European headache federation consensus on the definition of resistant and refractory migraine : developed with the endorsement of the European Migraine & Headache Alliance (EMHA)

Research output: Contribution to journalArticlepeer-review

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European headache federation consensus on the definition of resistant and refractory migraine  : developed with the endorsement of the European Migraine & Headache Alliance (EMHA). / Sacco, Simona ; Braschinsky, Mark; Ducros, Anne; Lampl, Christian ; Little, Patrick; Maassen Van Den Brink, Antoinette; Pozo-Rosich, Patricia ; Reuter, Uwe; Ruiz De La Torre, Elena ; Sanchez Del Rio, Margarita; Sinclair, Alex; Katsarava, Zaza; Martelletti, Paolo.

In: The Journal of Headache and Pain, Vol. 21, 76, 16.06.2020.

Research output: Contribution to journalArticlepeer-review

Harvard

Sacco, S, Braschinsky, M, Ducros, A, Lampl, C, Little, P, Maassen Van Den Brink, A, Pozo-Rosich, P, Reuter, U, Ruiz De La Torre, E, Sanchez Del Rio, M, Sinclair, A, Katsarava, Z & Martelletti, P 2020, 'European headache federation consensus on the definition of resistant and refractory migraine : developed with the endorsement of the European Migraine & Headache Alliance (EMHA)', The Journal of Headache and Pain, vol. 21, 76. https://doi.org/10.1186/s10194-020-01130-5

APA

Sacco, S., Braschinsky, M., Ducros, A., Lampl, C., Little, P., Maassen Van Den Brink, A., Pozo-Rosich, P., Reuter, U., Ruiz De La Torre, E., Sanchez Del Rio, M., Sinclair, A., Katsarava, Z., & Martelletti, P. (2020). European headache federation consensus on the definition of resistant and refractory migraine : developed with the endorsement of the European Migraine & Headache Alliance (EMHA). The Journal of Headache and Pain, 21, [76]. https://doi.org/10.1186/s10194-020-01130-5

Vancouver

Author

Sacco, Simona ; Braschinsky, Mark ; Ducros, Anne ; Lampl, Christian ; Little, Patrick ; Maassen Van Den Brink, Antoinette ; Pozo-Rosich, Patricia ; Reuter, Uwe ; Ruiz De La Torre, Elena ; Sanchez Del Rio, Margarita ; Sinclair, Alex ; Katsarava, Zaza ; Martelletti, Paolo. / European headache federation consensus on the definition of resistant and refractory migraine  : developed with the endorsement of the European Migraine & Headache Alliance (EMHA). In: The Journal of Headache and Pain. 2020 ; Vol. 21.

Bibtex

@article{aafe5dc7b7bf49558faa0870252ceec9,
title = "European headache federation consensus on the definition of resistant and refractory migraine : developed with the endorsement of the European Migraine & Headache Alliance (EMHA)",
abstract = "Introduction: Despite advances in the management of headache disorders, some patients with migraine do not expe-rience adequate pain relief with acute and preventive treatments. It is the aim of the present document to provide a definition of those migraines which are difficult-to-treat, to create awareness of existence of this group of patients, to help Healthcare Authorities in understanding the implications, and to cre-ate a basis to develop a better pathophysiological understanding and to support further therapeutic advances.Main body: Definitions were established with a consensus process using the Delphi method.Patients with migraine with or without aura or with chronic migraine can be defined as having resistant migraine and refractory migraine according to previous preventative failures. Resistant migraine is defined by having failed at least 3 classes of migraine preventatives and suffer from at least 8 debili-tating headache days per month for at least 3 consecutive months without improvement; definition can be based on review of medical charts. Refractory migraine is defined by having failed all of the avail-able preventatives and suffer from at least 8 debilitating headache days per month for at least 6 con-secutive months. Drug failure may include lack of efficacy or lack of tolerability. Debilitating head-ache is defined as headache causing serious impairment to conduct activities of daily living despite the use of pain-relief drugs with established efficacy at the recommended dose and taken early during the attack; failure of at least two different triptans is required.Conclusions: We hope, that the updated EHF definition will be able to solve the conflicts that have limited the use of definitions which have been put forward in the past. Only with a widely accepted definition, pro-gresses in difficult-to-treat migraine can be achieved. This new definition has also the aim to increase the understanding of the impact of the migraine as a disease with all of its social, legal and healthcare implications. It is the hope of the EHF Expert Consensus Group that the proposed criteria will stimu-late further clinical, scientific and social attention to patients who suffer from migraine which is diffi-cult-to-treat.",
keywords = "migrane, chronic migraine, resistant migraine, refractory migraine, intractable migraine",
author = "Simona Sacco and Mark Braschinsky and Anne Ducros and Christian Lampl and Patrick Little and {Maassen Van Den Brink}, Antoinette and Patricia Pozo-Rosich and Uwe Reuter and {Ruiz De La Torre}, Elena and {Sanchez Del Rio}, Margarita and Alex Sinclair and Zaza Katsarava and Paolo Martelletti",
year = "2020",
month = jun,
day = "16",
doi = "10.1186/s10194-020-01130-5",
language = "English",
volume = "21",
journal = "The Journal of Headache and Pain",
issn = "1129-2377",
publisher = "Springer",

