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Abstract：
To incorporate recent research findings, expert consensus, and patient perspectives into updated guidance on the use of new acute and preventive treatments for migraine in adults.
The American Headache Society previously published a Consensus Statement on the use of newly introduced treatments for adults with migraine. This update, which is based on the expanded evidence base and emerging expert consensus concerning postapproval usage, provides practical recommendations in the absence of a formal guideline.
This update involved four steps: (1) review of data about the efficacy, safety, and clinical use of migraine treatments introduced since the previous Statement was published; (2) incorporation of these data into a proposed update; (3) review and commentary by the Board of Directors of the American Headache Society and patients and advocates associated with the American Migraine Foundation; (4) consideration of these collective insights and integration into an updated Consensus Statement.
Since the last Consensus Statement, no evidence has emerged to alter the established principles of either acute or preventive treatment. Newly introduced acute treatments include two small-molecule calcitonin gene-related peptide (CGRP) receptor antagonists (ubrogepant, rimegepant); a serotonin (5-HT1F ) agonist (lasmiditan); a nonsteroidal anti-inflammatory drug (celecoxib oral solution); and a neuromodulatory device (remote electrical neuromodulation). New preventive treatments include an intravenous anti-CGRP ligand monoclonal antibody (eptinezumab). Several modalities, including neuromodulation (electrical trigeminal nerve stimulation, noninvasive vagus nerve stimulation, single-pulse transcranial magnetic stimulation) and biobehavioral therapy (cognitive behavioral therapy, biofeedback, relaxation therapies, mindfulness-based therapies, acceptance and commitment therapy) may be appropriate for either acute and/or preventive treatment; a neuromodulation device may be appropriate for acute migraine treatment only (remote electrical neuromodulation).
The integration of new treatments into clinical practice should be informed by the potential for benefit relative to established therapies, as well as by the characteristics and preferences of individual patients.
The American Headache Society previously published a Consensus Statement on the use of newly introduced treatments for adults with migraine. This update, which is based on the expanded evidence base and emerging expert consensus concerning postapproval usage, provides practical recommendations in the absence of a formal guideline.
This update involved four steps: (1) review of data about the efficacy, safety, and clinical use of migraine treatments introduced since the previous Statement was published; (2) incorporation of these data into a proposed update; (3) review and commentary by the Board of Directors of the American Headache Society and patients and advocates associated with the American Migraine Foundation; (4) consideration of these collective insights and integration into an updated Consensus Statement.
Since the last Consensus Statement, no evidence has emerged to alter the established principles of either acute or preventive treatment. Newly introduced acute treatments include two small-molecule calcitonin gene-related peptide (CGRP) receptor antagonists (ubrogepant, rimegepant); a serotonin (5-HT1F ) agonist (lasmiditan); a nonsteroidal anti-inflammatory drug (celecoxib oral solution); and a neuromodulatory device (remote electrical neuromodulation). New preventive treatments include an intravenous anti-CGRP ligand monoclonal antibody (eptinezumab). Several modalities, including neuromodulation (electrical trigeminal nerve stimulation, noninvasive vagus nerve stimulation, single-pulse transcranial magnetic stimulation) and biobehavioral therapy (cognitive behavioral therapy, biofeedback, relaxation therapies, mindfulness-based therapies, acceptance and commitment therapy) may be appropriate for either acute and/or preventive treatment; a neuromodulation device may be appropriate for acute migraine treatment only (remote electrical neuromodulation).
The integration of new treatments into clinical practice should be informed by the potential for benefit relative to established therapies, as well as by the characteristics and preferences of individual patients.
摘要：
为了结合最近的研究结果，专家共识,和病人的观点，以更新的指导使用新的急性和预防性治疗成人偏头痛。
美国头痛协会此前发表了一份关于使用新推出的治疗成人偏头痛的共识声明。此更新,这是基于扩大的证据基础和关于批准后使用的新兴专家共识，在没有正式准则的情况下提供实用建议。
此更新包括四个步骤：（1）审查有关疗效的数据，安全,和自上次声明发表以来引入的偏头痛治疗的临床应用；（2）将这些数据纳入拟议的更新；（3）美国头痛协会董事会以及与美国偏头痛基金会相关的患者和倡导者的审查和评论；（4）考虑这些集体见解并整合到更新的共识声明中。
自上次共识声明以来，目前还没有任何证据可以改变既定的急性或预防性治疗原则.新引入的急性治疗包括两种小分子降钙素基因相关肽（CGRP）受体拮抗剂（ubrogepant，rimegepant）；5-羟色胺（5-HT1F）激动剂（lasmiditan）；非甾体抗炎药（塞来昔布口服液）；和神经调节装置（远程电神经调节）。新的预防性治疗包括静脉内抗CGRP配体单克隆抗体(eptinezumab)。几种模式，包括神经调节（三叉神经电刺激，非侵入性迷走神经刺激，单脉冲经颅磁刺激)和生物行为疗法(认知行为疗法，生物反馈,放松疗法,基于正念的疗法，接受和承诺治疗）可能适用于急性和/或预防性治疗；神经调节设备可能仅适用于急性偏头痛治疗（远程电神经调节）。
将新疗法整合到临床实践中应该考虑到相对于既定疗法的潜在益处，以及个体患者的特征和偏好。
美国头痛协会此前发表了一份关于使用新推出的治疗成人偏头痛的共识声明。此更新,这是基于扩大的证据基础和关于批准后使用的新兴专家共识，在没有正式准则的情况下提供实用建议。
此更新包括四个步骤：（1）审查有关疗效的数据，安全,和自上次声明发表以来引入的偏头痛治疗的临床应用；（2）将这些数据纳入拟议的更新；（3）美国头痛协会董事会以及与美国偏头痛基金会相关的患者和倡导者的审查和评论；（4）考虑这些集体见解并整合到更新的共识声明中。
自上次共识声明以来，目前还没有任何证据可以改变既定的急性或预防性治疗原则.新引入的急性治疗包括两种小分子降钙素基因相关肽（CGRP）受体拮抗剂（ubrogepant，rimegepant）；5-羟色胺（5-HT1F）激动剂（lasmiditan）；非甾体抗炎药（塞来昔布口服液）；和神经调节装置（远程电神经调节）。新的预防性治疗包括静脉内抗CGRP配体单克隆抗体(eptinezumab)。几种模式，包括神经调节（三叉神经电刺激，非侵入性迷走神经刺激，单脉冲经颅磁刺激)和生物行为疗法(认知行为疗法，生物反馈,放松疗法,基于正念的疗法，接受和承诺治疗）可能适用于急性和/或预防性治疗；神经调节设备可能仅适用于急性偏头痛治疗（远程电神经调节）。
将新疗法整合到临床实践中应该考虑到相对于既定疗法的潜在益处，以及个体患者的特征和偏好。
