ISSN 0017-8748 doi: 10.1111/head.12504 Published by Wiley Periodicals, Inc.
Headache © 2015 American Headache Society
Guest Editorial Acute Migraine Treatment E. Bigal, MD, PhD, with the help of B. Lee Peterlin, DO, Brian B. Grosberg, MD, William B. Young, MD, Starr H. Pearlman, PhD, Jay Rosenberg, MD, C. Argoff, MD, Richard B. Lipton, MD, and Stephen D. Silberstein, MD, was utilized. The new evidence criteria used in the original guidelines created a problem because many of the older drugs were rated by the old criteria. We have attempted to update these drugs when possible. The AHS Guidelines Committee is developing and will publish a companion piece to allow translation of the evidence-based guidelines to daily practice.
Migraine sufferers are often dissatisfied patients; half of those who consult stop seeking medical care for their headaches. Only 28% of sufferers are very satisfied with their usual treatment.1 Migraine has major implications for a patient’s job and for their family and social life.2 Migraine sufferers experience significant disability, lost workdays, and diminished quality of life, accounting for over $13 billion dollars a year because of missed workdays.2 There have been a number of advances in the diagnosis and treatment of migraine and great strides in understanding its pathogenesis. The American Academy of Neurology (AAN) and the U.S. Headache Consortium developed evidence-based guidelines for migraine, which were published in 2000.3 The guidelines contained five parts: Overview of Program Description and Methodology; Neuroimaging in Patients with Nonacute Headache; Pharmacological Management of Acute Attacks; Behavioral and Physical Treatments; and Pharmacological Management for Prevention of Migraine. The goals of the guidelines were to reduce attacks, improve the response to medication, and restore patients’ ability to function. Each treatment was graded based on the quality of available evidence, scientific effect, clinical impression of effect, and adverse events. Since the publication of these guidelines, the evidence criteria changed and recommendations are largely based on the quality of evidence in published literature.4,5 The AAN and the American Headache Society (AHS) updated the preventive guidelines in 2012 using these criteria.6,7 In cooperation with the AAN, the AHS has now updated the Pharmacological Management of Acute Attacks, which is published in this issue of Headache using this updated criterion. An earlier AAN unpublished update chaired by Marcelo
Stephen D. Silberstein, MD; Michael J. Marmura, MD Thomas Jefferson University, Department of Neurology, Jefferson Headache Center, Philadelphia, PA, USA
REFERENCES 1. Lipton RB, Stewart WF. Acute migraine therapy: Do doctors understand what patients with migraine want from therapy? Headache. 1999;39:S20-S26. 2. Hu X, Markson LE, Lipton RB, Stewart WF, Berger ML. Burden of migraine in the United States: Disability and economic costs. Arch Intern Med. 1999;159: 813-818. 3. Silberstein SD. Practice parameter – Evidence-based guidelines for migraine headache (an evidence-based review): Report of the quality standards subcommittee of the American Academy of Neurology for the United States Headache Consortium. Neurology. 2000;55:754-762. 4. American Academy of Neurology Guideline Development Process Manual, 2004 edn. St. Paul, MN: American Academy of Neurology; 2004.
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2 5. American Academy of Neurology Clinical Practice Guideline Process Manual, 2011 edn. St. Paul, MN: American Academy of Neurology; 2011. 6. Silberstein SD, Holland S, Freitag F, Dodick DW, Argoff C, Ashman E. Evidence-based guideline update: Pharmacologic treatment for episodic migraine prevention in adults: Report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology. 2012;78:1337-1345.
January 2015 7. Holland S, Silberstein SD, Freitag F, Dodick DW, Argoff C, Ashman E. Evidence-based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults: Report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology. 2012;78:1346-1353.
Headache © 2015 American Headache Society
Guest Editorial Acute Migraine Treatment E. Bigal, MD, PhD, with the help of B. Lee Peterlin, DO, Brian B. Grosberg, MD, William B. Young, MD, Starr H. Pearlman, PhD, Jay Rosenberg, MD, C. Argoff, MD, Richard B. Lipton, MD, and Stephen D. Silberstein, MD, was utilized. The new evidence criteria used in the original guidelines created a problem because many of the older drugs were rated by the old criteria. We have attempted to update these drugs when possible. The AHS Guidelines Committee is developing and will publish a companion piece to allow translation of the evidence-based guidelines to daily practice.
Migraine sufferers are often dissatisfied patients; half of those who consult stop seeking medical care for their headaches. Only 28% of sufferers are very satisfied with their usual treatment.1 Migraine has major implications for a patient’s job and for their family and social life.2 Migraine sufferers experience significant disability, lost workdays, and diminished quality of life, accounting for over $13 billion dollars a year because of missed workdays.2 There have been a number of advances in the diagnosis and treatment of migraine and great strides in understanding its pathogenesis. The American Academy of Neurology (AAN) and the U.S. Headache Consortium developed evidence-based guidelines for migraine, which were published in 2000.3 The guidelines contained five parts: Overview of Program Description and Methodology; Neuroimaging in Patients with Nonacute Headache; Pharmacological Management of Acute Attacks; Behavioral and Physical Treatments; and Pharmacological Management for Prevention of Migraine. The goals of the guidelines were to reduce attacks, improve the response to medication, and restore patients’ ability to function. Each treatment was graded based on the quality of available evidence, scientific effect, clinical impression of effect, and adverse events. Since the publication of these guidelines, the evidence criteria changed and recommendations are largely based on the quality of evidence in published literature.4,5 The AAN and the American Headache Society (AHS) updated the preventive guidelines in 2012 using these criteria.6,7 In cooperation with the AAN, the AHS has now updated the Pharmacological Management of Acute Attacks, which is published in this issue of Headache using this updated criterion. An earlier AAN unpublished update chaired by Marcelo
Stephen D. Silberstein, MD; Michael J. Marmura, MD Thomas Jefferson University, Department of Neurology, Jefferson Headache Center, Philadelphia, PA, USA
REFERENCES 1. Lipton RB, Stewart WF. Acute migraine therapy: Do doctors understand what patients with migraine want from therapy? Headache. 1999;39:S20-S26. 2. Hu X, Markson LE, Lipton RB, Stewart WF, Berger ML. Burden of migraine in the United States: Disability and economic costs. Arch Intern Med. 1999;159: 813-818. 3. Silberstein SD. Practice parameter – Evidence-based guidelines for migraine headache (an evidence-based review): Report of the quality standards subcommittee of the American Academy of Neurology for the United States Headache Consortium. Neurology. 2000;55:754-762. 4. American Academy of Neurology Guideline Development Process Manual, 2004 edn. St. Paul, MN: American Academy of Neurology; 2004.
1
2 5. American Academy of Neurology Clinical Practice Guideline Process Manual, 2011 edn. St. Paul, MN: American Academy of Neurology; 2011. 6. Silberstein SD, Holland S, Freitag F, Dodick DW, Argoff C, Ashman E. Evidence-based guideline update: Pharmacologic treatment for episodic migraine prevention in adults: Report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology. 2012;78:1337-1345.
January 2015 7. Holland S, Silberstein SD, Freitag F, Dodick DW, Argoff C, Ashman E. Evidence-based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults: Report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology. 2012;78:1346-1353.
