Episodic and Chronic Migraine Treatment during the COVID-19 Pandemic
COVID-19 has made it necessary for clinicians to adapt how they diagnose, treat, and manage patients with chronic diseases, including migraine. With lockdowns and patients concerns about leaving their homes, telemedicine and the availability of efficacious self-administered therapies, such as subcutaneous prophylactic CGRPs, have facilitated the continued care of migraineurs.
Initiation of prophylactic CGRPs is typically prescribed for migraineurs with 4+ migraine days per month who have failed 2+ oral therapies However, since the COVID-19 pandemic, migraine treatment decisions have likely changed due to Botox injection cancellations, potential SARS-CoV-2 infections, increased anxiety or headache triggers, and putative links between the use of certain drugs, such as angiotensin‐converting enzyme (ACE) inhibitors/angiotensin receptor blockers (ARBs), and increased COVID-19 infection risk1. (I would delete this portion because it relates to hospitalized COVID-19 patients)
How has the COVID-19 pandemic impacted your prescribing decisions regarding the initiation of prophylactic CGRP therapy in episodic and chronic migraine patients? What are the factors that contribute to treatment selection during the pandemic?
1 https://www.acc.org/latest-in-cardiology/articles/2020/03/17/08/59/hfsa-acc-aha-statement-addresses-concerns-re-using-raas-antagonists-in-covid-19
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Sumanjit Kaur 1 week 1 day
I am prescribing CGRP inhibitors , pandemic has not effected my decision, preauthorisation process is the one that takes time.. -
Amy Gonzales from Doctor Unite 1 week 1 day
Some of the factors that contribute to treatment selection would be the patients history of using previous medications for migraines, effectiveness of switching to a new medication, and mode of Show More
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This is a good review, it is important to distinguish between waking up with a headache and waking up because of a headache, which can sometimes be more worrisome. Show More