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Review Article
Pediatric Headache: Children and Adolescents
- Gepants for the Treatment of Migraine in Children and Adolescents: Acute and Preventive Roles, Current Evidence, and Ongoing Trials
- Ji-Hoon Na
- Headache Pain Res. 2026;27(3):246-257. Published online October 19, 2026
- DOI: https://doi.org/10.62087/hpr.2026.0034
- 1,116 View
- 16 Download
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Abstract
PDF - Migraine affects approximately 10% of children and adolescents and is often disabling, but evidence-based options for acute treatment and prevention remain limited. A high placebo response has also complicated pivotal pediatric trials. Therapies targeting the calcitonin gene-related peptide (CGRP) pathway have reshaped adult migraine care, and the approval of one CGRP monoclonal antibody for pediatric prevention has validated this target in pediatric patients. Gepants, small-molecule oral or intranasal CGRP receptor antagonists, are of particular interest because, unlike injectable antibodies, they offer acute or preventive treatment without vasoconstrictive activity. This review summarizes the pharmacology and adult evidence for the four approved gepants, their emerging pediatric use, and ongoing clinical trials. Depending on the agent, gepants have established efficacy for acute treatment or prevention in adults, with favorable long-term safety and no new hepatic or cardiovascular safety signals. Pediatric evidence is limited to small retrospective studies of off-label use in patients whose migraine is refractory to standard therapy. These reports suggest acceptable tolerability and possible benefit in some patients, but controlled trials are needed to determine efficacy. Phase 3 randomized trials are evaluating ubrogepant for acute treatment and atogepant and rimegepant for the prevention of episodic and chronic migraine in pediatric patients aged 6–17 years for acute treatment and episodic migraine prevention, and 12–17 years for chronic migraine prevention, with estimated completion expected between 2027 and 2032. Until controlled data become available, gepant use should be individualized and restricted to patients who have not responded to standard therapies. Pediatric dosing, long-term safety, and the lower age limit of benefit remain key questions.
Original Article
Pediatric Headache: Children and Adolescents
- Serum Triglyceride Levels in Pediatric Migraine and Tension-Type Headache: A Retrospective Study
- Ki Taek Oh
- Headache Pain Res. 2026;27(2):154-157. Published online June 30, 2026
- DOI: https://doi.org/10.62087/hpr.2026.0016
- 1,227 View
- 9 Download
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Abstract
PDF
Supplementary Material - Purpose: Migraine and tension-type headache (TTH) are the most common primary headache disorders in children. However, potential metabolic differences between these conditions remain incompletely understood.
Methods
This retrospective study included pediatric patients diagnosed with migraine or TTH. Clinical characteristics and laboratory parameters were compared between the groups. Serum triglyceride (TG) levels were analyzed using multivariable linear regression adjusted for age and sex. Additional analyses included body mass index (BMI)-adjusted models and logarithmically transformed TG analyses.
Results
In total, 139 patients were included: 85 with migraine and 54 with TTH. Serum TG data were available for 101 patients. Mean TG levels were significantly higher in patients with TTH than in those with migraine (130.7±80.4 mg/dL vs. 92.1±42.4 mg/dL, p=0.006). This association remained significant after adjustment for age and sex (β=36.61 mg/dL, p=0.004), after logarithmic transformation (p=0.006), and in the BMI-adjusted subgroup analysis (β=42.84 mg/dL, p=0.040).
Conclusion
This exploratory retrospective study identified higher serum TG levels in pediatric patients with TTH than in those with migraine. Given the retrospective design and potential for residual confounding, these findings should be considered hypothesis- generating and require confirmation in prospective studies.
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