Complexities in Conducting Combination Migraine Therapy Trials: Andrew Blumenfeld, MD

The director of the Headache Center of Southern California shared his thoughts on the factors and barriers that go into conducting trials that treat patients with migraine with multiple drugs.

"Think about migraine freedom. We need the payers to think about it because if it gets the patient out of the emergency room and back to work quicker, they will save money in the long run. That’s if they allow us to do these combinations, which are good for the patients. It’s a no-brainer. Unfortunately, we need data to change the system.”

Using a layered treatment approach with onabotulinumtoxinA (Botox; Allergan/AbbVie) and calcitonin gene-related peptide (CGRP) monoclonal antibody, data has indicated that there is an additional clinically meaningful improvement in headache frequency and migraine-related disability compared with a singular use of onabotulinumtoxinA. Lead author Andrew Blumenfeld, MD, and colleagues recently presented these findings at the 2021 American Headache Society (AHS) 63rd Scientific Annual Meeting, June 3-6.

Conducting trials that utilize these types of layered methods have become more relevant in recent years, but often come with complications. Blumenfeld, director of the Headache Center of Southern California, notes that these complications stem from funding and permission from drug companies, as well as choosing the right drugs. He added that the importance of these trials and the doors they open in research should not go unnoticed.

In an interview with NeurologyLive, Blumenfeld discussed the complexities that come with conducting trials that incorporate a layered approach. He also stressed that new drug development isn’t always necessary, but rather combining existing products in a rational way is a worthwhile endeavor to hopefully reaching a cultural migraine freedom.

For more coverage of AHS 2021, click here.