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Ahead of sessions kicking off on June 13, Jessica Ailani, MD, FAHS, offers a look into what data, plenary talks, and developments are set to be presented at the upcoming AHS 2020 annual meeting.
Jessica Ailani, MD
As has been the case for many medical societies and organizations, the American Headache Society's (AHS) annual scientific meeting has shifted to a virtual format, with sessions expected to launch on Saturday, June 13, 2020.
Each year, the scientific meeting disseminates the latest research and scientific advances in headache medicine, designed for physicians, psychologists, scientists, researchers, physician assistants, nurse practitioners, and other health professionals involved in the care of patients with head, neck, and orofacial pain. To learn more about what this year’s meeting will offer, NeurologyLive caught up with a fellow of the AHS and a member of its scientific committee, Jessica Ailani, MD.
“We’re really getting to see where science has been in the last year when it comes to headache medicine and focus in on some of the details of the research. I think that’s always important as a clinician,” Ailani, director of MedStar Georgetown Headache Center and associate professor of neurology at MedStar Georgetown University Hospital, told NeurologyLive. “I'm always looking at where the scientists are right now because what they're doing today is what's going to come to my patients 5 to 10 years from now. When I have that patient in front of me that has refractory disease that I'm really struggling to treat because my options are limited, they want to know that our scientists are focused on them. They want to know that we're looking for an answer, we're looking for ways to better diagnose and ways to better treat.”
WATCH: Ailani discusses what to expect at AHS 2020.
And while the meeting, which generally sets its yearly theme in accordance with the latest and greatest science, is certainly going to continue to focus on that work, Ailani added that it will not ignore the elephant in the room: the ongoing coronavirus 2019 pandemic. Following opening remarks from AHS President Peter J. Goadsby, MD, PhD, a trio of plenary talks centered around headache medicine in the era of COVID-19 will take place.
Those talks include a presentation titled “Headache & COVID-19: A Short-term Challenge With Long-Term Insights,” from Patricia Pozo Rosich, MD, PhD, of Vall d’Hebron Hospital in Barcelona, Spain, followed by “COVID-19 and Headache: the New York Experience,” presented by Matthew S. Robbins, MD, FAHS, of Weill Cornell Medicine in New York. Additionally, Christina L. Szperka, MD, MSCE, FAHS, of the Perelman School of Medicine at the University of Pennsylvania and Children’s Hospital of Philadelphia, will offer insight in her presentation titled, “Migraine Care in the Era of COVID‐19: Clinical Pearls and Plea to Insurers.”
The goal of these talks will be to sum up what the field knows at this point and to glean from the experiences in Spain and New York. A number of experts have warned of the chance of a possible second wave of the virus occurring this year and these plenary talks aim to push preparedness toward the forefront of thinking. They will offer insights into what redeployment might look like for headache providers as well as how the pandemic has affected neurology students, residents, and fellows.
“That's really important for any of us who are headache educators,” Ailani said. “It's already so difficult to have that time with the students and the residents and the fellows—to have that time shifted is very difficult to think about. In our program, we have a fellowship for headache, and we've had to really think about what is that fellowship going look like over the next 6 to 8 months if patients are very anxious about meeting with multiple providers because that puts them at risk.”
There are a number of abstracts focused on residency education in headache expected to be presented, and Ailani expressed hope that they will allow physicians to make sure they continue to put that education forward. The long-term outcome of this may be fewer number of residents interested in headache, fewer fellows, and fewer providers.
WATCH: Ailani offers insight into the plenary talks
Additionally, the conference will offer a number of abstracts focused on the aforementioned latest and greatest science in headache. These presentations will include long-term safety data on the new calcitonin gene-related peptide (CGRP) inhibitors, the latest label updates, postmarketing data on newly approved therapeutics, as well as a number of datasets on the nonpharmaceutical therapeutic options offered to patients. Ailani noted that the committee reviewed hundreds of abstracts that focus not just on what is coming in the future, but what is being observed right now.
This year’s presentations will also feature the Harold G. Wolff Award Lecture, “Cognitive Networks Disarrangement in Patients with Migraine Predicts Cutaneous Allodynia,” which will be presented by Antonio Russo, MD, PhD, of the University of Campania. Allodynia, a symptom that often occurs during a migraine attack that renders the scalp tender, is also often a risk factor for progression from episodic to chronic migraine. Russo and colleagues examined those with cutaneous allodynia to see if a change that occurs in the brain puts them more at risk for allodynia, which then puts them more at risk for progression to chronic migraine.
“This is fascinating,” Ailani told NeurologyLive, noting that the addition of a biomarker—even it's an imaging marker—would allow physicians the ability to better elucidate a treatment strategy for patients to better address their migraine attacks early on.
“This kind of tool, 5 to 10 years in the future, is extremely helpful and very relevant to clinical practice,” she added. “Our fear when this meeting was going to have to be halted, was taking science like that and not bringing it to the forefront—this can't wait a year. We need to know this kind of information. I'm excited that we're going get to see that and we're going to get to see a lot of the top abstracts presented as well.”
WATCH: Ailani shares her thoughts on the abstracts
Although this year’s meeting does not feature the plethora of neuromodulatory device-related science that has been observed in prior years, there are a number of abstracts focused on the use of behavioral-based tools and strategies to help benefit patients with migraine. These range from behavioral intervention strategies to smartphone apps which patients can incorporate into their daily routines.
Ailani explained that due to the pandemic, even with the interest in these types of add-on treatments, there has been a big challenge in bringing these types of therapy to patients who are unable to attend in-person visits. The data addressing these topics include a few small studies exploring telehealth for occupational therapy for headache, as well as assessments of apps that are being used for different types of behavioral feedback modulation. One such project is an app for progressive muscle relaxation as a treatment option in patients with migraine.
Even Ailani noted that these data are coming at the perfect time. She explained that having data on how these interventions might work in a virtual environment is extraordinarily helpful at this time. Additionally, she shared her perspective on these types of interventions, calling them the “next wave” in headache, and great additions to the treatment armamentarium to offer to patients.
“I think this is a really great time that if you've never been able to make one of these meetings before because you’re interested in hedache, but maybe not a headache specialist—you can now join anytime in the month of June from your own home and learn a little bit more,” Ailani explained. “I definitely would suggest getting those plenary talks in there to see that focus. The great thing is that we've also been able to include many other topics of interest which are science-based.”