8 ms·

FDA approves new treatment for adults with migraine

85 points by apsec112 7y ago

natdempk 7y ago
Does anyone know if they publish details about the size/strength of the effect anywhere or a link to the actual numbers for the study population?
- lanewinfield 7y ago
  Looks like it "works" (2-hour pain free marker) for ~10% of people. https://www.evaluate.com/vantage/articles/news/snippets/ubrelvys-winner-not-long https://www.evaluate.com/vantage/articles/news/snippets/ubre...
  - nharada 7y ago
    It might not sound impressive, but I think this is great news for two reasons: 1) Even if only 10% of people respond, this is likely going to give thousands of people for whom nothing else works a drug that actually does something. 2) Nearly all existing migraine meds fall into the "triptan" class of drugs. This is an entirely new class (CGRP antagonist), and may pave the way to new treatments even if this specific iteration isn't as effective as future ones.
    - ekianjo 7y ago
      for 2), this is not news, back in October 2019 Lilly got their drug approved as well in this class: https://www.bloomberg.com/news/articles/2018-09-28/eli-lilly-migraine-drug-approved-and-will-be-free-to-patients https://www.bloomberg.com/news/articles/2018-09-28/eli-lilly...
      - Tharkun 7y ago
        The news here is that ubrogepant is a tablet taken as an abortive, while emgality etc are injections taken as a preventative.
AmericanChopper 7y ago
Diclofenac works very well for me. Tablets work within an hour most of the time, and intramuscular shots work within about 20 minutes every time. But the long term potential side effects aren’t great, so new options would be fantastic.
- dillonmckay 7y ago
  How do you get the shot, logistically? Once I have a migraine, travel is exceedingly difficult for me.
  - ekianjo 7y ago
    > https://www.drugs.com/uk/pdf/leaflet/801174.pdf https://www.drugs.com/uk/pdf/leaflet/801174.pdf self injection is an option, apparently.
  - AmericanChopper 7y ago
    It was always terrible. I used to live half a block from my doctors office, so I’d just (slowly) walk then. Now my wife will drive me (probably only need a couple of them a year though). Basically it just sucked. Especially sitting in the bright waiting room, sweating bullets, trying not to throw up before I was seen. My most serious migraines can last a couple of days, and are just awful. Making it go away almost instantly was alway worth the hour or so of additional suffering to get a shot. I’ve also got a rather high pain tolerance, and tend to only get worn down by pain that lasts a long time. I don’t know if it would be as effective for anybody else, but if you get migraines that seem worse than death, I’d recommend asking your doctor about it.
    - ta999999171 7y ago
      How does cannabis affect your symptoms, if you vaporize some of that instead of heading for the Dr?
      - AmericanChopper 7y ago
fhostghost1989 7y ago
Mico dose lsd far better and safer. Cant patent that so capitalism wins again. Greed always causes nothing but death suffering. Capitalism almost stops innovation. Capitalism has gotten so bad. No need for war to hold population from exploding. Terrible products and systems to make products kills 100-140 million every 6 years. Designed to destroy and profit a few
kyle_morris 7y ago
I’ve had migraines since I was a kid and have been fortunate to have identified my triggers(caffeine/cacao) and found medication that works when one comes on. I can’t imagine how awful it is for folks who have no respite and hope this treatment can provide some relief.
- coldcode 7y ago
  I used to get horrible migraines from high school age on, my triggers were bright reflections and too much MSG (I kept track of what I ate and then tried to avoid anything that triggered) and generally I was useless for at least 4 hrs several times a month. If I was really quick a single Vicodin would at least make it manageable but generally I could keep nothing down. As I got older the headache itself got less and less and mostly what I get now is the aura (freaky lightshow in your eyes) and a single Tylenol is fine. But for 20 years it was not a fun experience at all. I know people with way more frequency to the point of being unable to do much at all. One summer in college for a month I got a cluster headache every morning. 20 minutes of absolute agony that made migraines seem like a walk in the park. Thankfully those never came back. I am glad research has been finding more ways to treat and even stop them.
  - shantly 7y ago
    > As I got older the headache itself got less and less and mostly what I get now is the aura (freaky lightshow in your eyes) and a single Tylenol is fine. But for 20 years it was not a fun experience at all. I know people with way more frequency to the point of being unable to do much at all. I also started getting mine in high school (sophomore or junior year, I think?). Never had them frequently, just once or twice a year, which is plenty. I too have noticed a shift in their effect as I get older, away from my predictable blind-spots-followed-by-pain to a wider variety of visual effects and usually just feeling really weird and "off" for the rest of the day. Oddest one so far involved fairly bad tunnel vision, which was new and I've not had again since, plus the usually just-off-center-of-vision blind spot I get, followed about a half hour later by needing to sleep. It wasn't the same feeling as being very tired, exactly, but I just needed to get in bed and go to sleep. No pain, just that. So weird.
latchkey 7y ago
About a year ago there is this one... https://www.theguardian.com/science/2018/jul/31/first-ever-pill-to-prevent-chronic-migraines-approved-by-eu https://www.theguardian.com/science/2018/jul/31/first-ever-p...
