Headache and Pain Research

Evidence-Based Recommendations on Pharmacologic Treatment for Migraine Prevention: A Clinical Practice Guideline from the Korean Headache Society: 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; Received June 23, 2024 Accepted September 11, 2024 Published online January 16, 2025; DOI: https://doi.org/10.62087/hpr.2024.0019 [Epub ahead of print]

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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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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

Update on Tension-type Headache: Hye Jeong Lee, Soo-Jin Cho, Jong-Geun Seo, Henrik Winther Schytz; Received September 7, 2024 Accepted October 4, 2024 Published online December 30, 2024; DOI: https://doi.org/10.62087/hpr.2024.0025 [Epub ahead of print]

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Abstract PDF: Tension-type headache (TTH) is the most common type of headache, characterized by mild to moderate intensity, bilateral, with a pressing or tightening (non-pulsating) quality. Migraine and TTH can occur in the same person, and their risk factors and treatments can overlap. However, TTH receives less attention than migraine. Furthermore, despite the expanding market for migraine treatments targeting calcitonin gene-related peptide (CGRP) mechanisms, the lack of evidence regarding mechanisms related to CGRP-related mechanisms in TTH continues to be neglected. There remains a need to develop effective preventive treatments for chronic TTH, which imposes a very high burden of disease. From this perspective, this review aims to provide the latest evidence on TTH.

Menstrual Migraine: A Review of Current Research and Clinical Challenges: Jong-Geun Seo; Headache Pain Res. 2024;25(1):16-23. Published online April 22, 2024; DOI: https://doi.org/10.62087/hpr.2024.0004

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The term “menstrual migraine” is commonly used to describe migraines that occur in association with menstruation, as distinct from other migraine types. A significant proportion of women of reproductive age experience migraine attacks related to their menstrual cycle. Menstrual migraine is characterized by migraine attacks occurring on day 1±2 (i.e., days −2 to +3) of menstruation in at least two out of three menstrual cycles. Although the reported prevalence of menstrual migraine varies considerably, population-based studies have found that menstrual migraine affects up to 60% of women with migraines. Several hypotheses have been proposed to explain the etiology of menstrual migraine, among which the estrogen withdrawal hypothesis is the most widely accepted. Women who experience menstrual migraines often face considerable disability due to perimenstrual attacks. Studies have reported that perimenstrual attacks are more severe and more difficult to manage. The principles of acute managing perimenstrual attacks are the same as those for managing nonmenstrual attacks. Short-term preventive therapy is needed to prevent menstrual migraines before they occur during the perimenstrual period. This review summarizes the prevalence, distinct clinical features, pathophysiological mechanisms, and management of menstrual migraine.

Citations

Citations to this article as recorded by

Migraine in Women: Inescapable Femaleness?
Soo-Kyoung Kim
Headache and Pain Research.2024; 25(1): 1. CrossRef
Three-month treatment outcome of medication-overuse headache according to classes of overused medications, use of acute medications, and preventive treatments
Sun-Young Oh, Jin-Ju Kang, Hong-Kyun Park, Soo-Jin Cho, Yooha Hong, Mi-Kyoung Kang, Heui-Soo Moon, Mi Ji Lee, Tae-Jin Song, Young Ju Suh, Min Kyung Chu
Scientific Reports.2024;[Epub] CrossRef
Understanding the Connection between the Glymphatic System and Migraine: A Systematic Review
Myoung-Jin Cha, Kyung Wook Kang, Jung-won Shin, Hosung Kim, Jiyoung Kim
Headache and Pain Research.2024; 25(2): 86. CrossRef

Zavegepant: Intranasal Drug for Acute Migraine Treatment: Jong-Geun Seo; Korean J Headache. 2023;24(1):17-19. Published online June 30, 2023

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Abstract PDF: Calcitonin gene-related peptide (CGRP) is probably the most potent vasodilator in cerebral circulation. The new CGRP-targeted therapy for the treatment of acute treatment are now available for clinical practice. This review article summarized efficacy and safety of zavegepant, which is the first intranasal small molecule CGRP receptor antagonist for acute migraine treatment.

Clinical Practice Guideline of Pharmacologic Treatment for Migraine Prevention in Adults 2021: The Committee of Clinical Practice Guideline of the Korean Headache Society: 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; Published online December 31, 2021

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Abstract PDF: 성인 편두통 예방치료 약제 진료지침 2021: 대한두통학회 진료지침위원회

A Case of Pneumocephalus after Lumbar Puncture in Spontaneous Intracranial Hypotension: Ayeong Jeong, Sung-Pa Park, Jong-Geun Seo; Published online December 31, 2021

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Abstract PDF: 자발두개내압 저하에서 요추 천자 이후 발생한 공기머리증 1례

Recurrent Cerebral Venous Thrombosis Associated with Antiphospholipid Syndrome: Ho-Cheol Lee, Sung-Pa Park, Jong-Geun Seo, Ph.D.; Published online June 30, 2019

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Abstract PDF: 항인지질증후군과 연관된 재발성 뇌정맥혈전증

The Assessment Tools for Impact on Daily Life and Psychiatric Comorbidities in Migraine: Jong-Geun Seo, Ph.D.; Published online December 31, 2017

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Abstract PDF: 편두통의 일상생활에의 영향과 동반된 정신질환에 대한 평가도구

A Case of Spontaneous Intracranial Hypotension Presented with Right Abducens Nerve Palsy: Wooryang Byun, Sung-Pa Park, Jong-Geun Seo; Published online June 30, 2016

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Abstract PDF: 우측 외전신경마비를 동반한 자발두개내압저하에 기인한 두통

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