New guidance from NICE will  give 170,000 people in England more treatment options for preventing migraine attacks.

The final draft guidance recommends that patients with both chronic and episodic migraines should be offered treatment with atogepant, the first oral preventative treatment option available for patients who suffer from migraines.

The medication, made by AbbVie, is also known as Aquipta and will be available to patients who have had at least four migraine days per month and where at least three previous preventive treatments have failed.

Appeals against the final draft guidance are now open, but if no appeals are received from registered consultees, the final guidance is expected to be published next month.

Around 4.5 million people in the UK experience migraines and the condition significantly impacts a person’s daily life and places a heavy burden on the NHS, as well as the wider economy. Episodic migraines are classified as fewer than 15 headache days each month, whereas chronic migraines are when a person has at least 15 headache days a month, with at least eight of those having features of migraine.

The new oral treatment is a tablet that works by blocking the calcitonin gene-related peptide (CGRP) receptor in the body. CGRP is a protein thought to play a significant role in the development of migraines by causing blood vessels in the head and neck to dilate, leading to inflammation and pain. Blocking the effects of CGRP molecules can reduce the symptoms of migraines.

In the final draft guidance, NICE recommends that health practitioners should consider atogepant as one of a range of possible treatments for patients with migraines and, after discussing the advantages and disadvantages of all the options, use the least expensive option.

Helen Knight, director of medicines evaluation at NICE, said: ‘Today’s final draft guidance demonstrates our commitment to focusing on what matters most and getting the best care to people while ensuring value for the taxpayer.’

She added: ‘Currently, the most effective options for people with chronic migraines who have already tried three preventative treatments are drugs that need to be injected. The committee heard from patient experts that some people cannot have injectable treatments, for example, because they have an allergy or phobia of needles. So, some people with chronic migraines would welcome an oral treatment. Atogepant also offers more choice for people with episodic migraine.’

The final draft guidance states that atogepant should be stopped after 12 weeks of treatment if the frequency of migraine attacks does not reduce by at least 30 per cent in chronic migraine and 50 per cent in episodic migraine.

Health Minister Andrew Stephenson added: ‘This new treatment will help prevent recurring migraine attacks when other medicines have failed. It will allow more people to manage their migraines more effectively and to live their lives to the fullest.’

This article first appeared on our sister site Nursing in Practice.