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Headache and Migraine Disease Blog Carnival

It’s that time of month for the Headache & Migraine Disease Blog Carnival!  This month’s topic – Coping strategies for migraine.  There’s quite an eclectic set of posts, as always.  Not only are there some articles about coping, there are a few posts on other topics.

If you’re a migraine blogger yourself, you may want to participate.  Next month’s topic is Migraines and Physical Activity: How do you remain active?

Exercise and headache is a hotly discussed topic.  To get started, read these exercise tips for those with headache, this article about how exercise can fight headache and migraine, and these tips to stop getting a headache from exercise.

DosePro: toward needle-free injections

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A world where you can inject yourself without a needle?  Well, we’re one step closer.

I’ve injected myself with medication – maybe you have too.  There are few things worse, in my opinion, than asking someone with a migraine attack to poke something sharp into her/his skin.  But the technology is progressing through the system – technology which will get the medication where it’s needed fast – no need to put anything in your mouth, no need to shove something up your nose, no need to put a needle in your skin.

I first wrote about Intraject back in 2004.  Since then there has been a merging of companies and a renaming of the product.  The company is Zogenix, and the product is now called DosePro.

Zonegix

Sumatriptan DosePro is the specific product which is now moving through the system in the USA.  The product now has an official application with the FDA, and it will be reviewed (all going well) later this year.  It will be marketed for both cluster and migraine.  Sumatriptan is, of course, a common migraine-fighter, a triptan, marketed as Imigran and Imitrex.

Administered to the thigh or abdomen, it only takes a tenth of a second.  Tests so far indicate it’s every bit as good at fighting an attack as an injection.  But, as we all know – the less pain the better!

More on the recent application of Sumatriptan DosePro here.

Tonabersat – a new kind of migraine drug

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Back in early 2006 I wrote about a new class of migraine drugs that was in the testing phases.  It’s called a gap junction blocker, and the drug being tested is called tonabersat.  It’s time for an update!

A major phase of the clinical trials have been completed for tonabersat.  The results were encouraging, and reason enough to continue to testing.

At the end of a three month treatment, patients had a 50% better improvement than those on a placebo.  Patients also were able to significantly cut down on the amount of abortives that they were taking (ie painkillers).  In the third month of the study, they took on average 60% less of these other medications.

This is really still in the early testing stages, meaning that there’s still a lot of work to be done to find the best dosages and so forth.  So there’s reason to be optimistic that there will be more significant improvement in future trials.

The research is being continued at the Danish Headache Center under founder Dr. Jes Olesen.  For more, visit the Minister Pharmaceuticals page on Tonabersat.

MIST II trial cancelled

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MIST II cancelled

The MIST I and II trials have been the centre of a lot of controversy.  You might not remember the name, but you may remember the treatment.  Some people have a patent foramen ovale (PFO), which is an opening in the heart.  A simple operation is able to close this opening, and some people have found a reduction in migraine attacks after the procedure.

The idea was to conduct multiple trials and collect data in MIST I, II, III and IV.  MIST II was more ambitious than MIST I, a larger study with a longer follow-up time.

But a number of problems came out after MIST I.  First, the results were less than encouraging.  Then in October a co-investigator of the trial, Dr Peter Wilmshurst, expressed concerns about how the data was managed and reported.  Those running the trial then claimed Dr Wilmshurst was in fact not a co-investigator, but was dropped due to protocol violations.  Then other experts called for an independent review, but it was claimed patients would need to give their consent, and so on and so on….

In the end, the NMT Medical (who was running the trial) closed it.  It looks like the bottom line was money – the trial required a lot of patient screening, and it was going to drag on too long to be "worth it".

This was an important study, and it’s too bad it died.  There was a lot of media attention, making it sound like this was a cure-all for migraine, which is unlikely.  It would be nice to get the confusion cleared up.

The good news is that this is not the end of PFO treatment for migraine.  Other trials are on and continuing and we will hear more about it in the future.  Meanwhile, NMT continues its studies but will be focusing on PFO closure and stroke.  Read more in NMT Medical to shut down patent foramen ovale/migraine MIST II trial.

Does insurance cover you?

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Is your insurance really a help, or not?  I was curious to find out how much of your treatment and medication is actually covered.  You answered by taking our poll!  Here’s what you said:

Q: How much of your treatment has your insurance covered?

Insurance poll results

Thanks for your responses!  Quite a few of you have (amazingly) gotten full coverage.  But there are still about 30% who must pay at least 50% of the cost out-of-pocket.  Ouch!

Have ideas and stories that will help others make the most of their insurance (honestly, of course)?  Share your ideas in our current Community Question.

Meanwhile, read Lori Andrews thought on how to Fight for Your Health Care (US article, but much applies in other countries).  via Chronic illness Pain Support

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