}

RIS

TY - JOUR

T1 - European headache federation consensus on the definition of resistant and refractory migraine 

T2 - developed with the endorsement of the European Migraine & Headache Alliance (EMHA)

AU - Sacco, Simona

AU - Braschinsky, Mark

AU - Ducros, Anne

AU - Lampl, Christian

AU - Little, Patrick

AU - Maassen Van Den Brink, Antoinette

AU - Pozo-Rosich, Patricia

AU - Reuter, Uwe

AU - Ruiz De La Torre, Elena

AU - Sanchez Del Rio, Margarita

AU - Sinclair, Alex

AU - Katsarava, Zaza

AU - Martelletti, Paolo

PY - 2020/6/16

Y1 - 2020/6/16

N2 - Introduction: Despite advances in the management of headache disorders, some patients with migraine do not expe-rience adequate pain relief with acute and preventive treatments. It is the aim of the present document to provide a definition of those migraines which are difficult-to-treat, to create awareness of existence of this group of patients, to help Healthcare Authorities in understanding the implications, and to cre-ate a basis to develop a better pathophysiological understanding and to support further therapeutic advances.Main body: Definitions were established with a consensus process using the Delphi method.Patients with migraine with or without aura or with chronic migraine can be defined as having resistant migraine and refractory migraine according to previous preventative failures. Resistant migraine is defined by having failed at least 3 classes of migraine preventatives and suffer from at least 8 debili-tating headache days per month for at least 3 consecutive months without improvement; definition can be based on review of medical charts. Refractory migraine is defined by having failed all of the avail-able preventatives and suffer from at least 8 debilitating headache days per month for at least 6 con-secutive months. Drug failure may include lack of efficacy or lack of tolerability. Debilitating head-ache is defined as headache causing serious impairment to conduct activities of daily living despite the use of pain-relief drugs with established efficacy at the recommended dose and taken early during the attack; failure of at least two different triptans is required.Conclusions: We hope, that the updated EHF definition will be able to solve the conflicts that have limited the use of definitions which have been put forward in the past. Only with a widely accepted definition, pro-gresses in difficult-to-treat migraine can be achieved. This new definition has also the aim to increase the understanding of the impact of the migraine as a disease with all of its social, legal and healthcare implications. It is the hope of the EHF Expert Consensus Group that the proposed criteria will stimu-late further clinical, scientific and social attention to patients who suffer from migraine which is diffi-cult-to-treat.

AB - Introduction: Despite advances in the management of headache disorders, some patients with migraine do not expe-rience adequate pain relief with acute and preventive treatments. It is the aim of the present document to provide a definition of those migraines which are difficult-to-treat, to create awareness of existence of this group of patients, to help Healthcare Authorities in understanding the implications, and to cre-ate a basis to develop a better pathophysiological understanding and to support further therapeutic advances.Main body: Definitions were established with a consensus process using the Delphi method.Patients with migraine with or without aura or with chronic migraine can be defined as having resistant migraine and refractory migraine according to previous preventative failures. Resistant migraine is defined by having failed at least 3 classes of migraine preventatives and suffer from at least 8 debili-tating headache days per month for at least 3 consecutive months without improvement; definition can be based on review of medical charts. Refractory migraine is defined by having failed all of the avail-able preventatives and suffer from at least 8 debilitating headache days per month for at least 6 con-secutive months. Drug failure may include lack of efficacy or lack of tolerability. Debilitating head-ache is defined as headache causing serious impairment to conduct activities of daily living despite the use of pain-relief drugs with established efficacy at the recommended dose and taken early during the attack; failure of at least two different triptans is required.Conclusions: We hope, that the updated EHF definition will be able to solve the conflicts that have limited the use of definitions which have been put forward in the past. Only with a widely accepted definition, pro-gresses in difficult-to-treat migraine can be achieved. This new definition has also the aim to increase the understanding of the impact of the migraine as a disease with all of its social, legal and healthcare implications. It is the hope of the EHF Expert Consensus Group that the proposed criteria will stimu-late further clinical, scientific and social attention to patients who suffer from migraine which is diffi-cult-to-treat.

KW - migrane

KW - chronic migraine

KW - resistant migraine

KW - refractory migraine

KW - intractable migraine

U2 - 10.1186/s10194-020-01130-5

DO - 10.1186/s10194-020-01130-5

M3 - Article

VL - 21

JO - The Journal of Headache and Pain

JF - The Journal of Headache and Pain

SN - 1129-2377

M1 - 76

ER -