title: Taking the negative view of current migraine treatments: the unmet needs.
abstract: Acute migraine treatment is given to abolish ongoing attacks, while prophylactic migraine treatment is given on a daily basis to prevent the occurrence of migraine attacks as far as possible. The majority of migraine patients do not use the specific acute anti-migraine drugs, the triptans. Thus, only 10% (Denmark) to 35% (France) of migraine patients use triptans. This is most likely due to relatively low efficacy. Thus, in randomized controlled trials (RCTs) pain freedom after 2 hours ranges from 12% (frovatriptan 2.5 mg) to 40% (rizatriptan 10 mg). For prophylactic treatment (propranolol, valproate, topiramate) a response (at least a 50% reduction in migraine frequency) is observed in 40-50%. In addition, prophylactic treatment is hampered by adverse events and withdrawals. There is a need for new acute anti-migraine drugs and targets are already available and there are more to come. It has been estimated that approximately 2% of the adult population need prophylactic treatment because of frequent migraine attacks. For prophylactic migraine drugs there is an even greater need for new drugs than for acute drug treatment.
authors.affiliation: Danish Headache Center, Health Science Faculty, University of Copenhagen, Department of Neurology, Glostrup Hospital, Glostrup, Denmark. ptha@glo.regionh.dk
authors.forename: Peer
authors.initials: P
authors.lastname: Tfelt-Hansen
authors.forename: Jes
authors.initials: J
authors.lastname: Olesen
mesh_terms: D000208:Acute Disease; D000328:Adult; D016503:Drug Delivery Systems; D015195:Drug Design; D006801:Humans; D008881:Migraine Disorders / Q000188:drug therapy* / Q000503:physiopathology / Q000517:prevention & control; D014363:Tryptamines / Q000627:therapeutic use
chemical_list: D014363:Tryptamines