The American Academy of Neurology and the American Headache Society updated guidance about drug treatments to prevent migraine, the first revision since 2012.The guideline was based on evidence from a systematic review of 217 studies of migraine prevention drugs.Both newer CGRP-targeted therapies and established drugs showed benefit in episodic and chronic migraine.
New guidance from the American Academy of Neurology (AAN) and the American Headache Society (AHS) aims to help clinicians identify which migraine prevention drugs may be most effective for certain patients.
The guidelines -- the first update since 2012 -- were published in Neurology and were based on evidence from a systematic review of migraine prevention drugs, said author Rebecca Burch, MD, of the University of Vermont Larner College of Medicine in Burlington.
"Since the previous guidelines were published in 2012, there has been a wealth of new treatment available for prevention of migraine, and specifically, the migraine-specific CGRP [calcitonin gene-related peptide]-targeted therapy category," Burch noted in a press briefing.
CGRP is a potent vasodilator thought to play a significant role in migraine. In 2018, erenumab (Aimovig), an injectable treatment targeting CGRP receptors, was the first monoclonal antibody approved for migraine prevention; fremanezumab (Ajovy), galcanezumab (Emgality), and eptinezumab (Vyepti) soon followed. Oral CGRP receptor antagonists rimegepant (Nurtec) and atogepant (Qulipta) were approved for migraine prevention in 2021.
