Recent Therapeutic Approaches for
Migraine Management: The Latest Developments in Diagnosis and
A continuing medical education
activity provided by NAMCP and AAMCN
This activity is an archive of the live session from the 2021 Spring
Managed Care Forum. If you participated in the live session, you are
not eligible for continuing education credits from this archive.
This activity is valid from July 1, 2021 – August 1, 2022
Instructions for CME/NCPD: Complete the pre-test, listen to the
audio and view the slides, complete the post test, complete the
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This activity is intended for healthcare professionals practicing in
managed care environments.
This activity is supported by
an educational grant from
Migraine is a major neurological disease that affects more than 36
million men, women and children in the United States. The disease
impacts 1 in 4 households, 1 in 5 women, 1 in 16 men, and 1 in 11
children in the United States. Migraine headache is the most common
type of headache presented by patients that seek medical treatment,
and the World Health Organization (WHO) has ranked migraine in the
top fifteen most disabling medical conditions. In many patients with
migraine headache, their pain is unrelieved, and recurrence of
migraine is a common reason for patient dissatisfaction with
treatment. Although approximately 38% of migraineurs need preventive
therapy, only 3% to 13% currently use it. The fact that diagnosis is
based entirely on clinical history poses a challenge for healthcare
professionals, as migraine is only 1 of approximately 300 headache
disorders. Although accurate diagnosis is needed for appropriate
treatment, currently available migraine therapy is often inadequate.
Fortunately for patients who suffer from migraine headaches, a new
class of therapy has emerged that offers vastly improved efficacy
and safety over traditional treatment regimens. Calcitonin
gene-related peptide (CGRP) monoclonal antibodies offer healthcare
professionals a new and improved armamentarium in the treatment and
prevention of migraines.
The diagnosis of a migraine is based on signs and symptoms.
Neuroimaging tests are not necessary to diagnose migraine, but may
be used to find other causes of headaches in those whose examination
and history do not confirm a migraine diagnosis. It is believed that
a substantial number of people with the condition remain
undiagnosed, which stresses the importance of proper screening and
diagnostic tools and strategies. Patients with frequent migraines
and/or who experience functional disability need preventative
migraine treatment. While traditional pharmaceutical intervention
has worked adequately in the past, new and emerging options are
available that have shown the ability to vastly improve outcomes,
quality of life and adherence in migraine patients. CGRP monoclonal
antibodies are specifically designed to bind to and inhibit the
activity of CGRP that may prevent or significantly reduce the
frequency of monthly migraine headache days in patients with
episodic and chronic migraine and cluster headache. The role of CGRP
in migraine has been verified by basic research. The peptide is
present throughout the trigeminovascular system and in central brain
regions. During spontaneous migraine attacks, jugular-venous blood
concentrations of CGRP increase, and the recombinant human CGRP can
induce a migraine attack. Monoclonal antibodies targeting CGRP have
become available in the preventative management of migraine.
Upon completion of this
activity, participants will be able to:
treatment strategies to address unmet clinical and economic
burdens for patients with migraine
Describe diagnostic and
evidence-based strategies to differentiate migraine from other
Examine the role of calcitonin
gene-related peptide (CGRP) in the pathophysiology of migraine
Explore the efficacy, safety, and
tolerability of CGRP monoclonal antibodies in the prevention and
management of migraine
Discuss the managed care
considerations of anti-CGRP therapies by exploring where these
agents fit in the evolving migraine prevention paradigm
Assess comprehensive management
plans for migraine patients based on preventative treatment and
||Andrew Charles, MD
Professor of Neurology
Director, UCLA Goldberg Migraine Program
Meyer and Renee Luskin Chair in Migraine and Headache
David Geffen School of Medicine at UCLA
serves as a consultant for Amgen, Biohaven, Lilly,
Lundbeck, Satsuma, and My Everyday Health. He serves on
the speaker's bureau for Lundbeck. His presentation has
been peer reviewed for any bias.
MD has no financial relationships with ineligible
companies to disclose.
Jeremy Williams has no financial relationships with
ineligible companies to disclose.
Jacqueline Cole, RN, MS, CMCN has no financial
relationships with ineligible companies to disclose.
NAMCP and/or the presenter
has copyright or has received permissions for use of
materials provided in this activity.
Accreditation & Designation
This activity has been planned and implemented in accordance with
the accreditation requirements and policies of the Accreditation
Council for Continuing Medical Education (ACCME) through the joint
providership of the National Association of Managed Care Physicians
(NAMCP) and American Association of Managed Care Nurses (AAMCN). The
National Association of Managed Care Physicians is accredited by the
ACCME to provide continuing medical education for physicians.
NAMCP designates this enduring material for a maximum of 1 AMA
PRA Category 1 credit(s)TM. Each
physician should claim credit commensurate with the extent of their
participation in the activity.
The American Association of Managed Care Nurses is accredited as a
provider of nursing continuing professional development by the
American Nurses Credentialing Center's Commission on Accreditation.
Nurses who complete this activity and achieve a passing score will
receive 1 hour in nursing continuing professional development.
This activity has been approved by the American Board of Managed
Care Nursing for 1.0 contact hours toward CMCN recertification
This activity is supported by an educational grant from
NAMCP and/or this website does not
provide medical advice, diagnosis or treatment. NAMCP does not
endorse or imply endorsement of the content on any linked website.
This website is to be used as an informational resource. With any
health related concern, consult with your physician or healthcare
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