American Headache Society Issues New Migraine Prevention Guidance

The American Headache Society (AHS) has published a consensus position statement in Headache: The Journal of Head and Face Pain that provides guidance supporting the use of calcitonin gene-related peptide (CGRP)-targeting therapies as a first-line approach for migraine prevention. The new guidance encourages clinicians to use CGRP-targeting therapies as a first-line treatment along with other first-line treatments, regardless of whether patients have experienced failure when using other classes of migraine preventive therapies.

The consensus statement was based on a comprehensive review of clinical trial and real-world data, which demonstrated the safety, efficacy, and tolerability of CGRP-targeting therapies. The statement provides details about the fundamental role of CGRP in migraine as well as recommendations for implementing the guidance into practice including medication switching, adherence, and adverse effects. Additionally, the consensus statement states that most CGRP-targeting therapies, including CGRP monoclonal antibodies and small-molecule CGRP receptor antagonists, are approved by the Food and Drug Administration (FDA) for the preventive treatment of episodic and chronic migraine and are “migraine-specific” compared with other established therapies.

“Moving CGRP-targeting therapies to the first line of treatment could have a transformational impact on the prevention of migraine attacks and their associated burdens,” said Andrew Charles, MD, FAHS, President of the AHS and co-author of the consensus position statement. “Elevating CGRP-targeting therapies to the first line should reduce barriers for patients to receive these effective treatments and bring hope to countless people who experience this invisible, yet debilitating disease.”