Guideline on Migraine Prevention Says No Clinically Important Advantages for Newer, Expected Medications

Guideline on Migraine Prevention Says No Clinically Important Advantages for Newer, Expected Medications


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The American College of Physicians (ACP) have developed new recommendations to prevent Episodic migraines in nonpregnant adults in outpatint settings. The clinical guideline, which includes three recommendations centered around monotherapy, is Published in Annals of internal medicine,

In recommendation Gic blocker, eater metoprolol or propranol; The antiseizure Medication Valproate; The serotonin and norepinephrine reuptake inhibitor venlafaxine; or the tricyclic antidepressant amitriptyline.

In recommendation 2, if these patients do not tolerate or inadequately respond to a trial or trials of treates in recommendation Rp) Antagonist (atgogepant or rimegepant) or a cgrp Monoclonal Antibody (Eptinezumab, Erenumab, Fremanezumab, Or Galcanezumab).

In recommendation 3, if patients still do not tolerate or inadequately responsible Amate.

Migraine is Characterized by Recurrent Episodes of Usually Moderate-to-Severe Intensity Headache Lasting Four to 72 hours with or without sensory disturbances, general Usea, vomiting, or aversion to light or sound. Because the condition remains under-diagnosed and under-treated, only a small percentage of eligible people receive preventive preventant paharmacologic treatments.

ACP Considered The Findings from an ACCompanying Comparative Effectiveness Systematic Review that Used The Grade Approach to Analyze the effects of Pharmacic Treatment to Prevent EPISINE ING Outcomes: migraine frequency and duration, number of days medicine was taken for acute treatment of migraine, Frequency of Migraine-Related Emergency Room Visits, Migraine-Related Disability, Quality of Life and Physical Function, and Discontinuations due to adverse events.

Additional data about adverse events were identified through food and Drug Administration Meditation Labels and Eligible Studies.

BeCAuse of the Lack of Differences in Clinical Net Benefit Between Virtually all trees, The CGC Used Economic Evidence and PATENTS ‘Values ​​and Preferences Data as Primary factor e prevention treates. The media annual costs of recommended Initial Oral Treatments Varied Substantily.

The Guideline Emphasizes that a PATINCE ADEHERENCE to Pharmacologic Treatment is Crucial Because Improvement May Occur Gradually after Initiating a long-treatment for pregnancy With an effect that may become apparent after the first few weeks of treatment.

More information:
Prevention of Episodic Migraine Headache Using Pharmacologic Treatments in Outpatient Settings: a Clinical Guideline from the American College of Physicians, Annals of internal medicine (2025). Doi: 10.7326/Annals-24-01052

Provided by American College of Physicians


Citation: Guideline on Migraine Prevention Says No Clinically Important Advantages for Newer, Expected Medications (2025, February 3) retrieved 3 February 2025 from

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