According to The American Migraine Foundation, one is said to have migraine if “within his or her lifetime there have been five or more attacks of unprovoked headache lasting 4-72 hours, severe enough to markedly restrict or even prohibit routine daily activity and accompanied by nausea or light/sound sensitivity.” Lucky for migraine sufferers, there are new drugs on the market that could bring relief.
Migraine affects an estimated 38 million individuals. Three to seven million of those people have chronic migraines, meaning they average 15 or more days of headache a month for at least three months.
-The American Migraine Foundation
New Class of Drugs
Although there are migraine therapies available, few have been developed specifically for the condition. The US Food and Drug Administration recently approved three agents in a new class of drugs, known as calcitonin gene-related peptide antagonists (CGRP), for the prevention of migraine headaches in adults.
These products include:
• Aimovig™ (erenumab)
• Ajovy™ (fremanezumab)
• Emgality™ (galcanezumab)
All three medications have a yearly price tag of $6,900, without factoring in potential discounts and rebates.
How Well Do They Work?
Studies showed migraines were reduced by an average of two per month over placebo, although 30 percent of users saw their migraines reduced by half.¹ Typical oral migraine preventative medications reduce migraine days by an average of one to four.²
Since blocking CGRP limits opening of the blood vessels, there may be increased risk for those with pre-existing or high risk of heart disease.
When Should You Use Them?
If you have the following symptoms, talk to your doctor about a CGRP that may be right for you:
- Migraines occurring at least four days per month, who haven’t tolerated/responded to a six-week trial of at least two evidence-based oral preventative medications and who have at least moderate disability resulting from their migraines
- Chronic migraines who haven’t tolerated/ responded to a six week trial of at least two evidence-based oral preventative medications or the inability to tolerate/respond to Botox injections.³
- Lancet. 2018 Nov 24;392(10161):2280-2287. Reuter U, Goadsby PJ, Lanteri-Minet M, Wen S, Hours-Zesiger P5 Ferrari MD, Klatt J
- Antiepileptics in migraine prophylaxis: An updated Cochrane review. Wim M Mulleners1, Douglas C McCrory2,3 and Mattias Linde4,5. Cephalalgia 2015, Vol. 35(1) 51–62.
- AHS Consensus Statement Free Access The American Headache Society Position Statement On Integrating New Migraine Treatments Into Clinical Practice. American Headache Society. 10 December 2018