[Migraine headaches: What is new in treatment?]

Area of Science:

• Neurology
• Pediatrics
• Pharmacology

Background:

• Migraine is a prevalent headache disorder in children and adolescents.
• Current management strategies include acute and preventive interventions.
• Limited evidence exists for novel treatments in the pediatric population.

Purpose of the Study:

• To review current evidence for acute and preventive migraine treatments in pediatrics.
• To focus on emerging therapies for pediatric migraine, including those approved for adults and under investigation in children.
• To discuss both pharmacological and nonpharmacological strategies.

Main Methods:

• Literature review of current evidence for pediatric migraine therapies.
• Focus on emerging treatments such as onabotulinumtoxinA, neuromodulation devices, gepants, monoclonal antibodies, and 5-hydroxytryptamine receptor agonists.
• Inclusion of both established and investigational treatments.

Main Results:

• Topiramate and propranolol demonstrate modest benefits over placebo for pediatric migraine.
• Evidence for novel therapies like onabotulinumtoxinA, gepants, and monoclonal antibodies in pediatric populations is expanding.
• Nonpharmacological strategies and neuromodulation devices are also under investigation.

Conclusions:

• The evidence base for novel pediatric migraine treatments is growing but remains limited.
• Further research is needed to establish the efficacy and safety of emerging therapies in children and adolescents.
• Current options like topiramate and propranolol offer modest benefits, highlighting the need for more effective pediatric migraine interventions.