Browsing by Author "Ashina, Messoud"
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- European Headache Federation guideline on the use of monoclonal antibodies targeting the calcitonin gene related peptide pathway for migraine prevention – 2022 updatePublication . Sacco, Simona; Amin, Faisal Mohammad; Ashina, Messoud; Bendtsen, Lars; Deligianni, Christina I.; Gil-Gouveia, Raquel; Katsarava, Zaza; MaassenVanDenBrink, Antoinette; Martelletti, Paolo; Mitsikostas, Dimos Dimitrios; Ornello, Raffaele; Reuter, Uwe; Sanchez-del-Rio, Margarita; Sinclair, Alexandra J.; Terwindt, Gisela; Uluduz, Derya; Versijpt, Jan; Lampl, ChristianBackground: A previous European Headache Federation (EHF) guideline addressed the use of monoclonal antibodies targeting the calcitonin gene-related peptide (CGRP) pathway to prevent migraine. Since then, randomized controlled trials (RCTs) and real-world evidence have expanded the evidence and knowledge for those treatments. Therefore, the EHF panel decided to provide an updated guideline on the use of those treatments. Methods: The guideline was developed following the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) approach. The working group identified relevant questions, performed a systematic review and an analysis of the literature, assessed the quality of the available evidence, and wrote recommendations. Where the GRADE approach was not applicable, expert opinion was provided. Results: We found moderate to high quality of evidence to recommend eptinezumab, erenumab, fremanezumab, and galcanezumab in individuals with episodic and chronic migraine. For several important clinical questions, we found not enough evidence to provide evidence-based recommendations and guidance relied on experts’ opinion. Nevertheless, we provided updated suggestions regarding the long-term management of those treatments and their place with respect to the other migraine preventatives. Conclusion: Monoclonal antibodies targeting the CGRP pathway are recommended for migraine prevention as they are effective and safe also in the long-term.
- Hallmarks of primary headache: part 3 - cluster headachePublication . Coppola, Gianluca; Arruda, Marco Antônio; Ashina, Messoud; Barloese, Mads; Belin, Andrea Carmine; Bottiroli, Sara; Chowdhury, Debashish; Icco, Roberto De; Lorenzo, Cherubino di; Stefano, Giulia Di; Edvinsson, Jacob C. A.; Evers, Stefan; Ferraro, Stefania; Fronczek, Rolf; García-Azorín, David; Goadsby, Peter J.; Grazzi, Licia; Holle, Dagny; Jansen, Julia J.; Gil-Gouveia, Raquel; Lambru, Giorgio; Lanteri-Minet, Michel; Lisicki, Marco; Mitsikostas, Dimos D.; Monteith, Teshamae; Montisano, Danilo Antonio; Obermann, Mark; Pan, Li Ling Hope; Peng, Kuan Po; Peres, Mario; Petrušic, Igor; Cecchini, Alberto Proietti; Vila-Pueyo, Marta; Raggi, Alberto; Rainero, Innocenzo; Sandrini, Giorgio; Sebastianelli, Gabriele; Takizawa, Tsubasa; Tanprawate, Surat; Tassorelli, Cristina; Truini, Andrea; Valeriani, Massimiliano; Vuralli, Doga; Waliszewska-Prosół, Marta; Wang, Shuu Jiun; Wang, Yonggang; Wijeratne, Tissa; Martelletti, PaoloBackground: Cluster headache (CH) is a rare primary headache disorder characterized by recurrent episodes of strictly unilateral excruciating pain accompanied by trigemino-autonomic signs, which significantly impacts the quality of life, social interactions, and occupational functioning of those who are affected. To promote a better understanding of this disabling condition and to foster research on the topic, this review provides a comprehensive description of the hallmarks of CH, including its clinical presentation, diagnostic challenges, pathophysiology, and current and novel therapeutic targets. It concludes by describing the disease burden and advocating for significant improvements in healthcare systems, and promoting health equity, as well as reducing stigma. Principal findings: Despite its distinctive clinical and chronobiological features, CH may be mistaken for other primary headache disorders or different types of orofacial pain. Key pathogenic characteristics include the activation of the trigeminal-autonomic system with the release of several neuropeptides, the involvement of the hypothalamus in regulating the circadian rhythm, genetic variants, and the mesolimbic system. Both invasive and non-invasive neuromodulation treatments have been used to target the trigemino-cervical, parasympathetic, and hypothalamic systems. Additionally, novel therapeutic targets are currently being study. Alongside canonical therapies, several complementary approaches have been explored over the years, with most evidence deriving from uncontrolled research involving individuals who do not respond to standard pharmacological treatments. Despite advancements in our understanding of this complex disease, CH continues to pose considerable social, economic, and psychological challenges. Advocacy is essential and should prioritize early diagnosis, alleviate stigma, provide specialized training for healthcare professionals, and offer support to and through patient associations. Conclusions: CH is characterised by a complex, multifactorial, pathophysiology that is still not fully understood. Precise diagnosis, additional research studies, and robust psychosocial and institutional support are necessary to improve the quality of life for individuals affected by this debilitating condition.
- Rethinking headache as a global public health case model for reaching the SDG 3 HEALTH by 2030Publication . Martelletti, Paolo; Leonardi, Matilde; Ashina, Messoud; Burstein, Rami; Cho, Soo Jin; Charway-Felli, Augustina; Dodick, David W.; Gil-Gouveia, Raquel; Grazzi, Licia; Lampl, Christian; Maassen Van Den Brink, Antoinette; Minen, Mia T.; Mitsikostas, Dimos Dimitrios; Olesen, Jes; Owolabi, Mayowa Ojo; Reuter, Uwe; Ruiz de la Torre, Elena; Sacco, Simona; Schwedt, Todd J.; Serafini, Gianluca; Surya, Nirmal; Tassorelli, Cristina; Wang, Shuu Jiun; Wang, Yonggang; Wijeratne, Tissa; Raggi, AlbertoThe 2030 Agenda for Sustainable Development sets out, through 17 Sustainable Development Goals (SDGs), a path for the prosperity of people and the planet. SDG 3 in particular aims to ensure healthy lives and promote well-being for all at all ages and includes several targets to enhance health. This review presents a “headache-tailored” perspective on how to achieve SDG 3 by focusing on six specific actions: targeting chronic headaches; reducing the overuse of acute pain-relieving medications; promoting the education of healthcare professionals; granting access to medication in low- and middle-income countries (LMIC); implementing training and educational opportunities for healthcare professionals in low and middle income countries; building a global alliance against headache disorders. Addressing the burden of headache disorders directly impacts on populations’ health, as well as on the possibility to improve the productivity of people aged below 50, women in particular. Our analysis pointed out several elements, and included: moving forward from frequency-based parameters to define headache severity; recognizing and managing comorbid diseases and risk factors; implementing a disease management multi-modal management model that incorporates pharmacological and non-pharmacological treatments; early recognizing and managing the overuse of acute pain-relieving medications; promoting undergraduate, postgraduate, and continuing medical education of healthcare professionals with specific training on headache; and promoting a culture that favors the recognition of headaches as diseases with a neurobiological basis, where this is not yet recognized. Making headache care more sustainable is an achievable objective, which will require multi-stakeholder collaborations across all sectors of society, both health-related and not health-related. Robust investments will be needed; however, considering the high prevalence of headache disorders and the associated disability, these investments will surely improve multiple health outcomes and lift development and well-being globally.