- Evidence-Based Recommendations on Pharmacologic Treatment for Migraine Prevention: A Clinical Practice Guideline from the Korean Headache Society
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Byung-Su Kim, Pil-Wook Chung, Jae Myun Chung, Kwang-Yeol Park, Heui-Soo Moon, Hong-Kyun Park, Dae-Woong Bae, Jong-Geun Seo, Jong-Hee Sohn, Tae-Jin Song, Seung-Han Lee, Kyungmi Oh, Mi Ji Lee, Myoung-Jin Cha, Yun-Ju Choi, Miyoung Choi
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Headache Pain Res. 2025;26(1):5-20. Published online January 16, 2025
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DOI: https://doi.org/10.62087/hpr.2024.0019
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- Purpose: The aim of this clinical practice guideline (CPG) from the Korean Headache Society is to provide evidence-based recommendations on the pharmacologic treatment for migraine prevention in adult migraine patients.
Methods
The present CPG was developed based on the guideline adaptation methodology through a comprehensive systematic search for literature published between January 2012 and July 2020. The overall quality of the CPGs was assessed using the Korean version of the Appraisal of Guidelines for Research and Evaluation II tool. High-quality CPGs were adapted to make key recommendations in terms of strength (strong or weak) and direction (for or against).
Results
The authors selected nine available high-quality guidelines throughout the process of assessment of quality. Regarding oral migraine preventive medications, propranolol, metoprolol, flunarizine, sodium divalproex, and valproic acid are recommended to adult patients with episodic migraines based on high-quality evidence (“strong for”). Topiramate can be recommended for either episodic or chronic migraine (“strong for”). For migraine prevention using calcitonin gene-related peptide monoclonal antibodies, galcanezumab, fremanezumab, erenumab, and eptinezumab are recommended for adult patients with either episodic or chronic migraine on the basis of high-quality evidence (“strong for”). OnabotulinumtoxinA is recommended for adult patients with chronic migraine based on high-quality evidence (“strong for”). Last, frovatriptan, naratriptan, and zolmitriptan are recommended for short-term prevention in women with menstrual migraine (“strong for”).
Conclusion
In the present CPG, the authors provide specific, straightforward, and easy-to-implement evidence-based recommendations for pharmacologic migraine prevention. Nevertheless, these recommendations should be applied in real-world clinical practice based on optimal individualization.
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Citations
Citations to this article as recorded by  - One-Year Compliance After Calcitonin Gene-Related Peptide Monoclonal Antibody Therapy for Migraine Patients in a Real-World Setting: A Multicenter Cross-Sectional Study
Mi-kyoung Kang, Jong-Hee Sohn, Myoung-Jin Cha, Yoo Hwan Kim, Yooha Hong, Hee-Jin Im, Soo-Jin Cho
Journal of Clinical Medicine.2025; 14(3): 734. CrossRef - Beyond the Pain: Rethinking Migraine Care with the RELIEF PLAN Approach
Sanghyo Ryu
Headache and Pain Research.2025; 26(1): 1. CrossRef
- Lasmiditan: Another Therapeutic Option for Acute Migraine Treatment
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Hong-Kyun Park
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Published online December 31, 2021
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- 라스미디탄: 급성기 편두통 치료의 또 다른 방법
- Comorbid Medical Conditions in Patients with Medication Overuse Headache: Multicenter Prospective Medication Overuse Headache Registry Analysis
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Yooha Hong, Soo-Jin Cho, Min Kyung Chu, Sun-Young Oh, Heui-Soo Moon, Tae-Jin Song, Mi Ji Lee, Jin-Ju Kang, Hong-Kyun Park
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Published online December 31, 2021
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- 약물과용두통 환자에서 동반 이환되는 내과적 문제: 국내 다기관 전향적 약물과용두통 등록체계
- Clinical Practice Guideline of Pharmacologic Treatment for Migraine Prevention in Adults 2021: The Committee of Clinical Practice Guideline of the Korean Headache Society
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Kim Byung-Su, Jae Myun Chung, Pil-Wook Chung, Kwang-Yeol Park, Jin-Young Ahn, Heui-Soo Moon, Hong-Kyun Park, Dae Woong Bae, Jong-Geun Seo, Jong-Hee Sohn, Tae-Jin Song
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Published online December 31, 2021
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- 성인 편두통 예방치료 약제 진료지침 2021: 대한두통학회 진료지침위원회
- Migraine and Stroke
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Hong-Kyun Park, Keun-Sik Hong
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Published online December 31, 2018
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- 편두통과 뇌졸중
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