Zonisamide reduces monthly migraine days in kids
Key takeaways:
- Treatment led to median decrease from 18 to 6 headache days per month at first follow up after initiation.
- By the time of first follow up, 34% of enrollees transitioned from chronic to episodic migraine.
In children and teenagers, treatment with zonisamide was associated with a significant reduction in the number of monthly migraine days, particularly after at least 2 months of use, preliminary data show.
The full results will be presented at the American Academy of Neurology Annual Meeting, taking place April 5-9 in San Diego.
“Migraine disease is debilitating and can lead to kids having to miss school and other activities,” Anisa F. Kelley, MD, director of the outpatient headache program at Ann & Robert H. Lurie Children’s Hospital of Chicago, wrote in a release related to the study. “Currently, there is only one FDA-approved migraine preventative medication for this age group.”
Kelley and colleagues investigated the efficacy of the anti-seizure medication zonisamide in reducing the number of headache days per month (HDPM) in 256 children and teenagers (median age, 15 years; 70% girls) with migraine, 28% of whom were diagnosed with intractable migraine, defined as unsuccessful treatment with two or more previous medications.
The researchers divided the population into three subgroups to analyze change in HDPM based on the amount of time taking zonisamide, at initial presentation and first follow up. The subgroup comparisons were stratified by time to first follow up, intractable vs. non-intractable migraine, as well as transitions from chronic and episodic migraine status.
The researchers reported an overall median decrease from 18 HDPM to 6 HDPM (95% CI, -12 to -8.5) at first follow up after zonisamide initiation. The largest reduction was observed in patients who followed up within 2 to 6 months after initiation, with a median decrease of 6 HDPM.
Data further showed that both intractable and non-intractable migraine groups recorded a median decrease of 6 HDPM at first follow up.
At the first follow up, 34% of patients had transformed from chronic to episodic migraine and 4% from episodic to chronic.
“It’s very exciting that we may have an effective way to treat difficult migraine disease in children and teens, however, it’s important to note that our study did have limitations,” Kelley said in the release. “For instance, our study did not compare people taking the medication to people who did not take the medication. Future studies are needed with control groups to confirm our results.”
Reference:
Drug may prevent some migraine attacks in children and teens. https://www.aan.com/PressRoom/Home/PressRelease/5237. Published Feb. 26, 2025. Accessed March 26, 2025.
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Kelley AF, et al. Effectiveness of zonisamide prophylaxis in reducing headache days per month for pediatric
patients with migraine disease, a retrospective analysis. Presented at: American Academy of Neurology Annual Meeting; Apr. 5-9, 2025; San Diego.
