New Migraine Prevention Medications!

By Brett Dees

Most people have heard of migraine headaches. They are relatively common, affecting 18% of women and 6% of men in the U.S., an estimated 38 million people. What many people don’t know, however, is the enormous burden they cause for those that suffer from them. The World Health Organization lists migraine as the 6th or 7th (depending on the study year) most debilitating condition in the world based on years lost due to disability. It causes missed work days, missed family time, and missed major life events such as weddings and graduations. Even when migraine sufferers are able to attend events or work, they are not always on their A-game due to headaches—they still miss out.

Most people have heard of migraine headaches. They are relatively common, affecting 18% of women and 6% of men in the U.S., an estimated 38 million people. What many people don’t know, however, is the enormous burden they cause for those that suffer from them. The World Health Organization lists migraine as the 6th or 7th (depending on the study year) most debilitating condition in the world based on years lost due to disability. It causes missed work days, missed family time, and missed major life events such as weddings and graduations. Even when migraine sufferers are able to attend events or work, they are not always on their A-game due to headaches—they still miss out.

Prior to May of this year, there were no migraine preventative therapies which were actually designed for migraine. They were mostly anti-seizure, anti-hypertensive, and antidepressant medications. The only FDA-approved choices were propranolol, timolol, Depakote, Topamax, and Botox (which is approved for chronic migraine only). The effectiveness of these medications is often limited by side effects including drowsiness, cognitive slowing, weight gain, weight loss, etc.

Now, for the first time in history, treatments have been developed for the prevention of migraine headache. These medications can be used to prevent transformation of episodic into the chronic, difficult-to-treat migraine. They can also be used to treat migraine which has become chronic. Since May 17, 2018, there have been three FDA-approved medications for the prevention of migraine. A fourth medication is currently under FDA-review and may be approved in 2019.

The first on the market (May 17, 2018) is called Aimovig. The second approved drug is call Ajovy, which was FDA-approved September 14, 2018. The third is Emgality, which was approved September 24, 2018 (it will be available in pharmacies by mid October 2018). All three of these medications are injections, which can be given at home by the patient. Aimovig and Emgality are once monthly injections. Ajovy is given once monthly or once quarterly based on patient preference. All three of these medications have similar efficacy data, with 50% or more percent of patients experiencing a 50% or greater reduction in headache days. Side effects of this class of medications are few, with constipation and injection site discomfort being the main adverse reaction in studies. Detailed information on the individual medications may be found at their respective website locations: www.aimovig.com, www.ajovy.com, and www.emgality.com

This article is not intended to promote the use of any particular medication, but is for informational purposes only. Talk to your doctor regarding the appropriateness of these medications for your condition.