Treatment of migraines promising

Migraine is a common, chronic disease that continues to be a Top 10 cause of disability in the United States. There is no known cure. Odds favor that you or someone you know has experienced a migraine. If not, consider these notable migraine sufferers: John F. Kennedy, Julius Caesar, Elizabeth Taylor, Elvis Presley, Lewis Carroll and Serena Williams.

We have come a long way in the treatment of migraines, but there’s still a sprawling gap in care for many people. The good news: That gap is closing.

The first thing to know is the migraine is a unique type of severe headache, frequently joined by symptoms like nausea and sensitivity to light. Over-the-counter drugs like acetaminophen and ibuprofen usually don’t work. The standard-of-care and most effective treatment for migraines is a class of medications called “triptans.”

There are currently seven triptan drugs that may be taken as a pill, injection or nasal spray. The first triptan drug, sumatriptan (Imitrex), became available in 1991 and cleared a new path for managing these debilitating headaches.

However, just as the frequency and intensity of migraine headaches vary from person to person, so does a person’s response to treatment. A triptan can stop the headache on the spot for one person while barely lessening the pain in another. Also, some people cannot take triptans if they have other health conditions – namely, cardiovascular disease.

So, while triptans were a giant leap forward in managing migraines, there’s still work to be done. One key feature missing with the triptans is that while they are taken at the point when the migraine starts, they don’t prevent the migraine.

In 2018, a batch of three new medications – erenumab (Aimovig), fremanezumab (Ajovy) and galcanezumab (Emgality) – that prevent migraines were approved by the FDA. These drugs are antibodies that work at a new target, i.e., they block the calcitonin generelated peptide (CGRP) receptor/ protein. They are given at a clinic by intravenous injection every 1 to 3 months with few side effects (they may even be administered to people with cardiovascular disease). As with most new drugs, these recently approved products are expensive (about $460 to $690 per month) and may not be fully covered by insurance.

In October 2019, the newest drug, lasmiditan (Reyvow), was FDA approved for acute treatment