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Diener HC, Tassorelli C, Dodick DW, Silberstein SD, Lipton RB, Ashina M, Becker WJ, Ferrari MD, Goadsby PJ, Pozo-Rosich P, Wang SJ, Mandrekar J. Guidelines of the International Headache Society for controlled trials of acute treatment of migraine attacks in adults: Fourth edition. Cephalalgia 2019; 39:687-710. [PMID: 30806518 PMCID: PMC6501455 DOI: 10.1177/0333102419828967] [Citation(s) in RCA: 100] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The quality of clinical trials is an essential part of the evidence base for the treatment of headache disorders. In 1991, the International Headache Society Clinical Trials Standing Committee developed and published the first edition of the Guidelines for controlled trials of drugs in migraine. Scientific and clinical developments in headache medicine led to second and third editions in 2000 and 2012, respectively. The current, fourth edition of the Guidelines retains the structure and much content from previous editions. However, it also incorporates evidence from clinical trials published after the third edition as well as feedback from meetings with regulators, pharmaceutical and device manufacturers, and patient associations. Its final form reflects the collective expertise and judgement of the Committee. These updated recommendations and commentary are intended to meet the Society's continuing objective of providing a contemporary, standardized, and evidence-based approach to the conduct and reporting of randomised controlled trials for the acute treatment of migraine attacks.
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Affiliation(s)
| | - Cristina Tassorelli
- 2 Headache Science Center, IRCCS Mondino Foundation, Pavia, Italy.,3 Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - David W Dodick
- 4 Department of Neurology, Mayo Clinic, Phoenix, AZ, USA
| | | | - Richard B Lipton
- 6 Montefiore Headache Center, Department of Neurology and Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Messoud Ashina
- 7 Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Glostrup, Denmark
| | - Werner J Becker
- 8 Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.,9 Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - Michel D Ferrari
- 10 Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Peter J Goadsby
- 11 National Institute for Health Research Wellcome Trust King's Clinical Research Facility, King's College London, London, England
| | - Patricia Pozo-Rosich
- 12 Headache Research Group, Vall d'Hebron Institute of Research, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Shuu-Jiun Wang
- 13 Headache & Craniofacial Pain Unit, Neurology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,14 Neurological Institute, Taipei Veterans General Hospital and Brain Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Jay Mandrekar
- 15 Department of Health Sciences Research, Mayo Clinic Rochester, MN, USA
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Eikermann-Haerter K, Can A, Ayata C. Pharmacological targeting of spreading depression in migraine. Expert Rev Neurother 2012; 12:297-306. [PMID: 22364328 PMCID: PMC3321647 DOI: 10.1586/ern.12.13] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Migraine, particularly with aura, is a genetically heterogeneous disorder of ion channels, pumps or transporters associated with increased cortical excitability. Spreading depression, as one reflection of hyperexcitability, is the electrophysiological event underlying aura symptoms and a trigger for headache. Endogenous (e.g., genes and hormones) and exogenous factors (e.g., drugs) modulating migraine susceptibility have also been shown to modulate spreading depression susceptibility concordantly, suggesting that spreading depression can be a relevant therapeutic target in migraine. In support of this, several migraine prophylactic drugs used in clinical practice have been shown to suppress spreading depression susceptibility as a probable mechanism of action, despite belonging to widely different pharmacological classes. Hence, susceptibility to spreading depression can be a useful preclinical model with good positive and negative predictive value for drug screening.
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Affiliation(s)
- Katharina Eikermann-Haerter
- Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, 149 13th Street, Charleston, MA 02129, USA.
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Tfelt-Hansen P, Pascual J, Ramadan N, Dahlöf C, D'Amico D, Diener HC, Hansen JM, Lanteri-Minet M, Loder E, McCrory D, Plancade S, Schwedt T. Guidelines for controlled trials of drugs in migraine: Third edition. A guide for investigators. Cephalalgia 2012; 32:6-38. [DOI: 10.1177/0333102411417901] [Citation(s) in RCA: 279] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | | | | | - Nabih Ramadan
- Nebraska HHS and Beatrice State Developmental Center, USA
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