational grant from Lilly USA.

References

1. Silberstein, SD. Migraine. Lancet. 2004; 363(9406): 381391.Google Scholar
2. Silberstein, SD, Saper, JR, Freitag, F. Migraine: diagnosis and treatment. In Silberstein SD, Lipton RB, Dalessio DJ, eds. Wolff’s Headache and Other Head Pain, 7th ed. New York: Oxford University Press; 2001: 121237.Google Scholar
3. Lipton, RB, Silberstein, SD. Why study the comorbidity of migraine? Neurology. 1994; 44(17): 45.Google Scholar
4. Silberstein, SD, Winner, PK, Chmiel, JJ. Migraine preventive medication reduces resource utilization. Headache. 2003; 43(3): 171178.Google Scholar
5. Chu, MK, Buse, DC, Bigal, ME, Serrano, D, Lipton, RB. Factors associated with triptan use in episodic migraine: results from the American Migraine Prevalence and Prevention Study. Headache. 2012; 52(2): 213223.Google Scholar
6. Silberstein, SD. Practice parameter—evidence-based guidelines for migraine headache (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology for the United States Headache Consortium. Neurology. 2000; 55(6): 754762.Google Scholar
7. Aurora, S, Kori, S, Barrodale, P, Nelsen, A, McDonald, S. Gastric stasis occurs in spontaneous, visually induced, and interictal migraine. Headache. 2007; 47(10): 14431446.Google Scholar
8. Jakubowski, M, Levy, D, Goor-Aryeh, I, Collins, B, Bajwa, Z, Burstein, R. Terminating migraine with allodynia and ongoing central sensitization using parenteral administration of COX1/COX2 inhibitors. Headache. 2005; 45(7): 850861.Google Scholar
9. Brandes, JL, Kudrow, D, Stark, SR, et al. Sumatriptan-naproxen for acute treatment of migraine: a randomized trial. JAMA. 2007; 297(13): 14431454.Google Scholar
10. Silberstein, SD, Mannix, LK, Goldstein, J, et al. Multimechanistic (sumatriptan-naproxen) early intervention for the acute treatment of migraine. Neurology. 2008; 71(2): 114121.Google Scholar
11. Rapoport, AM. Acute treatment of headache. J Headache Pain. 2006; 7(5): 355359.Google Scholar
12. Silberstein, SD. Emerging target-based paradigms to prevent and treat migraine. Clin Pharmacol Ther. 2013; 93(1): 7885.Google Scholar
13. Malik, SN, Hopkins, M, Young, WB, Silberstein, SD. Acute migraine treatment: patterns of use and satisfaction in a clinical population. Headache. 2006; 46(5): 773780.Google Scholar
14. Worthington, I, Pringsheim, T, Gawel, MJ, et al. Canadian Headache Society Guideline: acute drug therapy for migraine headache. Can J Neurol Sci. 2015; 40(S3): S1S3.Google Scholar
15. Bigal, ME, Ho, TW. Is there an inherent limit to acute migraine treatment efficacy? J Headache Pain. 2009; 10(6): 393394.Google Scholar
16. De, FM, Ossipov, MH, Wang, R, et al. Triptan-induced enhancement of neuronal nitric oxide synthase in trigeminal ganglion dural afferents underlies increased responsiveness to potential migraine triggers. Brain. 2010; 133(Pt 8): 24752488.Google Scholar
17. Kellerman, D, Lickliter, J, Mardell, J, von Stein, T. Pharmacokinetics and tolerability of a new intracutaneous microneedle system of zolmitriptan (ZP-zolmitriptan). PF01 AHS San Diego. 2016: 2016.Google Scholar
18. Rapport, MM, Green, AA, Page, IH. Serum vasoconstrictor, serotonin; isolation and characterization. J Biol Chem. 1948; 176(3): 12431251.Google Scholar
19. McCorvy, JD, Roth, BL. Structure and function of serotonin G protein-coupled receptors. Pharmacol Ther. 2015; 150: 129142.Google Scholar
20. Silberstein, SD. The pharmacology of ergotamine and dihydroergotamine. Headache. 1997; 37(Suppl 1): S15S25.Google Scholar
21. Ramírez Rosas, MB, Labruijere, S, Villalón, CM, Maassen VanDenBrink, A. Activation of 5-hydroxytryptamine1B/1D/1F receptors as a mechanism of action of antimigraine drugs. Expert Opin Pharmacother. 2013; 14(12): 15991610.Google Scholar
