Reading about migraines is enough to give anyone a headache. Not only is migraine the sixth most prevalent non-fatal condition in the world and the second most common cause of disability (low back pain still tops the list),1 it ranks as the number one cause of years lived with disability (YLDs) in individuals under the age of 50.2 In the most recent Global Burden of Disease Study, migraine was found to account for nearly 76 million YLDs across 195 countries and territories, with prevalence on the rise.1
The World Health Organization has identified headache disorders as a major public health concern, citing the annual loss of 25 million workdays and school-days from migraine in the United Kingdom alone.3 And in the United States, migraine is thought to affect more than 20% of Americans in various ages and stages,4,5 and is responsible for an estimated $78 billion each year that encompasses the direct costs of treatment and the indirect costs of lost productivity.5 Yet, individuals with migraine are often confronted with being inadequately treated at best or disbelieved at worst, even when in the throes of a head-splitting attack. So what can be done?
Migraine treatment typically focuses on resting in a dark, quiet room for hours or days at a time while waiting for symptoms to pass naturally or respond to medications. But although prevention is key, long-suffering migraineurs have learned to manage dietary and lifestyle triggers such as food additives, caffeine, alcohol, inadequate exercise, altered sleep patterns, and secondhand cigarette smoke or perfume with limited success.
However, just in time for National Migraine and Headache Awareness Month this month, a new FDA-approved preventative migraine medication delivers a spark of hope. This novel approach uses monoclonal antibodies to block calcitonin gene-related peptide (CGRP) protein molecules that are involved in the onset of migraine in susceptible individuals.6 The once-monthly self-injectable medication helps zap migraines before they start, and will soon be accompanied by three more CGRP-blocking antibody medications currently undergoing clinical trials. At MDGuidelines, we will be watching these medications closely in hopes that they will provide individuals with migraines a flash of relief, enabling them to step back out into the light.
1. GBD 2016 Disease and Injury Evidence and Prevalence Collaborators. Global, Regional, and National Incidence, Prevalence, and Years Lived with Disability for 328 Diseases and Injuries for 195 Countries, 1990-2016: A Systematic Analysis for the Global Burden of Disease Study 2016. Lancet. 390 10100 (2017) 1211-1259. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5605509/
2. Steiner, T.J., et al. Migraine is First Cause of Disability in Under 50s: Will Health Politicians Now Take Notice? J Headache Pain. 19 1 (2018): 17. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5821623/
3. Headache Disorders: Key Facts. World Health Organization. 8 Apr. 2016. WHO. 12 Jun. 2018. http://www.who.int/news-room/fact-sheets/detail/headache-disorders
4. Burch, R., P. Rizzoli, and E. Loder. The Prevalence and Impact of Migraine and Severe Headache in the United States: Figures and Trends From Government Health Studies. Headache. 58 4 (2018): 496-505. https://onlinelibrary.wiley.com/doi/full/10.1111/head.13281
5. Gooch, C.L., E. Pracht, and A.R. Borenstein. The Burden of Neurological Disease in the United States: A Summary Report and Call to Action. Ann Neurol. 81 4 (2017): 479-484. https://onlinelibrary.wiley.com/doi/full/10.1002/ana.24897
6. FDA Approves Novel Preventive Treatment for Migraine. FDA News Release May 17, 2018. https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm608120.htm