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Optimal migraine treatment is a key challenge to neurologists every day. Most headache in clinical practice is migraine, and this disease causes more years lived with disability than all other neurologic disorders combined.1 Many treatment options exist, but choice has historically been determined by comorbidities, side effects, and provider experience/preference. Now that medications specifically targeting migraine pathophysiology are available, and physicians can focus less on expected side effects of preventive treatment and more on choosing the therapy most likely to improve the everyday well-being of their patients. Although this choice should be evidence-based, it is difficult to compare drug trials with varying methods and patient populations. Furthermore, primary endpoints such as number of headache days or reduction in abortive medication use may not always translate into what matters most to patients and providers: quality of life. Thankfully, recent trials have begun to assess the effect of preventive therapy on validated patient-reported outcome measures (PROMs) assessing migraine-related quality of life (QoL). This shift has the potential to dramatically affect prescription choices and improve provider and patient confidence.
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the editorial.
See page 364
- Received September 13, 2022.
- Accepted in final form September 28, 2022.
- © 2022 American Academy of Neurology
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