22. Ramadan, NM, Skljarevski, V, Phebus, LA, Johnson, KW. 5-HT1F receptor agonists in acute migraine treatment: a hypothesis. Cephalalgia. 2003; 23(8): 776785.Google Scholar
23. Furman, JM, Marcus, DA, Balaban, CD. Vestibular migraine: clinical aspects and pathophysiology. Lancet Neurol. 2013; 12(7): 706715.Google Scholar
24. Ferrari, MD, Farkkila, M, Reuter, U, et al. Acute treatment of migraine with the selective 5-HT1F receptor agonist lasmiditan—a randomised proof-of-concept trial. Cephalalgia. 2010; 30(10): 11701178.Google Scholar
25. Nelson, DL, Phebus, LA, Johnson, KW, et al. Preclinical pharmacological profile of the selective 5-HT1F receptor agonist lasmiditan. Cephalalgia. 2010; 30(10): 11591169.Google Scholar
26. Farkkila, M, Diener, HC, Geraud, G, et al. Efficacy and tolerability of lasmiditan, an oral 5-HT(1F) receptor agonist, for the acute treatment of migraine: a phase 2 randomised, placebo-controlled, parallel-group, dose-ranging study. Lancet Neurol. 2012; 11(5): 405413.Google Scholar
27. CoLucid Pharmaceuticals. SAMURAI—pivotal phase 3 clinical trial conducted under SPA (special protocol assessment). European Headache and Migraine Trust International Congress. Glasgow, UK; 2016.Google Scholar
28. CoLucid Pharmaceuticals. An open-label, long-term, safety study of lasmiditan for the acute treatment of migraine (GLADIATOR). October 1, 2015. https://clinicaltrials.gov/ct2/show/NCT02565186.Google Scholar
29. CoLucid Pharmaceuticals. Three doses of lasmiditan (50 mg, 100 mg and 200 mg) compared to placebo in the acute treatment of migraine (SPARTAN). November 16, 2015. https://clinicaltrials.gov/ct2/show/NCT02605174.Google Scholar
30. Ho, TW, Edvinsson, L, Goadsby, PJ. CGRP and its receptors provide new insights into migraine pathophysiology. Nat Rev Neurol. 2010; 6(10): 573582.Google Scholar
31. Eftekhari, S, Edvinsson, L. Calcitonin gene-related peptide (CGRP) and its receptor components in human and rat spinal trigeminal nucleus and spinal cord at C1-level. BMC Neurosci. 2011; 12: 112.Google Scholar
32. Walker, CS, Hay, DL. CGRP in the trigeminovascular system: a role for CGRP, adrenomedullin and amylin receptors? Br J Pharmacol. 2013; 170(7): 12931307.Google Scholar
33. Hansen, JM, Hauge, AW, Olesen, J, Ashina, M. Calcitonin gene-related peptide triggers migraine-like attacks in patients with migraine with aura. Cephalalgia. 2010; 30(10): 11791186.Google Scholar
34. Amrutkar, DV, Ploug, KB, Hay-Schmidt, A, Porreca, F, Olesen, J, Jansen-Olesen, I. mRNA expression of 5-hydroxytryptamine 1B, 1D, and 1F receptors and their role in controlling the release of calcitonin gene-related peptide in the rat trigeminovascular system. Pain. 2012; 153(4): 830838.Google Scholar
35. Goadsby, PJ, Edvinsson, L. Sumatriptan reverses the changes in calcitonin gene-related peptide seen in the headache phase of migraine. Cephalagia. 1991; 11(11 Suppl 1): 34.Google Scholar
36. Ho, TW, Ferrari, MD, Dodick, DW, et al. Efficacy and tolerability of MK-0974 (telcagepant), a new oral antagonist of calcitonin gene-related peptide receptor, compared with zolmitriptan for acute migraine: a randomised, placebo-controlled, parallel-treatment trial. Lancet. 2008; 372(9656): 21152123.Google Scholar
37. Diener, HC, Barbanti, P, Dahlof, C, Reuter, U, Habeck, J, Podhorna, J. BI 44370 TA, an oral CGRP antagonist for the treatment of acute migraine attacks: results from a phase II study. Cephalalgia. 2011; 31(5): 573584.Google Scholar
38. Olesen, J, Diener, HC, Husstedt, IW, et al. Calcitonin gene-related peptide receptor antagonist BIBN 4096 BS for the acute treatment of migraine. N Engl J Med. 2004; 350(11): 11041110.Google Scholar
39. Hewitt, DJ, Aurora, SK, Dodick, DW, et al. Randomized controlled trial of the CGRP receptor antagonist MK-3207 in the acute treatment of migraine. Cephalalgia. 2011; 31(6): 712722.Google Scholar