fnord77 7y ago
had to go to wikipedia for the MOA > It is a small-molecule calcitonin gene-related peptide receptor antagonist
- deleted 7y ago
  [deleted]
lawn 7y ago
I've also had migraine on-and-off, and I had one even this night. So I went up and took my medicine, and I can function fairly well today. Before I had this medicine the whole day would've been ruined, and I would be very inefficient and lazy tomorrow as well. While I don't get migraine that often, it makes a world of difference when I do get them.
- learnstats2 7y ago
  Triptans changed my life in this way.
Cougher 7y ago
If only someone would remove the headache of pharmaceutical companies artificially increasing the costs of drugs, particularly when drugs like triptans reach the generic market.
DailyHN 7y ago
Growing up, I had multiple friends die from brain aneurysms. Those start with a bad headache. That has lead to me avoiding all medicines every time I get a headache (yes, I understand correlation is not causation). My primary route to solve any headache is hydration. Adding electrolytes is also important because too much water without them can also give you a headache. My experience has also lead me to focus on consuming the healthiest diet I can find (currently intermittent fasting + keto with intermittent-vegan weeks, mostly organic, with all nutrients from food sources). On the other hand, my mother, who could convince the majority she's healthy based on her weight and latest diet buzzwords, has had migraines for the past 30 years, maybe longer — even landing her in the hospital on many occasions. A migraine is your body telling you something is wrong with your most valuable asset. Are you sure you want to sweep this problem under the rug? There is a documentary on Amazon called "Fat". It illustrates how many children with epilepsy were harmed by the combination of 1. lack of understanding food and 2. pharmaceuticals with side effects that render them permanently disabled. Good luck with your search for health and wellbeing.
- BiteCode_dev 7y ago
  Indeed. Migraines for 30 years. Painkillers allows you to keep up with whatever wrong you are doing. So if you have migraines, it is not normal. It is not incurable either. Use pain killers when you must, but keep looking for a solution. The solution can be different for everybody. Start with diet, it's a very common cause for it. Don't limit yourself to what you think is right. Try things, even weird ones. Took me 3 decades of trials and errors to not need pain killers.
  - fgonzag 7y ago
    If pain killers worked for your migraines, they were extremely mild migraine. OTC pain killers (and even prescribed pain killers) don't really do anything for the 3 people I know that get migraines. These people have to lay down under their sheets to block all sun light, they can not do absolutely anything at all during the episode but block sunlight and hope whatever medicine sort of worked last time will work this time. Preaching and generalizing from your mild case helps no one.
jobaoana 7y ago
Moderate to heavy doses of psilocybin at quarterly intervals can eliminate migranes and cluster headaches.
- AstralStorm 7y ago
  They are somewhat chemically similar to triptans, and consequently usually do not work for migraines resistant to triptans. But then, there's a lot of variance there. But yes, they do sometimes work and when they do it's relatively long term compared to regular triptan use. And allegedly they're much more potent, especially when it comes to aborting migraines. Some non-hallucinogenic chemical variants are being also researched, both of psilocybin and LSD. LSA has also shown effectiveness sometimes. At least 3 phase 1/2B-style RCTs of hallucinogens are under way. (Finding working doses, schedules, cataloguing side effects.) Expect results of one for psilocybin mid 2020. There's also long running RCT of LSD, finishing in 2023. I think both of these are for cluster headaches rather than migraines, but close enough. Pilot trials have been done a long time ago by MAPS, with success. Now it's time for bigger science. The link is also somewhat interestingly tenuous with ECT and seizures. (In that migraines and seizures rarely coexist, but share symptoms in some cases.)
__tg__ 7y ago
I've had migraines for 40 years, and suffered much before being prescribed Sumatriptan. It relieves the migraine completely in about 30min. Doesn't work for my wife who also has migraines but an alternate formulation, Rizatriptan, does. My migraines have also evolved over the years from intense day long affairs to duller 3-day ones. Sometimes I need a subcutaneous triptan shot which relieves it in, I kid you not, 1 minute. I tried preventative medications but the cure seemed worse than the disease. One, Topiramate, made me forget things and lose my train of thought. No thank you. I also tried keto for a while and noticed that I hardly had any migraines while on it. There are a lot of options available now. If you suffer from migraines, go talk to a neurologist with current knowledge, not something they learned 30 years ago.
- ComputerGuru 7y ago
  Topiramate (topomax) is the antidote worse than the disease. It turned me into a zombie, literally living in my head but too dead to even open my mouth to say “hi” or “good morning” when I made eye contact with a stranger (yes, I’m from the Midwest and we do that here). (Venlafaxine on the other hand is like a shock collar wrapped tightly around your brain waiting for you to miss a dose by even two hours, after which it’ll punish you for the next twenty four hours with electric shocks and spasms in your freaking brain. It’s a real pity it actually kind of worked :/ I still don’t know if I would ever do it again.)

