An Algorithm of Migraine Treatment

Abstract

A satellite symposium at the XXI World Congress of Neurology 2013 presented the third edition of the International Classification of Headache Disorders and summarised the main changes, which reflect the importance of diagnosis based on phenomenology rather than aetiology. For this reason, a treatment algorithm for migraines has been created to assess the correct pathway and to reinforce the fact that triptans are the most effective treatment option. The symposium also discussed new guidelines regarding efficacy parameters in clinical trials, emphasising the importance of sustained pain free without relapse, an outcome measure that is important to patients. Crossover patient preference trials represent a true intra-individual comparison and allow the assessment of multiple endpoints defined by the patient preference, rather than the investigator. In clinical studies, frovatriptan has shown favourable tolerability and sustained effect with a lower rate of relapse compared with other triptans. These findings were confirmed in a series of patients who participated in the preference trials.