Update to Migraine Prophylaxis

09 Mar Update to Migraine Prophylaxis

All TreatGx users now have access to the updated treatment algorithm for Migraine Prophylaxis.

This update accounts for revisions made to existing clinical guidelines and will help health care providers select the safest and most effective medications with their patients. The algorithm now includes recommendations from migraine prophylaxis guidelines including the American Headache Society Consensus Statement 2021[1], Annals of Medicine 2021[2], American Family Physician 2019[3], Veterans Affairs and Department of Defense 2020[4], and Neurologic Clinics 2019[5].

As part of the update, new drugs have been added from the calcitonin gene-related peptide antibodies (CGRP) drug class. These drugs include erenumab, fremanezumab, galcanezumab, and eptinezumab. Atenolol and nadolol have also been added to expand the pharmacotherapy options within the beta-blocker drug class. Note that the scope has shifted towards providing prophylactic therapy options for only episodic migraines.

As always, this update includes the TreatGx standard of providing personalized dosing based on pharmacogenetics, kidney function, liver function, and drug interactions.

References

1. Ailani J, Burch RC, Robbins MS. The American Headache Society Consensus Statement: Update on integrating new migraine treatments into clinical practice. Headache. 2021;61(7):1021-1039.
2. Martin VT, Feoktistov A, Solomon GD. A rational approach to migraine diagnosis and management in primary care. Ann Med. 2021;53(1):1979-1990.
3. Ha H, Gonzalez A. Migraine Headache Prophylaxis. Am Fam Physician. 2019;99(1):17-24.
4. Department of Veterans Affairs/Department of Defense. VA/DoD Clinical Practice Guideline for the Primary Care Management of Headache. 2020. https://www.healthquality.va.gov/guidelines/pain/headache/VADoDHeadacheCPGFinal508.pdf.
5. Parikh SK, Silberstein SD. Preventive Treatment for Episodic Migraine. Neurol Clin. 2019;37(4):753-770.