The Changing Treatment Landscape for Acute Migraine - Episode 13

Therapies in Development for Acute Migraine

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Upcoming studies for treatment of acute migraine, including some promising devices, are highlighted.

Robert Cowan, MD, FAAN: There are a number of interesting studies coming out, and not only for CGRP monoclonal antibodies and antagonists. There are a number of devices that are coming to market or that have recently come to market for acute treatment, and eventually for prevention, that also have very nice efficacy and adverse-effect profiles. Over time, we will see the devices become more prominent in first-line treatment, assuming they can figure out how to make them affordable and accessible.

There are a number of molecules very early in the pipeline at this point, still a number of years out, that are promising. The PACAP molecule is very promising. This whole field is starting to blossom at this point, and we’re getting better medications with better adverse-effect profiles, fewer downsides, fewer drug interactions, and greater specificity for treating the entity itself rather than the symptoms.

My advice to community neurologists treating migraines is to be open to these new medications. In many cases, it’s worth it to go the extra mile to get these medications approved for patients who have not responded to medications that are more easily accessible. Don’t be overwhelmed by all the marketing. Try to look at the data. Listen to what specialists in the field are suggesting. Pay attention to your patients, and see what they’re looking for.