Conducting Clinical Trials in Pediatric Migraine: Christina Szperka, MD, MSCE

WATCH TIME: 6 minutes

“The CHAMP study showed that there were a lot of adverse effects in those meds, particularly topiramate. So, if we have another therapy that does ultimately have long-term safety and fewer adverse effects and that's easier in terms of adherence, maybe then the prescription patterns will eventually shift. But for right now, early on, when they meds have only been approved in adults for a couple of years, it's hard sometimes for parents to say, ‘I want to put my child in that study.’ That's something that we wrestle with, and it just depends.”

Difficulties surround enrollment for clinical trials in pediatric migraine, as new medications often have no long-term safety data, complicating parents’ decisions when it comes to enrolling their children and expose them to potential risks of an unproven therapy. Christina Szperka, MD, MSCE, director of the Pediatric Headache Program at the Children’s Hospital of Philadelphia (CHOP), commented on this issue, adding that trials are often designed for patients with “regular, more straightforward, earlier-on migraine,” leaving out those who have continuous headache and have become ineligible after failing multiple therapies. 

In conversation with NeurologyLive^®, Szperka also discussed advances made for general migraine during the COVID-19 pandemic, including a paper she coauthored during the lockdown period entitled, “Migraine care in the era of COVID-19: Clinical pearls and plea to insurers,” which provided alternative options for patients with migraine, in the event they could not visit a facility for usual procedures.1 For children with migraine, Szperka noted the introduction of virtual school and the beneficial aspects it had for those who could learn at home, avoiding school buildings that may generate issues due to lights and noise. Adding a caveat, Szperka also stressed the need to maintain healthy sleep, exercise, diet, and socialization, if cyber school is the preferable option. 

REFERENCE
1. Szperka CL, Ailani J, Barmherzig R, et al. Migraine care in the era of COVID-19: Clinical pearls and plea to insurers. Headache. 2020;60(5):833-842. doi:10.1111/head.13810