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2020 brought new hope for patients with migraine – how will 2021 build on this success?

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For Patricia Pozo-Rosich, 2020 was an important year for patients with migraine, especially in Spain where she works. With access to anti-CGRP therapies becoming available for the first time, neurologists were able to educate their patients about the new agents and start to see the effects in clinical practice.

Clinical trial data published in 2020 continued to support the efficacy and safety of anti-CGRP therapies in migraine prevention,1-4 and supportive evidence from real world experience confirmed the benefits of treatment, including in patients with comorbidities and medication overuse.5-8

In Spain, these advances have helped to raise awareness of the impact of migraine on the daily lives of patients and the potential of novel treatments to give new hope, including to those with migraine that is hardest to treat.

In 2021, Professor Pozo-Rosich hopes that anti-CGRP therapies will open the door to precision medicine in migraine. She believes that ‘omic’, clinical, imaging, and other research will start to differentiate between responders and non-responders to anti-CGRP therapies and lead to the development of biomarkers to predict response. As the precision approach gathers momentum in the years ahead, she expects to see a move towards a more pathologically-driven migraine classification.

References

  1. Dodick DW, Gottschalk C, Cady R et al. Eptinezumab Demonstrated Efficacy in Sustained Prevention of Episodic and Chronic Migraine Beginning on Day 1 After Dosing. Headache 2020 Nov;60(10):2220-2231
  2. Tepper SJ, Diener HC, Ashina M et al. Erenumab in chronic migraine with medication overuse: Subgroup analysis of a randomized trial. 2019 May 14;92(20):e2309-e2320.
  3. Mulleners WM, Kim BK, Láinez MJA et al. Safety and efficacy of galcanezumab in patients for whom previous migraine preventive medication from two to four categories had failed (CONQUER): a multicentre, randomised, double-blind, placebo-controlled, phase 3b trial. Lancet Neurol. 2020 Oct;19(10):814-825.
  4. Silberstein SD, Cohen JM, Seminerio MJ et al. The impact of fremanezumab on medication overuse in patients with chronic migraine: subgroup analysis of the HALO CM study. J Headache Pain. 2020 Sep 21;21(1):114.
  5. Kaan S, Hettie G, Loder E, Burch R. Real-world effectiveness and tolerability of erenumab: A retrospective cohort study. Cephalalgia 2020 Nov;40(13):1511-1522.
  6. Straube A, Stude P, Gaul C et al. First one-year real world evidence data with the monoclonal antibody, erenumab, in Germany. Neurology 2020; 94 (suppl 15): 1873
  7. Cheng S, Jenkins B, Limberg N, Hutton E. Erenumab in Chronic Migraine: An Australian Experience. Headache 2020; 60 (10): 2555-2562
  8. Barbanti P, Aurilia C, Cevoli S et al. The first, Italian, multicenter, real-life study with erenumab in the prevention of high frequency episodic and chronic migraine. Neurology 2020; 94 (suppl 15): 2307