85 points by apsec112 7y ago

Does anyone know if they publish details about the size/strength of the effect anywhere or a link to the actual numbers for the study population?

lanewinfield 7y ago
Looks like it "works" (2-hour pain free marker) for ~10% of people. https://www.evaluate.com/vantage/articles/news/snippets/ubrelvys-winner-not-long https://www.evaluate.com/vantage/articles/news/snippets/ubre...
- nharada 7y ago
  It might not sound impressive, but I think this is great news for two reasons: 1) Even if only 10% of people respond, this is likely going to give thousands of people for whom nothing else works a drug that actually does something. 2) Nearly all existing migraine meds fall into the "triptan" class of drugs. This is an entirely new class (CGRP antagonist), and may pave the way to new treatments even if this specific iteration isn't as effective as future ones.
  - ekianjo 7y ago
    for 2), this is not news, back in October 2019 Lilly got their drug approved as well in this class: https://www.bloomberg.com/news/articles/2018-09-28/eli-lilly-migraine-drug-approved-and-will-be-free-to-patients https://www.bloomberg.com/news/articles/2018-09-28/eli-lilly...
    - Tharkun 7y ago
      The news here is that ubrogepant is a tablet taken as an abortive, while emgality etc are injections taken as a preventative.

AmericanChopper 7y ago

Diclofenac works very well for me. Tablets work within an hour most of the time, and intramuscular shots work within about 20 minutes every time. But the long term potential side effects aren’t great, so new options would be fantastic.

