New migraine therapy brings hope to millions
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A new treatment designed to prevent migraine by using antibodies to alter the activity of chemicals in the brain has given hope to millions of sufferers. Sheena Grant finds out more.
Karen considers herself to be a generally healthy person yet for all of her adult life she has suffered from a condition more prevalent than diabetes, epilepsy and asthma combined.
And she’s far from alone. According to the charity Migraine Action, an estimated 8.5 million people in the UK live with migraine.
The frequency and duration of Karen’s migraines vary but she has at least five a month, often more.
“This week, for instance, I’ve had two in three days, one of which lasted an entire day,” she says. “And even when I’m not suffering from the intense, throbbing head pain, nausea, numbness down one side of my face, shivers, inability to tolerate light, smells and noise that characterise a full-blown attack I’m always vigilant. “If I get dehydrated, don’t get enough sleep, go out in sunlight without sunglasses, drink coffee or look at flickering lights I’m likely to get a migraine. And if I don’t take some of the high-strength ibuprofen I try to carry with me at all times when I feel the first signs of a migraine developing, chances are I won’t be able to get rid of it for hours.”
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And during those hours Karen, 48, a mother-of-one, who lives in north Suffolk, will feel very ill.
“Occasionally I have actually been sick and sometimes the pain in my head has been so intense I’ve wondered if I was dying,” she says. “I really am not exaggerating. At that stage there’s nothing else to do but take some of the pain killers I should have taken before the attack got hold and lie down in a totally dark room. On those occasions, when the attack eventually subsides I might continue to feel woozy for the next 24 hours.”
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Karen never uses the word ‘headache’ to describe her attacks.
“It trivialises what is a debilitating medical condition,” she says. “Despite the effect they have on my life, making me miss social occasions, work and once even causing me to spend Christmas Day in bed, I’ve always thought there’s little that could be done about my migraines as I don’t like the idea of taking regular, powerful medication anyway, so I’ve chosen to try and manage them with over-the-counter medication and lifestyle measures rather than prescription medication.”
But now the results of two clinical trials that suggest a new approach to preventing migraines can cut the number and severity of attacks is giving Karen and millions like her new hope - about 50% of people on one study halved the number of migraines they had each month, which researchers at King’s College Hospital called a “huge deal”.
The treatment is the first specifically designed for preventing migraine and uses antibodies to alter the activity of chemicals in the brain, though researchers say further trials will be needed to assess long-term effects.
Research has shown a chemical in the brain - calcitonin gene-related peptide or CGRP - is involved in both pain and sensitivity to sound and light in migraine and now four drug companies are racing to develop antibodies that neutralise this chemical. Clinical trials on two of the antibodies have been published in the New England Journal of Medicine. One antibody, erenumab, was trialled on 955 patients with episodic migraine, or migraine for fewer than 15 days a month.
The study found 50% of those given antibody injections halved their number of migraine days per month. Another antibody, fremanezumab, was trialled on 1,130 patients with chronic (more than 15 days a month) migraine. About 41% of patients halved their number of migraine days compared with 18% without treatment.
The antibodies are not the only preventative drugs for migraine but some others, including former epilepsy and heart disease pills as well as botox, come with side effects and do not work for everyone, says Simon Evans, chief executive of Migraine Action
“Migraine is a debilitating, chronic condition that can destroy lives,” he added. “The effects can last for hours – even days in many cases. An option that can prevent migraine and is well tolerated is therefore sorely needed and we hope this marks the start of real change in how this condition is treated and perceived.”
Top prevention and treatment tips
Research has shown that 3,000 headaches occur every day per million people in the general population, says Harley Street specialist Oliver Eaton, of the ProHealth Clinic. This equates to over 190,000 headaches every day in the UK.
“The most common type of headache is a tension headache, usually caused by poor posture, starring at a computer screen for too long or prolonged driving,” says Oliver. “Cluster Headaches are less common and affect more men than women. Researchers have found a strong link between levels of hormones melatonin and cortisol and the occurrence of cluster headaches. Migraines are more severe and can be associated with nausea, sensitivity to light and ‘stars in your eyes’. Triggers can include allergies, emotional stress, dehydration, nutrient deficiencies, undiagnosed silent viruses, bright lights, hormonal triggers, tiredness and poor posture; bad gut bacteria, foods containing tyramine (red wine, smoked fish, chicken livers), monosodium glutamate or aspartame and medication such as sleeping tablets, the contraceptive pill and hormone replacement therapy.”
Painkillers: “Mild tension headaches can usually be treated with over-the-counter painkillers or anti-inflammatories,” says Oliver Eaton. “Migraines require stronger prescription medication. Unfortunately, these can have side-effects like constipation, heartburn, an upset stomach, drowsiness, vision problems and nausea. And long-term use can have a negative effect on the liver.”
Asyra test: Originally developed by NASA, Asyra is one of the more effective alternative ways of tackling headaches and migraines as it addresses many of their root causes, says Oliver. “The Asyra testing machine measures and monitoring electrical wavelengths emitted from your skin. The data analysis will help give an accurate picture of what may be stressing the body to the point a headache or migraine occurs.”
Magnesium: “Many people suffering from headaches have low magnesium levels. Try taking a daily supplement - it’s a natural muscle relaxant so can be effective for tension type headaches.”
Peppermint & Lavender Essential Oil: “Peppermint oil cools the skin and stimulates skin blood flow in the forehead. It also has the ability to ease muscle contractions. Lavender oil is commonly used as a mood regulator and sedative. Research has shown it to be an effective treatment of migraines.”
Stretching: Many tension type headaches can be directly linked to prolonged sitting at a desk or poor posture. “Regularly stretching your neck and shoulders, and stretching your chest out between a doorway 30 seconds at a time, several times a day, can be very effective,” says Oliver.
Stay Hydrated: “Dehydration can contribute to all type of headaches. Most people in the UK don’t drink enough water, especially in winter.”