Providing Nonoral Migraine Care With Intranasal DHE: Jessica Ailani, MD


The director of the MedStar Georgetown Headache Center spoke to the efficacy and application of a new formulation of the longstanding agent dihydroergotamine in the treatment of migraine.

“We already know that DHE is very effective for migraine. It’s really considered the gold standard, especially for those who have what we call status migrainosus—you’re having a migraine attack that’s lasting greater than 36 hours and you’re really in trouble. That might be a reason to go to the emergency room seeking care, and this is really how DHE was initially studied.”

The 2021 American Academy of Neurology (AAN) Annual Meeting, April 17-22, featured an industry update session that covered some of the ongoing conversations about the use of nonoral medications for migraine, and the role that the interaction between the brain and the gut plays in the headache disorder. Part of this session covered the recently completed STOP 301 trial (NCT03557333) of a nasally delivered investigational migraine treatment, INP104, which is a reformulation of dihydroergotamine (DHE) administered via a novel precision olfactory delivery (POD) system.

To find out more about how this therapy has performed in its clinical development and what the STOP 301 trial revealed about its efficacy and safety, NeurologyLive spoke with Jessica Ailani, MD, director, MedStar Georgetown Headache Center, and associate professor of neurology, MedStar Georgetown University Hospital. In the conversation, she detailed the data from the trial and what her main takeaways were.

Specifically, she shared some of the unique approaches from this trial, and some clinical pearls about the use of DHE for patients with migraine and its history as an effective, but often difficult to obtain treatment. Ailani also discussed how DHE evolved over the years into this new formulation.

For more coverage of AAN 2021, click here

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