dillonmckay 7y ago
How do you get the shot, logistically? Once I have a migraine, travel is exceedingly difficult for me.
- ekianjo 7y ago
  > https://www.drugs.com/uk/pdf/leaflet/801174.pdf https://www.drugs.com/uk/pdf/leaflet/801174.pdf self injection is an option, apparently.
- AmericanChopper 7y ago
  It was always terrible. I used to live half a block from my doctors office, so I’d just (slowly) walk then. Now my wife will drive me (probably only need a couple of them a year though). Basically it just sucked. Especially sitting in the bright waiting room, sweating bullets, trying not to throw up before I was seen. My most serious migraines can last a couple of days, and are just awful. Making it go away almost instantly was alway worth the hour or so of additional suffering to get a shot. I’ve also got a rather high pain tolerance, and tend to only get worn down by pain that lasts a long time. I don’t know if it would be as effective for anybody else, but if you get migraines that seem worse than death, I’d recommend asking your doctor about it.
  - ta999999171 7y ago
    How does cannabis affect your symptoms, if you vaporize some of that instead of heading for the Dr?
    - AmericanChopper 7y ago

fhostghost1989 7y ago

Mico dose lsd far better and safer. Cant patent that so capitalism wins again. Greed always causes nothing but death suffering. Capitalism almost stops innovation. Capitalism has gotten so bad. No need for war to hold population from exploding. Terrible products and systems to make products kills 100-140 million every 6 years. Designed to destroy and profit a few

kyle_morris 7y ago

I’ve had migraines since I was a kid and have been fortunate to have identified my triggers(caffeine/cacao) and found medication that works when one comes on. I can’t imagine how awful it is for folks who have no respite and hope this treatment can provide some relief.

coldcode 7y ago
I used to get horrible migraines from high school age on, my triggers were bright reflections and too much MSG (I kept track of what I ate and then tried to avoid anything that triggered) and generally I was useless for at least 4 hrs several times a month. If I was really quick a single Vicodin would at least make it manageable but generally I could keep nothing down. As I got older the headache itself got less and less and mostly what I get now is the aura (freaky lightshow in your eyes) and a single Tylenol is fine. But for 20 years it was not a fun experience at all. I know people with way more frequency to the point of being unable to do much at all. One summer in college for a month I got a cluster headache every morning. 20 minutes of absolute agony that made migraines seem like a walk in the park. Thankfully those never came back. I am glad research has been finding more ways to treat and even stop them.
- shantly 7y ago
  > As I got older the headache itself got less and less and mostly what I get now is the aura (freaky lightshow in your eyes) and a single Tylenol is fine. But for 20 years it was not a fun experience at all. I know people with way more frequency to the point of being unable to do much at all. I also started getting mine in high school (sophomore or junior year, I think?). Never had them frequently, just once or twice a year, which is plenty. I too have noticed a shift in their effect as I get older, away from my predictable blind-spots-followed-by-pain to a wider variety of visual effects and usually just feeling really weird and "off" for the rest of the day. Oddest one so far involved fairly bad tunnel vision, which was new and I've not had again since, plus the usually just-off-center-of-vision blind spot I get, followed about a half hour later by needing to sleep. It wasn't the same feeling as being very tired, exactly, but I just needed to get in bed and go to sleep. No pain, just that. So weird.

latchkey 7y ago

About a year ago there is this one... https://www.theguardian.com/science/2018/jul/31/first-ever-pill-to-prevent-chronic-migraines-approved-by-eu https://www.theguardian.com/science/2018/jul/31/first-ever-p...

fnord77 7y ago

had to go to wikipedia for the MOA > It is a small-molecule calcitonin gene-related peptide receptor antagonist

deleted 7y ago
[deleted]

lawn 7y ago

I've also had migraine on-and-off, and I had one even this night. So I went up and took my medicine, and I can function fairly well today. Before I had this medicine the whole day would've been ruined, and I would be very inefficient and lazy tomorrow as well. While I don't get migraine that often, it makes a world of difference when I do get them.

learnstats2 7y ago
Triptans changed my life in this way.

Cougher 7y ago

If only someone would remove the headache of pharmaceutical companies artificially increasing the costs of drugs, particularly when drugs like triptans reach the generic market.

