The ‘Epipen’ that stops migraines before they start
SEVERE migraine sufferers could soon be given an Epipen-style DIY jab containing a powerful drug that stops attacks before they start. Previously, the medicine had to be administered by a doctor or nurse, or patients were taught to fill and self- inject using a needle and syringe. The new method will spare up to 10,000 patients from repeated hospital visits, allowing them to give themselves a dose in the comfort of their own home.
The drug, fremanezumab, was given the green light for NHS use in March, making it the first new treatment for migraine patients to be approved in 20 years. It is offered to those who suffer at least four days of migraine pain a month.
One of the first patients to use the new injections, Ted Rowntree, 26, began suffering from migraines five years ago, with intense dizzy spells and headaches.
Attacks lasted for three weeks and became so frequent and severe he was forced to give up his part-time insurance job.
Last month, his neurologist agreed to prescribe pre-filled fremanezumab jabs, and the effect has been dramatic. ‘Up to that point, I was spending weeks in a darkened room, only able to listen to audiobooks,’ said the PhD student from Chelmsford in Essex. ‘I had a bad migraine the day my first pen arrived. It was so easy to use: you take the cap off, press it against your thigh and hold it there while the fluid is injected – I could hardly feel it and there was just a tiny pinprick. I’m already feeling much better. I’ve really noticed the difference, and haven’t had to spend a day in bed.’
More than eight million Britons – three quarters of them women – suffer migraines, which involve dizziness, nausea and headaches.
The condition affects more people than diabetes, asthma and epilepsy combined and is the sixth most common cause of disability in the world. Patients make lifestyle changes, take painkillers, and are prescribed drugs including beta blockers, antidepressants and anticonvulsant drugs. Tablets called triptans relieve symptoms but over time these can cause headaches themselves.
If chronic migraine does not respond to at least three drug treatments, patients may be offered jabs of the muscle-freezing drug Botox, because of i ts nerve- blocking effects, but this can involve 31 separate injections per treatment and has to be done in a specialist clinic.
Fremanezumab is among a new wave of drugs which targets a certain protein – in this case, calcitonin gene-related peptide (CGRP), which is responsible for the pain and nausea associated with a migraine. CGRP causes blood vessels intertwined with nerve endings in the head to swell up. Fremanezumab, which must be given by injection either every month or three months, depending on dose, contains an antibody that blocks that process.
DR MARK Weatherall, consultant neurologist at Stoke Mandeville Hospital, Buckinghamshire, said: ‘Chronic migraine is a debilitating disorder which can, without the right treatment, strike at any time leaving the sufferer feeling helpless. Fremanezumab gives us an option when other treatments have failed. Patients are often worried about using traditional syringes to inject themselves, but a pen device is simple to self-administer and puts patients in control of managing their condition.’
The fremanezumab pen has a simple push-down mechanism that is similar to an Epipen, the lifesaving self-injector pen given to patients at risk of severe allergic reactions. It can be injected into the abdomen, thigh, or upper arm.
Studies suggest the drug can almost halve the number of days spent suffering from a migraine, and reduce severity of attacks.
Side effects include nausea and constipation, although the majority of patients felt able to continue the treatment.