On June 29, at the 10th Congress of the European Academy of Neurology (EAN), the early treatment of migraine to optimize care in a variety of different contexts was covered in two presentations during an AbbVie-sponsored satellite symposium, followed by a panel discussion. Despite the evidence that early initiation of acute treatment results in better outcomes, many patients do not take their medication in a timely manner and significant patient education will be required to drive a shift in their administration habits, says GlobalData, a leading data and analytics company.

Pippa Salter, Managing Neurology Analyst at GlobalData, comments: “Many patients are unaware that early administration can improve outcomes, something highlighted by key opinion leaders (KOLs) recently interviewed by GlobalData, who noted that when a patient is not responding well to an acute therapy, such as a triptan, their first solution is to often educate the patient that taking the drug early in their migraine episode will maximize treatment effectiveness.”

A further key challenge highlighted during the symposium is that, due to the variability of migraine episodes, many patients do not like to take medication early, but rather will hold out until the pain is sufficiently severe that they are then required to take acute medication.

Salter continues: “The favorable side effect profiles of the gepants, a new disease-targeting class of drug, present an opportunity for earlier treatment, as patients may be more willing to take these drugs earlier in their migraine episode, compared with the current first-line triptan drugs.”

In addition to the early timing of acute treatment, the importance of early onset preventive medication was also discussed during the symposium. There is clinical evidence that the new anti-calcitonin gene-related peptide (CGRP) monoclonal antibodies (mAbs) and gepants show efficacy just one week after treatment initiation.

Salter concludes: “The earlier that patients can see that a preventive medication is effective, the more likely they are to persist with that treatment. Lack of compliance has been a significant challenge with the old oral preventive therapies, particularly as many of the drugs also have poor side-effect profiles. In contrast, anti-CGRP mAbs and gepants have demonstrated greater efficacy for migraine prevention and have fewer side-effect concerns, making them more attractive options for patients.

“However, despite the potential benefits of early prevention with these therapies, the panel acknowledged that their higher price points mean that there are reimbursement restrictions in many European countries that would prevent them from being used early in a prevention landscape.”