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Two drug trials can provide some relief to migraine sufferers as well as those with cluster headaches, a rare but extremely painful type of headache that could be attributed to migraine headaches.
According to a study by The New England Medical Journal, two injections of the drug galcanezumab reduced the frequency of episodic cluster headache (ECH). And in another study published in the same issue of the journal, an experimental oral drug quickly cleared migraine pain in one in five patients.
Cluster headaches usually occur at least once a day – often at the same time of day or night – for weeks or months. The pain is usually around one eye. They end up leaving for a while, but may return after an absence of several months or years.
In the study on galcanezumab, 106 volunteers received two injections of anti-migraine medication or placebo, spaced one month apart. The drug reduced the average number of episodic cluster headaches by 51% in the first three weeks of treatment, from 17.8 per week to 9.1 per week. The placebo injections resulted in a 30% reduction from 17.3 a week to 12.1 a week.
Relief for many
Nearly three-quarters of participants found some reduction in headache frequency compared with about half of those taking placebo.
"Some patients are completely removed and others partly," said Reuters Health, the author of Dr. King Goadsby of King's College London. "I do not think we can overestimate the severity of a cluster attack."
To be eligible for the study, patients had to undergo at least one attack every two days but not more than eight per day. The typical volunteer had headaches for more than 16 years. The average age was about 46 years old and over 82% were men.
Each injection of 300 mg costs about $ 1,400, according to the website goodrx.com. Galcanezumab is sold under the brand name Emgality by Eli Lilly, and the company paid for this study.
"Patients report that ECH attacks are the most severe pain they face," said Goadsby, director of the clinical research center at NIHR-Wellcome Trust King and the SLaM biomedical research center.
"Imagine what it's like to give birth one to eight times a day, every day, for eight to twelve weeks a year.Do not imagine a full night of sleep for eight to twelve weeks and you know it will be the same next year, "he said. "This development is really important for these patients."
And this could trigger the development of even more effective treatments, he added.
The US Food and Drug Administration has approved the drug as an unprecedented treatment for episodic cluster headaches in June. The company estimates that about 250,000 people in the United States suffer from it.
For many, one migraine per month
In contrast, migraines affect about 39 million people in the United States, mostly women. Three quarters of migraine sufferers make at least one a month.
The migraine study was funded by Biohaven and involved the oral drug rimegepant drug from Biohaven Pharmaceuticals.
The researchers found that 19.6% of the 537 volunteers who took them while suffering from migraine no longer suffered in less than two hours, compared to 12% of the 535 volunteers receiving a placebo.
Half of the patients in both groups had a relapse of pain 2 to 48 hours after the dose was administered. Unlike conventional treatment with triptanes, taking a second dose does not provide additional relief, said lead author Dr. Richard Lipton, director of the Montefiore Headache Center in New York, during a telephone interview with Reuters Health.
"Triptans are well-established therapies, and about 25% of migraine sufferers currently take a triptan," said Lipton, also in the department of neurology at the Albert Einstein School of Medicine. "If it works well for them, they will not be candidates for this medicine.This is for people contraindicated for a triptan" or for people who are not relieved by the triptans.
The treatment with triptan costs about $ 7,000 a year, he said, and with regard to rhyme, "I'm hopeful that the drug will be affordable because many people need it."
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