Most patients with migraines do not experience adequate, timely relief

More than 50% of patients with migraines reported that they did not achieve an adequate response to acute treatment, according to research presented at the American Academy of Neurology annual meeting.

Perspective from Teshamae Monteith, MD

Alexandre Bennett, PhD, and colleagues stressed the need for assessing patients' treatment to ensure adequacy.

"Most migraine sufferers want pain freedom within 2 hours of taking an acute treatment for most of their attacks," the researchers wrote in their abstract. "The [American Migraine Prevalence and Prevention Study (AMPP)] database provides a resource for assessing adequacy of acute treatment."

Bennett and colleagues analyzed responses from the 2006 AMPP study, which featured a mailed survey asking people with migraines about treatment responses, treatment patterns, lifestyle characteristics, headache features and sociodemographics.

Results showed that only 44% of participants experienced an adequate 2-hour response. The researchers identified predictors of inadequate response, which included not using preventive medication (OR = 0.77; 95% CI, 0.65-0.92), clinical depression (OR = 1.45; 95% CI, 1.27-1.65), allodynia presence (OR = 1.49; 95% CI, 1.34-1.65) and higher pain intensity (OR = 1.15, 95% CI, 1.11-1.2).

"A majority of migraineurs (56%) do not receive an adequate [2-hour] response," Bennett and colleagues wrote. "Adequacy of treatment response should be assessed in all patients, particularly those with predictors of an inadequate response. Outcomes can be improved with medications that provide rapid and consistent relief." – by Chelsea Frajerman Pardes

Reference:

Bennett A, et al. Predictors of inadequate response to medication in episodic migraine: Results from American Migraine Prevalence and Prevention Study (AMPP). Presented at: American Academy of Neurology Annual Meeting; April 15-21, 2016; Vancouver, British Columbia.

Disclosures: Bennett is an employee of Dr. Reddy's Laboratories/Promius Pharma. Please see the full abstract for a complete list of all other authors' relevant financial disclosures.

Perspective

Teshamae Monteith, MD

The study investigates the proportion of individuals with a pain-free response to acute medications for migraine attacks in a well-defined population based cohort from the American Migraine Prevalence and Prevention (AMPP) study. The researchers found that more than half of individuals with migraine do not become pain free within 2 hours. Interestingly, many of the predictors associated with an inadequate response included risk factors for chronic migraine. The study findings emphasize the need for personalized approaches to optimize acute management of migraine. These may include the use of preventive medications in addition to both multi-mechanistic combination approaches and alternative routes of drug delivery.

Teshamae Monteith, MD

Assistant Professor of Clinical Neurology, Director of the Headache Program

University of Miami Miller School of Medicine

Disclosures: Monteith is a principal investigator for Lilly cluster headache trials.