Migraine is a painful headache syndrome and is the second-most disabling neurological disorder worldwide, affecting approximately 38-47 million Americans and costing more than $31 billion/year in the US alone. Nearly one in every five women and 6% men in the US suffer from migraine equaling to approximately 12% of the population. Migraine disorders range from low frequency episodic to chronic, have multiple associated symptoms from motor and sensory to cognitive and affective, and is a major cause of absentee days from work, decreased family and social activities as well as direct and indirect health care costs. The majority of people with migraine receive care from primary care providers with a smaller proportion of patients receiving care from specialists and subspecialists. Evidence-based acute “abortives”, prophylaxis “preventive”, and psychological/behavioral “non-pharmacological” modalities and treatments exist. Yet, there still remains unmet need for abortive treatments. Moreover, prevention and non-pharmacological modalities are underutilized in people with migraine. Poorly optimized abortive treatment of patients with episodic migraine is associated with an increased risk for these patients to develop chronic migraine. Patients with chronic migraine (CM) have greater disability, work loss, lower income, reduced productivity at home, greater use of healthcare resources and 4.4 times greater total medical cost than patients with episodic migraine. Recent FDA approved calcitonin gene related peptide (CGRP) treatments for migraine, in part, highlight an important aspect of the complex pathophysiology of the disorder. This course will explore the CGRP mechanisms in migraine with discussion and pearls for integrating these treatments into clinical practice. The target audience will include all healthcare professionals who are involved in treating patients with migraine with a special emphasis for those who practice primary care medicine, neurology, and headache medicine.
Explain the currently known role of CGRP in migraine pathophysiology
Review evidence-based abortive and preventive CGRP therapies for the treatment of migraine
Discuss the mechanism of action in which current CGRP therapies may exert their effect in migraine treatment
Identify potential recommendations for initiating CGRP therapies for the treatment of migraine