An update on new options for effective migraine treatment
This is an exciting time for people with migraine. New, promising treatment options are coming out, and these breakthroughs offer hope for better migraine symptom relief and prevention.
People with migraine usually take medication for their active migraine attacks, and some people also take medication to prevent future attacks. There have been major strides in both types of treatments with various methods. Plus, we can combine these new options for better treatment plans.
New Treatment Options
In this webinar, Dr. Jessica Ailani, the director of the MedStar Georgetown Headache Center in the Washington, D.C., area, and Dr. Stewart Tepper, a professor of neurology at Dartmouth in New Hampshire and director of the Headache Center at Dartmouth Hitchcock Medical Center, shared updates on new migraine treatments. Drs. Ailani and Tepper revealed new acute therapies, preventive treatments and other options awaiting FDA approval that will soon be available for prescription. This recap will brief you on these new treatments. But don’t miss the important details in the webinar recording available below.
New Acute Migraine Treatments
Triptans are commonly used for immediate migraine relief, but advancements in migraine research have led to the discovery of other oral medications, such as gepants, which are medications that target and reduce CGRP (calcitonin gene-related peptide, a protein that causes inflammation in the brain).
Another new class of medications is the ditans like lasmiditan (REYVOW®). While gepants work outside the brain, lasmiditan goes into the brain and essentially “turns off” the migraine during an acute attack. Because it crosses into the brain, it can cause dizziness and sedation, so providers will have to find the correct dosage for each person.
Finally, while many people with migraine use over-the-counter NSAIDs, like ibuprofen, these can take time to work and aren’t always effective for everyone. During the webinar, Dr. Ailani shared that there is a new liquid NSAID—celecoxib (Elyxyb®)—on the horizon awaiting approval.
Intranasal Medications (Nasal Spray)
Dihydroergotamine, also known as DHE, is an option when triptans are not effective. It comes in various formulations, including injection, infusion and nasal spray. Doctors prescribe DHE for acute relief.
While DHE is not new, methods of administering it are evolving. The FDA recently approved dihydroergotamine mesylate nasal spray (TRUDHESA™). This medication uses a proprietary nasal delivery system, which allows the medication to go deeper into the nasal cavity, offering better absorption. This offers a potentially new option for some people with migraine.
Injections and Infusions
Anti-CGRP treatments include injections specifically designed to bind to or block CGRP to prevent migraine attacks. There are currently three available as a self-administered injection and an intravenous infusion called eptinezumab (VYEPTI™.) Eptinezumab is a monoclonal antibody infusion that targets CGRP.
In addition to oral medications, injections, infusions and nasal sprays, neuromodulation devices can be used to change the way the nerves send information to the brain or adjust how the brain turns on and off the “pain lever,” as Dr. Ailani says.
It’s estimated that 40% of patients with migraine will need preventive treatment to reduce the frequency of migraine attacks. Patients can use some types of neuromodulation for both preventive and acute treatment, including the supraorbital transcutaneous stimulator, transmagnetic stimulator, vagus nerve stimulator and more.
We’ve made strides in neuromodulation, and Relivion is the newest device currently awaiting approval. It sits on the head, over the area where the occipital nerves (the nerves in the scalp) converge at the trigeminal system (the nerves that control motor function and sensation in the face). Stimulation to this area is thought to prevent future migraine attacks.
There’s so much more information available in the webinar with Drs. Ailani and Tepper—watch and learn more about the progress we’ve made in migraine treatment and the hopeful future for those living with migraine.
The American Migraine Foundation is committed to improving the lives of those living with this debilitating disease. For more of the latest news and information on migraine, visit the AMF Resource Library. For help finding a healthcare provider, check out our Find a Doctor tool. Together, we are as relentless as migraine.
Reviewed for accuracy by the American Migraine Foundation’s subject matter experts, headache specialists and medical advisers with deep knowledge and training in headache medicine. Click here to read about our editorial board members.