40. Marcus, R, Goadsby, PJ, Dodick, D, Stock, D, Manos, G, Fischer, TZ. BMS-927711 for the acute treatment of migraine: a double-blind, randomized, placebo controlled, dose-ranging trial. Cephalalgia. 2014; 34(2): 114125.Google Scholar
41. Ho, AP, Dahlof, CG, Silberstein, SD, et al. Randomized, controlled trial of telcagepant over four migraine attacks. Cephalalgia. 2010; 30(12): 14431457.Google Scholar
42. Tfelt-Hansen, P. Excellent tolerability but relatively low initial clinical efficacy of telcagepant in migraine. Headache. 2011; 51(1): 118123.Google Scholar
43. Voss, T, Lipton, RB, Dodick, DW, et al. A phase IIb randomized, double-blind, placebo-controlled trial of ubrogepant for the acute treatment of migraine. Cephalalgia. 2016; 36(9): 887898.Google Scholar
44. Silberstein, SD. Headaches in pregnancy. Neurol Clin. 2004; 22(4): 727756.Google Scholar
45. Lipton, RB, Diamond, M, Freitag, F, Bigal, M, Stewart, WF, Reed, ML. Migraine prevention patterns in a community sample: results from the American Migraine Prevalence and Prevention (AMPP) study. Headache. 2005; 45(6): 792793.Google Scholar
46. Silberstein, SD, Holland, S, Freitag, F, Dodick, DW, Argoff, C, Ashman, E. Evidence-based guideline update: pharmacologic treatment for episodic migraine prevention in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology. 2012; 78(17): 13371345.Google Scholar
47. Holland, S, Silberstein, SD, Freitag, F, Dodick, DW, Argoff, C, Ashman, E. Evidence-based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology. 2012; 78(17): 13461353.Google Scholar
48. Pringsheim, T, Davenport, W, Mackie, G, et al. Canadian Headache Society guideline for migraine prophylaxis. Can J Neurol Sci. 2012; 39(2 Suppl 2): S1S59.Google Scholar
49. Carville, S, Padhi, S, Reason, T, Underwood, M. Diagnosis and management of headaches in young people and adults: summary of NICE guidance. BMJ. 2012; 345: e5765.Google Scholar
50. Lipton, RB, Bigal, M, Diamond, M. Migraine prevalence, disease burden and the need for preventive therapy. Neurology. 2007; 68(5): 343349.Google Scholar
51. Olerud, B, Gustavsson, CL, Furberg, B. Nadolol and propranolol in migraine management. Headache. 1986; 26(10): 490493.Google Scholar
52. Ryan, RE, Sudilovsky, A. Nadolol: its use in the prophylactic treatment of migraine. Headache. 1983; 23(1): 2631.Google Scholar
53. Ryan, RE. Comparative study of nadolol and propranolol in prophylactic treatment of migraine. Am Heart J. 1984; 108(4): 11561159.Google Scholar
54. Sudilovsky, A, Stern, MA, Meyer, JH. Nadolol: the benefits of an adequate trial duration in the prophylaxis of migraine. Headache. 1986; 26(6): 325.Google Scholar
55. Ifergane, G, Buskila, D, Simiseshvely, N, Zeev, K, Cohen, H. Prevalence of fibromyalgia syndrome in migraine patients. Cephalalgia. 2006; 26(4): 451456.Google Scholar
56. Saunders, K, Merikangas, K, Low, NC, Von Korff, M, Kessler, RC. Impact of comorbidity on headache-related disability. Neurology. 2008; 70(7): 538547.Google Scholar
57. Schwedt, TJ. The migraine association with cardiac anomalies, cardiovascular disease, and stroke. Neurol Clin. 2009; 27(2): 513523.Google Scholar
58. Schoenen, J, Dodick, DW, Sandor, PS. Comorbidity in Migraine. Sussex, UK: Wiley Blackwell; 2011.Google Scholar
59. Silberstein, SD. Migraine and pregnancy. Neurol Clin. 1997; 15(1): 209231.Google Scholar
60. Ho, TW, Connor, KM, Zhang, Y, et al. Randomized controlled trial of the CGRP receptor antagonist telcagepant for migraine prevention. Neurology. 2014; 83(11): 958966.Google Scholar
61. Silberstein, S, Lenz, R, Xu, C. Therapeutic monoclonal antibodies: what headache specialists need to know. Headache. 2015; 55(8): 11711182.Google Scholar
