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Abstract
Migraine is common in children and adolescents and can cause significant disability. There are relatively limited evidence-based treatment options available, especially when compared with treatment of migraine in adults. The Pediatric Research Equity Act requires the study of a new drug or biologic in pediatric populations. As such it is mandatory that the newest migraine treatment options available for adults be evaluated in children and adolescents. It will take years before results from clinical trials in pediatric patients become available. In the meantime, there is eagerness among clinicians to seek out the existing evidence that may help provide clarity on utilization of the newer migraine therapies in children and adolescents because many of the currently available, guideline-recommended treatments do not provide benefit for all patients. In this narrative review, the literature regarding onabotulinumtoxinA, neuromodulatory devices, calcitonin gene-related peptide (CGRP) monoclonal antibodies, 5-hydroxytryptamine (1F) agonists (i.e., ditans), and CGRP small-molecule receptor antagonists (i.e., gepants) for the treatment of migraine in children and adolescents will be summarized.
Glossary
- 5-HT=
- 5-hydroxytryptamine;
- CGRP=
- calcitonin gene-related peptide;
- eCOT-NS=
- external concurrent occipital and trigeminal neurostimulation;
- eTNS=
- external trigeminal nerve stimulation;
- FDA=
- Food and Drug Administration;
- mAb=
- monoclonal antibody;
- nVNS=
- noninvasive vagus nerve stimulation;
- PREEMPT=
- Phase 3 Research Evaluating Migraine Prophylaxis Therapy;
- REN=
- remote electrical neuromodulation;
- sTMS=
- single-pulse transcranial magnetic stimulation
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 article.
Submitted and externally peer reviewed. The handling editor was Associate Editor Courtney Wusthoff, MD, MS.
- Received January 6, 2023.
- Accepted in final form June 6, 2023.
- © 2023 American Academy of Neurology
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