SYMPTOMS:  Study finds three other medications more effective than ibuprofen in alleviating the attacks…

By WSAM Correspondent

MINNEAPOLIS, US – For many people with migraine, it can be difficult to find a treatment that is effective and reliable.

Worse, information is lacking out there on how medications compare to one another in tackling the frequent headaches that often make life unbearable. Thankfully, a new study is about to change all that, making it less stressful for migraine sufferers to make comparisons and save them the headache of feeling like looking for a needle in a haystack. 

The study, drawing data from nearly 300 000 people using a smartphone app to help people make decisions about their medications, has found that certain migraine medications like triptans, ergots and anti-emetics may be two to five times more effective than ibuprofen for treating migraine attacks.

This is according to new research published in the November 29, 2023, online issue of Neurology®, the medical journal of the American Academy of Neurology.

Migraine attacks are characterised by intense throbbing head pain, sensitivity to light and sound, nausea or vomiting. Previous research has shown migraine can also be associated with cognitive issues. All of these symptoms may impact a person’s quality of life and productivity.

“There are many treatment options available to those  (living) with migraine. However, there is a lack of head-to-head comparisons of the effectiveness of these treatment options,” said researcher Chia-Chun Chiang, of the Mayo Clinic in Rochester, Minnesota, and member of the American Academy of Neurology.

“These results confirm that triptans should be considered earlier for treating migraine, rather than reserving their use for severe attacks.”

For the study, researchers observed over three million migraine attacks from nearly 300 000 users that were self-reported by people using a smartphone app during a six-year period. The app allows users to monitor the frequency of migraine attacks, triggers, symptoms and medication effectiveness.

For those migraine attacks, participants entered 4.7 million treatment attempts with various medications into the app.

They recorded in the app whether a medication was helpful or not. Researchers then used that information to calculate the effectiveness of each drug compared to ibuprofen.

Researchers looked at a total of 25 medications among seven drug classes. Different dosages of medication and formulas of each medication were combined in this analysis.

The study found that the top three classes of medications more effective than ibuprofen were triptans, ergots and anti-emetics. Triptans were five times more effective than ibuprofen, ergots were three times more effective and anti-emetics were two and a half times more effective.

When looking at individual medications, the top three were eletriptan which was six times more effective than ibuprofen, zolmitriptan, which was five and a half times more effective; and sumatriptan, which was five times more effective.

Researchers found that when using eletriptan, participants found it helpful 78% of the time. Zolmitriptan was helpful 74% of the time and sumatriptan was helpful 72% of the time. Ibuprofen was helpful 42% of the time.

Researchers also looked at other groups of medication such as acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs other than ibuprofen were 94% more effective than ibuprofen.

Participants found ketorolac helpful 62% of the time, indomethacin was helpful 57% of the time, and diclofenac was helpful 56% of the time. However, acetaminophen was helpful 37% of the time and found to be 17% less effective than ibuprofen when used for treating migraines.

Additionally, a common combination of medications used to treat migraine, aspirin, acetaminophen and caffeine was also evaluated and found to be 69% more effective than ibuprofen.

“For people whose acute migraine medication is not working for them, our hope is that this study shows that there are many alternatives that work for migraine, and we encourage people to talk with their doctors about how to treat this painful and debilitating condition,” said Chiang.

A limitation of the study was evaluations of medications could be influenced by a user’s expectations of the medication or the dosage they took. Another limitation was that newer migraine medications, gepants and ditans, were not included in the study due to the low amount of data when the study was conducted and lack of availability in many countries. The study was supported by the Kanagawa University of Human Services.

• Learn more about migraine at BrainandLife.org, home of the American Academy of Neurology’s free patient and caregiver magazine focused on the intersection of neurologic disease and brain health. Follow Brain & Life® on Facebook, Twitter and Instagram.

1,3 MILLION WOMEN AND GIRLS WITH HIV-AIDS WORLDWIDE BECOME PREGNANT  EVERY YEAR

Reduce: : The impact on mothers and children can be reduced if awareness increased and healthcare improved…

By Thuli Zungu

World AIDS Day, an annual observance held  every year on December 1, serves as a poignant reminder  of the global effort to raise awareness and extend  support to those grappling with the challenges of  HIV/AIDS.

Women are an important target in curbing the spread of HIV as they may face unique challenges, including gynaecological issues, potential  mother to child HIV virus transmission, an elevated risk of cervical cancer and possible complications related to HIV medication side effects.

Lizeth Kruger, Dis-Chem and Dis-Chem Baby City’s National Clinic Executive, says according to The World Health Organisation (WHO), an estimated 1.3 million women and girls living with HIV become pregnant each year.

In the absence of intervention, the rate of transmission of HIV from a mother living with HIV to her child during pregnancy, labour, delivery or breastfeeding ranges from 15% to 45%.

As such, identification of HIV infection should be immediately followed by an offer of linkage to lifelong treatment and care, including support to remain in care and virally suppressed and an offer of partner services.

Kruger says women are at the critical intersection of HIV, pregnancy and breastfeeding, therefore access to reliable information in supporting pregnant mothers living with HIV and ensuring safe breastfeeding practices is vital.

“Exploring medical advancements, support systems and knowledge have made it possible for expectant mothers living with HIV to lead healthier lives and protect their babies. By increasing awareness and continuing to improve healthcare and support services, we can further reduce the impact of HIV/AIDS on mothers and children, bringing us one step closer to an HIV-free generation.”

In recent years, significant progress has been made in supporting pregnant mothers living with HIV. Antiretroviral drugs (ARVs) have been a game-changer in preventing mother-to-child transmission of the virus.

“These medications not only protect the mother’s health but also greatly reduce the risk of passing the virus to their babies during pregnancy and childbirth, says Kruger.

One common concern for pregnant women with HIV is whether they can continue taking ARVs. The answer is a resounding yes. Stopping ARV during pregnancy can be more harmful than beneficial. Medical professionals greatly assist and can work closely with expectant mothers to adjust their treatment plans to ensure both the mother and the baby’s health during this crucial time.

Kruger says PrEP, a combination of anti-HIV medication that keeps HIV-negative people from getting HIV, can be taken even after a person falls pregnant. It is however important to note that PrEP only protects against HIV infection, not against pregnancy or any other sexually transmitted infections.

An international study led by the University of KwaZulu-Natal’s (UKZN) Professor Dhayendre Moodley, confirmed earlier this year that PrEP is safe in pregnant HIV negative women. Until 2019, pregnant and lactating women in South Africa did not receive the PrEP roll-out due to a lack of safety data on its use in pregnancy, says Kruger.

“Historically, breastfeeding posed a transmission risk for mothers living with HIV. However, with advancements, the virus, coupled with proper medication management and precautions, safe breastfeeding for mothers with HIV is now possible.”

For mothers living with HIV who wish to breastfeed, it is essential to follow specific guidelines to minimise the risk of transmission to their infants.

Kruger says these guidelines typically involve taking antiretroviral medication, exclusive breastfeeding and regularly consulting with healthcare providers for monitoring and support. Mothers and healthcare professionals must work together to make informed decisions that prioritise both the mother’s and baby’s well-being.

“Support is crucial for pregnant women living with HIV. From healthcare providers offering specialised care to support groups and counselling services, many resources are available to help mothers navigate the unique challenges they may face.

“This support extends beyond medical care to address emotional and social needs, fostering a holistic approach to health.