Preventing Migraine Under New Normal

May 28, 2020
Migraine experts
Migraine experts hold virtual media briefing on easing and preventing migraine amid COVID-19 pandemic. From left, Dr. Rosalina Espiritu-Picar, President, Philippine Neurological Association; Dr. Corina Maria Socorro Azores-Macalintal, Consultant Neurologist, Asian Hospital and Medical Center; Inset, TV Host and Model Ms. Bianca Gonzales-Intal; Dr. GiovellBarangan, Chief Scientific Officer, Novartis Healthcare Philippines, Inc.; and Jugo Tsumura, President and Managing Director, Novartis Healthcare Philippines, Inc.

STRESS, anxiety and fear induced by the COVID-19 pandemic and other incidents like unable to sleep well while being cooped up at home may trigger headache and migraine attack.

Many individuals regard this condition as simple headache and popping an over-the-counter medicine like paracetamol and other pain relievers could help relieve the pain.

On the contrary, this simple headache could already be a serious neurological disease called migraine which is often debilitating especially to migrainous person or migraine sufferer.

During a virtual media briefing, Dr. Corina Maria Socorro A. Macalintal, consultant neurologist at the Asian Hospital and Medical Center, said migraine sufferers (especially those who experience episodic migraine up to 14 migraine days each month) may grow anxious due to the overlap of migraine and COVID-19 symptoms.

Dr. Macalintal said headache is a manifestation of COVID-19 and in migraine attacks though the deadly virus is associated with fever and cough. Nausea, vomiting and sensitivity to light and sound are manifested in severe or chronic migraine.

“Migraine attacks may be more common these days because of stress and anxiety caused by the pandemic. It is important for migraine patients to consult a neurologist as migraine management is individualized, depending on the patient’s other health concerns and different reactions to medications,” Dr. Macalintal said.

Around 12 million Filipinos suffer from migraine, according to the Global Burden of Disease Study 2016. According to a recent World Health Organization (WHO) report, close to 14% of people with COVID-19 experience headaches, which may include migraine headaches. The Speak Your Migraine PH online survey conducted by Novartis among Filipino migraine sufferers revealed that stress and anxiety can trigger migraine attacks.

Many migraine sufferers admit they cannot work or function well during migraine attack and 45 percent reported missing family or social events while 52 percent of parents said migraine made them more likely to argue with their children.

TV host and model Bianca Gonzalez who was a migraine sufferer is very grateful to her husband for supporting her whenever she has migraine attacks. She said she would take a strong medicine and take a nap backstage before showtime when migraine attacks.

Some migraine sufferers are cautious about taking an over-the-counter medicine to relieve the pain. However, Dr. Rosalina Espiritu-Picar, President of the Philippine Neurological Association (PNA), advised patients especially those prone to chronic migraine attack to take medicine at the onset of the condition to prevent it from becoming severe.

She encouraged migraine patients who are stable and do not require acute emergency care to utilize telemedicine tools so that they can stay connected with their doctors.

According to health experts, there are pharmacological and non-pharmacological treatment options for migraine management. They said migraine patients and their neurologists should discuss treatment goals, which should not be limited to stopping the headache attack but to prevent recurrence. Newer treatment options on preventive management address recurrence and other limitations of oral medications.

In line with the newest treatment to migraine, Novartis has developed erenumab, the first of its kind to be approved by the US FDA, EMA, Swissmedic and Australian TGA for the prevention of migraine.

Dr. GiovellBarangan, Chief Scientific Officer, Novartis Healthcare Philippines, said Erenumab is approved for the prevention of migraine in adults.

Erenumab specifically targets the calcitonin gene-related peptide or CGRP receptor. It has been shown to safely and effectively reduce migraine frequency. The anti-migraine medicine is self-administered once monthly via a prefilled syringe. It does not require a loading dose and is easy to use. Erenumab has been launched in 43 other countries and is now available in the country.

The PNA also drafted telemedicine guidelines that all of its members follow to ensure the safety and privacy of both patients and doctors. Patients are encouraged to visit the official PNA website at www.philippineneurologicalassociation.com or the trunkline of the hospital nearest them to ask for a neurologists accepting telemedicine consultations.

“Monitoring migraine attacks can help migraine sufferers recognize trigger factors and warning signs. It can also help the doctor assess if the patient's migraine medication is working. The good news is that new treatment options on preventive migraine care are now available,” said Ms. Christine Fajardo, Corporate Affairs Head, Novartis Healthcare Philippines.