Cardiovascular Disease and Migraine: Are the New Treatments Safe? - Current Pain and Headache Reports
Source : https://link.springer.com/article/10.1007/s11916-022-01064-4
Purpose of Review The authors present data on cardiovascular safety for the new acute and preventive migraine treatments including ditans, gepants, and calcitonin gene-related peptide monoclonal antibodies (CGRP mAbs) alongside older medications like triptans and ergotamines. Recent Findings The authors conclude that there are no cardiovascular safety concerns for lasmiditan, and that it could be used in those with cardiovascular disease.
Summary: Long-term data is still needed, and prescribers should ensure patients are aware of the limitations of our knowledge at this time, while still offering these effective and well-tolerated treatment options.
• Source: Current Pain and Headache Reports
• Relevance: “The authors present data on cardiovascular safety for the new acute and preventive migraine treatments including ditans, gepants, and calcitonin gene-related peptide monoclonal antibodies (CGRP mAbs) alongside older medications like triptans and ergotamines.”
• Overall, these interventions appear safe and well-tolerated, although long-term data are needed.
• HCPs should inform patients of the limitations in data and knowledge, while still providing these effective migraine treatments.
• Triptans may be safer than what their contraindications indicate.
• Gepands and CGRP monoclonal antibodies should also not be contraindicated in those with stroke or MI, based on current date. Of note, erenumab has been linked to hypertension.
• Vasodilation secondary to CGRP antagonists could be an issue in those with small-vessel disease and used with caution in these patients.