Local neurologist leads study on non-drug migraine treatment
Two new treatments for debilitating migraine headaches have received approval from the U.S. government and are giving hope to migraine sufferers. One of the treatments doesn’t even involve taking medication, and research and trials on it were led by a neurologist here in Southwestern Pennsylvania.
Nearly 39 million Americans live with migraines, which can lead to severe throbbing head pain, nausea, vomiting and sensitivity to light and sound. Yet new treatments are bringing relief to many patients.
“It is an exciting time in migraine care,” says Dr. Andrea Synowiec, a neurologist at Allegheny Health Network (AHN). “In the past, we have been somewhat limited in treatment options. Currently there are a variety of safe, migraine-specific treatments designed to either prevent migraine attacks, treat the symptoms when they occur, or all of the above.”
She recommends anyone who suffers from migraine symptoms and had a bad experience with treatment should consider getting another evaluation.
The U.S. Food and Drug Administration (FDA) recently approved a new medication called Symbravo to treat migraines. Symbravo is a combination of meloxicam and rizatriptan and has been shown to relieve migraine pain within two to three hours with results lasting up to 48 hours. “The approval was based on data from three major clinical trials involving more than 21,000 migraine attacks,” explains Synowiec. “Symbravo is a combination of two other medications – rizatriptan, which is a migraine-specific acute medication targeting serotonin receptors, and meloxicam, a powerful anti-inflammatory medication that has been used to treat other kinds of pain but has never been available for migraine treatment in the past.”
She says combining the two medications makes a lot of sense because they work at different parts of the migraine attack. “One treats symptoms early on, and the other maintains symptom control so that the migraine doesn’t come back.”
An exciting new area of medical research is in wearable technology that treats medical conditions without the need for medication. One of these newly approved devices is called Nerivio, and it treats migraines with a high-tech armband that users link to their smartphone and wear for a 45-minute treatment involving neuromodulation.
Synowiec led a recent study on Nerivio at AHN in Pittsburgh which found that 74% of users reported consistent pain relief within two hours of treatment and experienced minimal side effects.
“Nerivio is a game-changer for many people with migraine,” says Synowiec. “We tend to think about drugs and pills as the way we treat medical conditions, but the remote electrical neuromodulation (REN) technology Nerivio uses not only treats migraine attacks when they happen, but can also be used as a preventive treatment to keep migraines away, or to make them less frequent and severe overall.”
She believes that as wearable technology becomes more widely accepted and covered by more insurance carriers, there will be an increase in people who prefer non-drug treatment options due to less side effects.
“This was such a great opportunity both for our team of headache physicians and for our patients as well,” she added. “Highmark and Theranica partnered up to basically give us and our migraine patients access to try out Nerivio and see if it would work for them. At that time, the device wasn’t covered by insurance, so through this opportunity we got a chance to use the device broadly in a real world setting and in a variety of patients.”
The study found less than 2% of patients had side effects and that patients generally had success treating their headaches on par with the type of treatment one would expect from a drug.
The non-drug treatment is a viable option for those who are pregnant, are sensitive to side effects, or who have complex medical conditions that put them at risk for drug interactions. “Migraine can be a disabling disorder, and most people need some kind of treatment, even if it is only once in a while,” says Synowiec. “Nerivio has a favorable side-effect profile which sets it apart from some of the drugs we have traditionally used to deal with acute migraine symptoms. And some people have migraine so frequently that they need preventive treatment to keep their attacks away.
“The nice thing about Nerivio is that it is FDA-cleared for both indications, meaning that it is safe to use only here and there if a person has infrequent attacks or can be used every other day to keep attacks away.” That’s in contrast to medications patients would take to prevent migraine attacks which need to be taken for a month or more before they become effective.
“Treatments like Nerivio offer flexibility for people who might need prevention, but not all the time, or who have a fluctuating frequency of attacks and don’t want to stay on medication all year for the couple months a year that things get out of control.”