US migraine guidance broadens preventive-treatment access

Expanded criteria for offering preventive treatment

According to the article, updated US clinical recommendations advise offering preventive treatment to people with migraine who have four or more moderate-to-severe headaches or attacks a month, or substantial migraine-related disability. Atogepant, erenumab, fremanezumab, galcanezumab, and eptinezumab are described as first-line options.

The prior joint guidance dated from 2012 and did not include Botox among its recommendations.

The reported update expands eligibility for preventive treatment and lists several CGRP-targeting medicines as first-line pharmaceutical options; it also says clinicians should offer Botox for chronic migraine.

Treatment options are also repositioned

The reported update concerns both who should be offered prevention and which medicines count as first-line options. Its effect in clinical care depends on how those recommendations are implemented.