The Treatment of Status Migrainosus in Emergency Care Settings: Matthew Robbins, MD

WATCH TIME: 2 minutes

“There’s thought that, say there was a high-risk population who could lapse into status migrainosus, or they do, in the emergency room. If you gave them this IV medication, [eptinezumab], not only could it get them out of the emergency room and feeling better in the moment, it could prevent the onset of status migrainosus.”

Status migrainosus, a condition in which a headache attack lasts 72 hours or longer, has posed significant clinical challenges for physicians and has placed a severe burden on the large population of patients with migraine. Currently, little literature on effective treatment options exists, with many physicians opting for a variety of approaches that are adjusted based on the situation at hand.

Some have suggested that one of the newer calcitonin gene-related peptide (CGRP) targeted therapies, eptinezumab (Vyepti; Lundbeck), could be a potential treatment for these individuals, Matthew Robbins, MD, told NeurologyLive® in a conversation at the 2022 American Headache Society (AHS) Annual Scientific Meeting, June 9-11, in Denver, Colorado. Although this needs to be explored further, some headache specialists think it could even prevent the future onset of status migrainosus because of the long half-life of the medication.

Although, Robbins, who is a neurologist and associate professor of neurology at Weill Cornell Medicine and NewYork-Presbyterian Hospital, explained that there are still barriers to this approach. These new CGRP therapies require prior authorizations, and clinicians outside of the headache specialty are often unfamiliar with their use and may be uncertain about utilizing them. Robbins offered his insight into this challenge and the state of treating status migrainosus.

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