Meeting patient expectations in migraine treatment: What are the key endpoints?

Fabio Antonaci, Grazia Sances, Elena Guaschino, Ilaria De Cillis, Giorgio Bono, Giuseppe Nappi

Research output: Contribution to journalArticlepeer-review

Abstract

Clinical outcomes of migraine treatment are generally based on two major endpoints: acute pain resolution and effects on quality of life (QOL). Resolution of acute pain can be evaluated in a number of ways, each increasingly challenging to achieve; pain relief, pain freedom at 2 h, sustained pain-freedom, and SPF plus no adverse events (SNAE, the most challenging). QOL questionnaires help assess the burden of migraine and identify optimal treatments. Pain resolution and improved QOL form the basis of the ultimate target - meeting patient expectations, to achieve patient satisfaction. To achieve this, it is crucial to choose appropriate endpoints that reflect realistic treatment goals for individual patients. Moreover, SNAE can help discriminate between triptans, with almotriptan having the highest SNAE score. Kaplan - Meier plots are also relevant when evaluating migraine treatments. The use of symptomatic medication may lead to the paradoxical development of medication-overuse headache. In general practice, patients should use simple tools for pain measurement (e.g. headache diary) and a QOL questionnaire. A composite endpoint of pain resolution and QOL restoration would constitute a step forward in migraine management.

Original languageEnglish
Pages (from-to)207-213
Number of pages7
JournalJournal of Headache and Pain
Volume9
Issue number4
DOIs
Publication statusPublished - 2008

Keywords

  • Migraine treatment
  • Outcome
  • Quality of life

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Neuroscience(all)

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