Major Study Looking at Medicine Treatments in Pediatric Migraine
by Lauren Doyle Strauss, DO
Migraine affects children, and it is estimated that there are more than 6 million children and adolescents in the US who suffer from them. There have been few research studies in the past looking at daily preventive treatments and how much they are able to reduce or take away migraines in children. There is currently only one FDA approved medication for children which is topiramate for patients > 13 years, and there are several other medicines used that have not been studied in large studies or compared to each other. Researchers Dr. Andrew Hershey and Dr. Scott Powers from Cincinnati Children’s Hospital organized the first large study funded by the NIH to study commonly used daily migraine treatment options. This trial is known as the CHAMP study (The Childhood and Adolescent Migraine Prevention) which tested the effects of amitriptyline and topiramate in comparison with each other and with a placebo (pill that does not contain active medicine). This trial involved multiple centers across the country and over 300 children were enrolled.
The results of the study were published in the New England Journal of Medicine and showed that headaches improved at the same rates with amitriptyline, topiramate, and surprising also with placebo over a 6 month period. Topiramate was noticed to have higher side effect reports from patients. There did not appear to be a difference between younger and older children in their responses with medications. This study further raises several questions including which medicines are most effective in children for migraine, and future research may focus on a patient’s genetics or other coexisting conditions that may affect which children respond to these medications. This study highlights the need to still engage in other non-medication treatments such as cognitive behavioral therapy (CBT) which has been studied to be beneficial in children with migraine.
Article: https://www.nejm.org/doi/full/10.1056/NEJMoa1610384