Candesartan linked to reduction in intensity, frequency of migraine in adolescents

Key takeaways:

• Researchers analyzed medical records of 50 adolescents treated at Texas Children’s Hospital Headache Clinic.
• Candesartan significantly reduced frequency and intensity of headache compared with baseline.

AUSTIN, Texas — Treatment with candesartan led to significant reduction in mean monthly headache days and headache intensity in adolescents with high baseline migraine frequency, according to a poster presented here.

“Candesartan is an angiotensin receptor II blocker that has shown effectiveness for migraine prevention in randomized controlled trials,” Irene Patniyot, MD, medical director of the Headache Clinic at Texas Children’s Hospital and assistant professor of pediatric neurology at Baylor College of Medicine, and colleagues wrote. “There are few FDA-approved migraine preventive therapies available for the pediatric and adolescent population.”

Researchers conducted a retrospective data analysis of electronic medical records of 50 adolescent patients at the Headache Clinic, all of whom had high baseline headache frequency and were prescribed candesartan between January 2016 and December 2022.

The primary outcome of interest was mean monthly headache frequency, while frequency of moderate to severe headache days served as the secondary outcome.

According to results, 24% of patients had an insurance denial that prevented treatment. Of 24 complete records of children aged 12 to 17 years (50% boys), data showed a significant reduction in mean monthly headache days, with patients experiencing 23.3 headache days before treatment with candesartan vs. 19.6 days after treatment (P = .04).

Median headache days reported before and after candesartan was 30 and 19.5, respectively, and five individuals reported at least a 50% reduction in the number of headache days after treatment initiation.

Researchers also reported a significant reduction in mean frequency of moderate to severe headache days per month (3.3 vs. 2.6; P = .04).

Few adverse effects were reported (12.5%) and included mild light-headedness and a drop in blood pressure.

“Using [candesartan] as a first-line preventive therapy could be more beneficial than later in the course of illness, however insurance coverage limits its use in a wider headache population,” Patniyot and colleagues wrote.