February 24, 2020
Migraine is a chronic condition characterized by episodic attacks of disabling headaches that can cause pain, nausea, light and sound sensitivity, or vomiting. These symptoms can last for hours or even days. For this reason, it’s understandable that any announcement of new migraine treatments is cause for excitement for those affected and discussion of how to effectively manage them.
Some migraine medications help prevent migraines (prophylactic), and others are taken to lessen the severity once a migraine begins (abortive). Triptans (e.g., Imitrex®, Zomig®) are in a class of medications commonly used as an abortive treatment; however, certain patients cannot tolerate triptans due to cardiovascular risks or other side effects.
Within the last year, there’s been a lot of buzz about new migraine treatments, starting with three new prophylactic medications — Aimovig™, Ajovy™, and Emgality™ — that were approved by the FDA in 2018.
These three medications form a new drug class called CGRP inhibitors. The medications in this drug class are unique because they:
One additional medication, Reyvow™, also recently received FDA approval. Reyvow™ is similar to triptans, but it has shown reduced cardiovascular risk, including vasoconstriction (narrowing of blood vessels).
New CGRPs are expected to be available soon. Ubrelvy™ (ubrogepant) recently received approval by the FDA for the acute treatment of migraines. Rimegepant is also seeking for FDA approval for the acute treatment of migraines.
Once they’re approved and available, these new migraine treatments will likely be prescribed for those who don’t respond or have contraindications to first‑line therapies.
1 Burton, WN, Landy, SH, Downs, KE, Runken, MC. The Impact of Migraine and the Effect of Migraine Treatment on Workplace Productivity in the United States and Suggestions for Future Research. Mayo Clin Proc. 2009 May; 84(5): 436–445.
This article was originally published on IBX Insights.
Lisa joined Independence Blue Cross in 2003 as a clinical pharmacist and have served as the Director of Clinical Pharmacy since 2014. My work here focuses on managing our drug formularies in a way that is both cost-effective and provides our members access to the medications they need. I earned a Doctor of Pharmacy (PharmD) degree from the University of the Sciences in Philadelphia and an MBA from Drexel University.