Migraine is the most common neurological disorder, affecting more than 80 million people in the US and in Europe and is certainly the most disabling. About a third of migraine patients have attacks with aura. A new study has shown that migraine attacks with aura are less responsive to sumatriptan (Imitrex) than migraine without aura. On the other hand, use of an inhaled DHE preparation seems effective in both migraine with and without aura. That drug will likely be approved by the FDA within the next year. It is not clear whether migraine with aura is merely more difficult to treat with sumatriptan or that there are different mechanisms that result in different responses to therapy. Understanding these differential responses to therapy may be an important step to personalized medicine in acute migraine treatment.
See Neurology, May 5, 2015, for articles beginning on page 1880 and a second article beginning on page 1828.
Jack Florin, MD
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