Newly Approved Agents for the Treatment and Prevention of Pediatric Migraine
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Published on: August 11, 2021
Joanne Kacperski1,2, Andrew D Hershey3,4
1Division of Neurology, Cincinnati Children's Hospital Medical Center, 3333 Burnett Avenue, Cincinnati, OH, 45229, USA. Joanne.Kacperski@cchmc.org.
Insights
Pediatric migraine treatment needs more research, with few trials for acute and preventive care. Newly approved agents offer safe and effective options for children and adolescents.
Area of Science:
- Neurology
- Pediatrics
Background:
- Pediatric migraine treatment faces challenges due to limited pediatric trials and high placebo response rates.
- Current practices often rely on adult data, leading to varied management strategies and inconsistent evidence-based care.
- There is a significant unmet need for robust research in pediatric migraine treatment.
Purpose of the Study:
- To review recently approved acute and preventive migraine treatments for pediatric patients.
- To highlight the safety and efficacy of available therapeutic options for young migraine sufferers.
Main Methods:
- Review of newly approved abortive and preventive migraine medications for pediatric use.
- Analysis of existing studies on the safety and effectiveness of these agents in children and adolescents.
Main Results:
- Over-the-counter anti-inflammatories (ibuprofen, naproxen sodium, aspirin, acetaminophen) are suitable first-line acute treatments.
- Triptans (rizatriptan, almotriptan, zolmitriptan nasal spray) and combination therapy (naproxen sodium/sumatriptan) are proven safe and effective for pediatric migraine.
Conclusions:
- Several new abortive and preventive migraine agents are now approved for pediatric use.
- Evidence supports the safety and efficacy of triptans and specific over-the-counter medications in managing pediatric migraines.
Abstract:
Treatment of pediatric migraine remains an unmet medical need. There continues to be a paucity of pediatric randomized controlled trials for the treatment of migraine, both in the acute and preventive settings. Pediatric studies are often complicated by high placebo-response rates and much of our current practice is based on adult trials. This lack of significant pediatric studies results in a wide variation in migraine management both amongst clinicians and between institutions, and evidence-based treatments are not always administered. In this article, we aim to briefly review newly approved abortive and preventive agents for migraine in the pediatric age group. Over-the-counter anti-inflammatory medications, including ibuprofen, naproxen sodium, aspirin, and acetaminophen are reasonable first-line options for abortive therapy. In addition, studies have shown triptans, or migraine-specific agents, to be safe and effective in children and adolescents and several formulations have been approved for the pediatric population, including rizatriptan, almotriptan, zolmitriptan nasal spray, and naproxen sodium/sumatriptan in combination.
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