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TEAM study of e-TNS for the Acute Treatment of Migraine: Deena Kuruvilla, MD

The medical director of the Westport Headache Institute shared her insight into the use of the e-TNS device and the role of neuromodulation in migraine.

“There are different roles for neuromodulation, in general, and for this e-TNS device. In the real world, I’ll tell you that one of the biggest challenges for patients is getting enough of their acute migraine treatments approved by their insurance company… Often, we run into this huge challenge in the real world where insurance companies and payers are not covering acute pharmacological migraine treatments… There is a lot of room to add neuromodulation and e-TNS to those treatments.”

Deena Kuruvilla, MD, medical director, Westport Headache Institute, presented data at the 2021 American Headache Society (AHS) Annual Scientific Meeting, June 3-6, from the TEAM study (NCT03465904) of external trigeminal nerve stimulation (e-TNS), done with the Cefaly device. Her presentation revealed that the device displayed superiority to a sham device in providing 2-hour pain freedom and freedom from the most bothersome symptom (MBS), as well as sustained pain freedom at 24 hours, in a population of patients with migraine.

All told, active stimulation was markedly more effective than sham in achieving 2-hour pain-freedom (active: 27.27%; sham: 17.72%; P = .0167) for a therapeutic gain of 9.55%, while a significantly higher proportion of active stimulation patients also achieved freedom from their MBS (58.85% vs. 42.19%; P = .0006).

To find out more about the effectiveness of e-TNS in both preventive and acute migraine treatment, and what role it can play in filling some of the gaps in care that persist despite a plethora of new approvals since 2018, NeurologyLive sat down with Kuruvilla. She offered her insight into the use of the device and the role of neuromodulation in migraine, particularly in light of access challenges to these new medicines.

For more coverage of AHS 2021, click here.

REFERENCE
Kuruvilla DE, Starling AJ, Tepper SJ, Mann JI, Johnson M. A phase 3 randomized, double-blind, sham-controlled trial of e-TNS for the acute treatment of migraine (TEAM). Presented at 2021 AHS Annual Scientific Meeting; June 3-6. Abstract IOR-02.
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