Unmet Needs in Preventive Treatment of Migraine

Migraine represents the most common cause of work disability in young women and the second one in the general population. Preventive treatment can reduce the frequency of attacks and their intensity, consequently improving the quality of life. Despite this, global health systems have shown important gaps in addressing optimal management of preventive therapy. Despite numerous adverse effects of traditional medications for migraine prevention being well known, these medications continue to be considered the standard of care for prophylaxis of this disease in many contexts. On the other hand, the widespread use of calcitonin gene-related peptide (CGRP) receptor antagonists, which have marked a breakthrough in prophylactic therapy of migraine, has been limited because of their high cost. We also highlight important shortcomings in migraine management by general practitioners (GPs) and poor patient education on the disease with a consequent delay in referring selected patients to dedicated headache centres. Over the next few years, we expect the headache medicine community to mobilize to address these gaps in preventive treatment of migraine.

Automated summary

Migraine is the main cause of work disability in young women and the second in the general population. Preventive treatment can improve the quality of life by reducing the frequency and intensity of attacks. However, there are significant gaps in the global health systems in terms of optimal management of preventive therapy. Traditional medications with known adverse effects are still considered the standard of care for migraine prevention in many cases, while the use of calcitonin gene-related peptide (CGRP) receptor antagonists is limited due to their high cost. There are also shortcomings in migraine management by general practitioners and a lack of patient education, resulting in delays in referring patients to specialized headache centers. We expect the headache medicine community to address these gaps in preventive treatment of migraine in the coming years.