Migraine
Publikation: Bidrag til tidsskrift › Review › Forskning › fagfællebedømt
Migraine is a common, chronic, disorder that is typically characterized by recurrent disabling attacks of headache and accompanying symptoms, including aura. The aetiology is multifactorial with rare monogenic variants. Depression, epilepsy, stroke and myocardial infarction are comorbid diseases. Spreading depolarization probably causes aura and possibly also triggers trigeminal sensory activation, the underlying mechanism for the headache. Despite earlier beliefs, vasodilation is only a secondary phenomenon and vasoconstriction is not essential for antimigraine efficacy. Management includes analgesics or NSAIDs for mild attacks, and, for moderate or severe attacks, triptans or 5HT1B/1D receptor agonists. Because of cardiovascular safety concerns, unreliable efficacy and tolerability issues, use of ergots to abort attacks has nearly vanished in most countries. CGRP receptor antagonists (gepants) and lasmiditan, a selective 5HT1F receptor agonist, have emerged as effective acute treatments. Intramuscular onabotulinumtoxinA may be helpful in chronic migraine (migraine on ≥15 days per month) and monoclonal antibodies targeting CGRP or its receptor, as well as two gepants, have proven effective and well tolerated for the preventive treatment of migraine. Several neuromodulation modalities have been approved for acute and/or preventive migraine treatment. The emergence of new treatment targets and therapies illustrates the bright future for migraine management.
| Originalsprog | Engelsk |
|---|---|
| Artikelnummer | 2 |
| Tidsskrift | Nature Reviews Disease Primers |
| Vol/bind | 8 |
| ISSN | 2056-676X |
| DOI | |
| Status | Udgivet - 2022 |
Bibliografisk note
Funding Information:
D.W.D. reports the following conflicts: consulting: AEON, Amgen, Clexio, Cerecin, Cooltech, Ctrl M, Allergan, Alder, Biohaven, GSK, Linpharma, Lundbeck, Promius, Eli Lilly, eNeura, Novartis, Impel, Satsuma, Theranica, WL Gore, Nocira, XoC, Zosano, Upjohn (Division of Pfizer), Pieris, Praxis, Revance, Equinox; honoraria: Clinical Care Solutions, CME Outfitters, Curry Rockefeller Group, DeepBench, Global Access Meetings, KLJ Associates, Academy for Continued Healthcare Learning, Majallin LLC, Medlogix Communications, MJH Lifesciences, Miller Medical Communications, Southern Headache Society (MAHEC), WebMD Health/Medscape, Wolters Kluwer, Oxford University Press, Cambridge University Press; research support: Department of Defense, National Institutes of Health, Henry Jackson Foundation, Sperling Foundation, American Migraine Foundation, Patient Centered Outcomes Research Institute (PCORI); stock options/shareholder/patents/boards of directors: Ctrl M (options), Aural Analytics (options), ExSano (options), Palion (options), Healint (options), Theranica (options), Second Opinion/Mobile Health (options), Epien (options/Board), Nocira (options), Matterhorn (shares/Board), Ontologics (shares/Board), King-Devick Technologies (options/Board), Precon Health (options/Board); patent 17189376.1-1466:v (title: Botulinum Toxin Dosage Regimen for Chronic Migraine Prophylaxis). M.A. is a consultant or scientific advisor for AbbVie, Allergan, Amgen, Eli Lilly, Lundbeck, Novartis and Teva; a primary investigator for ongoing Amgen, AbbVie/Allergan and Lundbeck trials; and has received grants from Lundbeck Foundation, Novo Nordisk Foundation and a research grant from Novartis. T.K. reports having contributed to an advisory board of CoLucid and a research project funded by Amgen, for which the Charité– Universitätsmedizin Berlin received an unrestricted compensation; he further reports having received honoraria from Lilly, Newsenselab, and Total for providing methodological advice, from Novartis and from Daiichi Sankyo for providing a lecture on neuroepidemiology and research methods, and from the BMJ for editorial services. P.J.G. reports, over the last 36 months, grants and personal fees from Amgen and Eli-Lilly and Company, a grant from Celgene, and personal fees from Alder Biopharmaceuticals, Aeon Biopharma, Allergan, Biohaven Pharmaceuticals Inc., Clexio, Electrocore LLC, eNeura, Epalex, GlaxoSmithKline, Impel Neuropharma, Lundbeck, MundiPharma, Novartis, Pfizer, Praxis, Sanofi, Santara Therapeutics, Satsuma, Teva Pharmaceuticals, Trigemina Inc., WL Gore, and personal fees for advice through Gerson Lehrman Group, and Guidepoint, fees for educational materials from Massachusetts Medical Society, Medery, Medlink, PrimeEd, UptoDate, WebMD, and publishing royalties from Oxford University Press, and Wolters Kluwer, and for medicolegal advice in headache, and a patent magnetic stimulation for headache (no. WO2016090333 A1) assigned to eNeura without fee. M.D.F. reports grants and consultancy or industry support from Electrocore, Medtronic, Eli Lilly, Amgen, Novartis, Satsuma, Lundbeck, and TEVA, and independent support from The Netherlands Organisation for Scientific Research (NWO), The Netherlands Organisation for Health Research and Development (ZonMW), The Dutch Brain Foundation, The Dutch Heart Foundation, The Dutch Ministry of Health, and The NutsOhra Foundation from the Dutch Insurance Companies. A.C. is a compensated consultant for Amgen, Biohaven, Eli Lilly, Lundbeck, and Satsuma; he is on the executive board of the American Headache Society. R.B. is the John Hedley-Whyte Professor of Anaesthesia and Neuroscience at the Beth Israel Deaconess Medical Center and Harvard Medical School; he has received research support from the NIH (R01 NS094198-01A1, R37 NS079678, R01NS095655, R01 NS104296, R21 NS106345), Allergan, Teva, Dr. Ready, Eli Lilly, Trigemina and the Migraine Research Foundation; he is a reviewer for NINDS; he holds stock options in AllayLamp, Theranica and Percept; he serves as consultant, advisory board member, or has received honoraria from: Alder, Allergan, Amgen, Autonomic Technologies, Avanir, Biohaven, Dr. Reddy’s Laboratory, electroCore, Eli Lilly, GlaxoSmithKline, Merck, Pernix, Theranica, Teva, and Trigemina; and has rev-eived CME fees from Healthlogix, Medlogix, WebMD/ Medscape. A.M.J.M.v.d.M. reports grants and or industry support from Precision Medicine and Schedule 1 Therapeutics and independent support from The Netherlands Organisation for Scientific Research (NWO) and The Netherlands Organisation for Health Research and Development (ZonMW). C.A. declares no competing interests.
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