62. Zhu, DXD, Zhang, J, Zhou, L, et al. A human CGRP receptor antagonist antibody, AA95, is effective in inhibiting capsaicin-induced increase in dermal blood flow in cynomolgus monkeys. American Headache Society 54th Annual Scientific Meeting. Los Angeles, CA, 6/21/12.Google Scholar
63. Dodick, DW, Goadsby, PJ, Spierings, EL, Scherer, JC, Sweeney, SP, Grayzel, DS. Safety and efficacy of LY2951742, a monoclonal antibody to calcitonin gene-related peptide, for the prevention of migraine: a phase 2, randomised, double-blind, placebo-controlled study. Lancet Neurol. 2014; 13(9): 885892.Google Scholar
64. ClinicalTrials.gov. A Study to Evaluate the Efficacy and Safety of AMG 334 in Chronic Migraine Prevention. www.clinicaltrials.gov/ct2/show/NCT02066415.Google Scholar
65. Bigal, ME, Walter, S, Rapoport, AM. Calcitonin gene-related peptide (CGRP) and migraine current understanding and state of development. Headache. 2013; 53(8): 12301244.Google Scholar
66. Bigal, ME, Dodick, DW, Rapoport, AM, et al. Safety, tolerability, and efficacy of TEV-48125 for preventive treatment of high-frequency episodic migraine: a multicentre, randomised, double-blind, placebo-controlled, phase 2b study. Lancet Neurol. 2015; 14(11): 10811090.Google Scholar
67. Bigal, ME, Edvinsson, L, Rapoport, AM, et al. Safety, tolerability, and efficacy of TEV-48125 for preventive treatment of chronic migraine: a multicentre, randomised, double-blind, placebo-controlled, phase 2b study. Lancet Neurol. 2015; 14(11): 10911100.Google Scholar
68. Dodick, DW, Goadsby, PJ, Silberstein, SD, et al. Safety and efficacy of ALD403, an antibody to calcitonin gene-related peptide, for the prevention of frequent episodic migraine: a randomised, double-blind, placebo-controlled, exploratory phase 2 trial. Lancet Neurol. 2014; 13(11): 11001107.Google Scholar
69. Dodick, D, Silberstein, S, Lipton, R, et al. Randomized, double-blind, placebo-controlled trial of ALD403, an anti-CGRP antibody in the prevention of chronic migraine. European Headache and Migraine Trust International Congress Glasgow, UK; 2016.Google Scholar
70. Sun, H, Dodick, DW, Silberstein, S, et al. Safety and efficacy of AMG 334 for prevention of episodic migraine: a randomised, double-blind, placebo-controlled, phase 2 trial. Lancet Neurol. 2016; 15(4): 382390.Google Scholar
71. Tepper, S, Ashina, M, Reuter, U, et al. Safety and efficacy of erenumab for preventive treatment of chronic migraine: a randomised, double-blind, placebo-controlled phase 2 trial. Lancet Neurol. 2017; 16(6): 425434.Google Scholar
72. Chabi, A, Zhang, Y, Jackson, S, et al. Randomized controlled trial of the orexin receptor antagonist filorexant for migraine prophylaxis. Cephalalgia. 2015; 35(5): 379388.Google Scholar
73. Bartsch, T, Levy, MJ, Knight, YE, Goadsby, PJ. Differential modulation of nociceptive dural input to [hypocretin] orexin A and B receptor activation in the posterior hypothalamic area. Pain. 2004; 109(3): 367378.Google Scholar
74. Hoivik, HO, Laurijssens, BE, Harnisch, LO, et al. Lack of efficacy of the selective iNOS inhibitor GW274150 in prophylaxis of migraine headache. Cephalalgia. 2010; 30(12): 14581467.Google Scholar
75. Palmer, JE, Guillard, FL, Laurijssens, BE, Wentz, AL, Dixon, RM, Williams, PM. A randomised, single-blind, placebo-controlled, adaptive clinical trial of GW274150, a selective iNOS inhibitor, in the treatment of acute migraine. Cephalalgia. 2009; 29(1): 124.Google Scholar
76. Aoki, KR, Guyer, B. Botulinum toxin type A and other botulinum toxin serotypes; a comparative review of biochemical and pharmacological actions. Eur J Neurol. 2001; 8(Suppl 5): 2129.Google Scholar
77. Mauskop, A. The use of botulinum toxin in the treatment of headaches. Pain Physician. 2004; 7: 377387.Google Scholar