DailyHN 7y ago

Growing up, I had multiple friends die from brain aneurysms. Those start with a bad headache. That has lead to me avoiding all medicines every time I get a headache (yes, I understand correlation is not causation). My primary route to solve any headache is hydration. Adding electrolytes is also important because too much water without them can also give you a headache. My experience has also lead me to focus on consuming the healthiest diet I can find (currently intermittent fasting + keto with intermittent-vegan weeks, mostly organic, with all nutrients from food sources). On the other hand, my mother, who could convince the majority she's healthy based on her weight and latest diet buzzwords, has had migraines for the past 30 years, maybe longer — even landing her in the hospital on many occasions. A migraine is your body telling you something is wrong with your most valuable asset. Are you sure you want to sweep this problem under the rug? There is a documentary on Amazon called "Fat". It illustrates how many children with epilepsy were harmed by the combination of 1. lack of understanding food and 2. pharmaceuticals with side effects that render them permanently disabled. Good luck with your search for health and wellbeing.

BiteCode_dev 7y ago
Indeed. Migraines for 30 years. Painkillers allows you to keep up with whatever wrong you are doing. So if you have migraines, it is not normal. It is not incurable either. Use pain killers when you must, but keep looking for a solution. The solution can be different for everybody. Start with diet, it's a very common cause for it. Don't limit yourself to what you think is right. Try things, even weird ones. Took me 3 decades of trials and errors to not need pain killers.
- fgonzag 7y ago
  If pain killers worked for your migraines, they were extremely mild migraine. OTC pain killers (and even prescribed pain killers) don't really do anything for the 3 people I know that get migraines. These people have to lay down under their sheets to block all sun light, they can not do absolutely anything at all during the episode but block sunlight and hope whatever medicine sort of worked last time will work this time. Preaching and generalizing from your mild case helps no one.

jobaoana 7y ago

Moderate to heavy doses of psilocybin at quarterly intervals can eliminate migranes and cluster headaches.

AstralStorm 7y ago
They are somewhat chemically similar to triptans, and consequently usually do not work for migraines resistant to triptans. But then, there's a lot of variance there. But yes, they do sometimes work and when they do it's relatively long term compared to regular triptan use. And allegedly they're much more potent, especially when it comes to aborting migraines. Some non-hallucinogenic chemical variants are being also researched, both of psilocybin and LSD. LSA has also shown effectiveness sometimes. At least 3 phase 1/2B-style RCTs of hallucinogens are under way. (Finding working doses, schedules, cataloguing side effects.) Expect results of one for psilocybin mid 2020. There's also long running RCT of LSD, finishing in 2023. I think both of these are for cluster headaches rather than migraines, but close enough. Pilot trials have been done a long time ago by MAPS, with success. Now it's time for bigger science. The link is also somewhat interestingly tenuous with ECT and seizures. (In that migraines and seizures rarely coexist, but share symptoms in some cases.)

__tg__ 7y ago

I've had migraines for 40 years, and suffered much before being prescribed Sumatriptan. It relieves the migraine completely in about 30min. Doesn't work for my wife who also has migraines but an alternate formulation, Rizatriptan, does. My migraines have also evolved over the years from intense day long affairs to duller 3-day ones. Sometimes I need a subcutaneous triptan shot which relieves it in, I kid you not, 1 minute. I tried preventative medications but the cure seemed worse than the disease. One, Topiramate, made me forget things and lose my train of thought. No thank you. I also tried keto for a while and noticed that I hardly had any migraines while on it. There are a lot of options available now. If you suffer from migraines, go talk to a neurologist with current knowledge, not something they learned 30 years ago.

ComputerGuru 7y ago
Topiramate (topomax) is the antidote worse than the disease. It turned me into a zombie, literally living in my head but too dead to even open my mouth to say “hi” or “good morning” when I made eye contact with a stranger (yes, I’m from the Midwest and we do that here). (Venlafaxine on the other hand is like a shock collar wrapped tightly around your brain waiting for you to miss a dose by even two hours, after which it’ll punish you for the next twenty four hours with electric shocks and spasms in your freaking brain. It’s a real pity it actually kind of worked :/ I still don’t know if I would ever do it again.)