Acute switch in a triptan-unsuitable patient
Late 40sestablished migraine, hypertensionchest tightness on her triptan
Classify the failure, or change the drug?
63%
The next treatment move
37%
The unsuitability category
What matters now
Migraine is the leading cause of years lived with disability among women of reproductive age. Yet fewer than 50% of people with migraine have discussed their symptoms with a physician.
Late 40sestablished migraine, hypertensionchest tightness on her triptan
Classify the failure, or change the drug?
63%
The next treatment move
37%
The unsuitability category
Late 30sepisodic migraine, four-plus days a monththree visits, acute only
Frequency threshold, or acute optimization?
34%
A later point to start
66%
The threshold already met
Late 30sperimenstrual headaches labelled stressnever worked up
Still migraine, or something else?
56%
Migraine under the criteria
44%
Another reading of the features
Early 40sepisodic migrainetwo oral preventives stopped for side effects
Real failure, or an unfinished trial?
56%
The response as it stands
44%
The adequacy of the trials
Late 40smigraine worsening in perimenopausenever offered prevention
A migraine shift, or a menopause symptom?
73%
A migraine pattern shift
27%
A perimenopausal symptom picture
What matters now
Migraine is the leading cause of years lived with disability among women of reproductive age. Yet fewer than 50% of people with migraine have discussed their symptoms with a physician.
5 Real World Scenarios
Late 40sestablished migraine, hypertensionchest tightness on her triptan
Classify the failure, or change the drug?
Where does the evidence land?
63%
The next treatment move
37%
The unsuitability category
Late 30sepisodic migraine, four-plus days a monththree visits, acute only
Frequency threshold, or acute optimization?
Where does the evidence land?
34%
A later point to start
66%
The threshold already met
Late 30sperimenstrual headaches labelled stressnever worked up
Still migraine, or something else?
Where does the evidence land?
56%
Migraine under the criteria
44%
Another reading of the features
Early 40sepisodic migrainetwo oral preventives stopped for side effects
Real failure, or an unfinished trial?
Where does the evidence land?
56%
The response as it stands
44%
The adequacy of the trials
Late 40smigraine worsening in perimenopausenever offered prevention
A migraine shift, or a menopause symptom?
Where does the evidence land?
73%
A migraine pattern shift
27%
A perimenopausal symptom picture