Interpretation of prevention of episodic migraine headache using pharmacologic treatments in outpatient settings：A clinical guideline from the American College of Physicians
10.19845/j.cnki.zfysjjbzz.2025.0116
- VernacularTitle:美国医师协会发作性偏头痛门诊药物预防临床指南解读
- Author:
Peng YU
1
;
Ming DONG
2
Author Information
1. 吉林大学第二医院眼科中心眼底病科，吉林 长春 130041
2. 吉林大学第一医院神经内科和神经科学中心，吉林 长春 130021
- Publication Type:Journal Article
- Keywords:
Migraine;
Outpatient settings;
Preventive pharmacotherapy
- From:
Journal of Apoplexy and Nervous Diseases
2025;42(7):610-614
- CountryChina
- Language:Chinese
-
Abstract:
The American College of Physicians（ACP） has developed a clinical practice guideline for the management of episodic migraine （defined as headache occurring on 1 to 14 days per month） in adults in outpatient settings. Based on a systematic literature review， this guideline reviews the benefits and harms of pharmacologic treatments， patient values and preferences， and health economic evidence， the Grading of Recommendations Assessment， Development and Evaluation approach was used to perform evidence-based evaluation of interventions. The guideline systematically evaluates the efficacy and safety of the following drug classes of angiotensin-converting enzyme inhibitor （lisinopril）， angiotensin II receptor antagonists （candesartan/telmisartan）， antiseizure medications （sodium valproate/topiramate）， β-blockers （metoprolol/propranolol）， calcitonin gene-related peptide pathway modulators （including the gepants such as atogepant/rimegepant and the monoclonal antibodies such as eptinezumab/erenumab/fremanezumab/galcanezumab）， serotonergic agents （fluoxetine/venlafaxine）， and tricyclic antidepressant （amitriptyline）. The key outcomes evaluated include migraine frequency， migraine duration， number of acute medication intake days， frequency of migraine-related emergency department visits， migraine-related disability， quality of life， and discontinuations due to adverse events， and FDA labels and research data from eligible studies were used to assess drug safety. The guideline puts forward three core recommendations with conditional strength （based on low-certainty evidence）： clinicians should initiate monotherapy to prevent episodic migraine in nonpregnant adults in outpatient settings； clinicians should consider alternative treatments in patients who do not tolerate or have inadequate response to initial therapy. In addition， the guideline provides clinical considerations to support evidence-based decision-making among internists and other clinicians.
- Full text:2025081113593819444美国医师协会发作性偏头痛门诊药物预防临床指南解读.pdf
