Is it possible to treat migraine with vaccines?

The main exacerbation of the pain in migraine is the enlargement of the head and brain vessels with the effect of the trigeminovascular system on the vessels. Migraine headaches can be seen in childhood or even infancy. However, after the effects of hormones in adolescence and stress factors come into play, the frequency and severity of pain between the ages of 35-45 affect daily life. Patients are born predisposed to hypersensitivity of the nerve.

Until 10 years ago, migraine treatment consisted of only pain relievers and drugs used in different diseases. Botulinum toxin is a drug that has found its place as the gold standard treatment in many different fields since 1989, and was approved by the FDA in 2009, specifically for the mechanism of formation of chronic migraine. The effectiveness and safety of the drug has been documented by thousands of studies and patients. There is very clear scientific evidence for its use in migraine. Botulinum toxin significantly increases the number of pain-free days in chronic migraine patients and enables patients to return to daily life with an increase in their quality of life.

VACCINE METHOD IN MIGRAINE TREATMENT

Drugs used during attacks, ie migraine attacks, are not suitable for long-term use. The first of these is the triptan group drugs that we know to be effective. Botulinum toxin is the only approved treatment option for chronic migraine as an effective and safe treatment in patients with frequent attacks of 15 days or more, since these drugs cannot be used more than 6-8 tablets per month.

With the advancement of drug technology, the interest in migraine treatment is increasing. We know that many diseases that could not be cured in the past can now be treated with the biological medicine revolution. However, these drugs are prioritized for the use of life-threatening diseases due to research and development processes and production costs. The drug defined as migraine vaccine (erenumab) is in the biological drug group and is basically not a vaccine. There is no such thing as completely treating and ending migraine. Because it is an injectable product, it has taken this name among the people. This drug blocks the receptors on the vessel to which cgrp substance, which is released from the trigeminal nerve endings and causes the vessels to dilate, is attached.

HOW IS THE MIGRAINE VACCINE APPLIED?

Erenumab is approved by the FDA for migraine preventive (prophylaxis) use. In patients with monthly headache days between 4 and 15, injection once a month reduced the number of migraine headache days by 50% in approximately 40% of the patients in the 3rd month. It is a treatment option specially developed for migraine in cases such as lifestyle change and insufficiency of acute treatments. However, the balance between monthly treatment costs and the effectiveness of patients on the number of days with headache in real life should be evaluated by a specialist neurologist. This treatment is not yet available in our country and it will take some time before it is approved by the Ministry of Health.

Nerve blockades are also among the economical options for patients who cannot benefit enough from conventional drugs in migraine treatment. Botulinum toxin is the most effective and safe drug today for patients with more than 3 migraine attacks per month, 8 days of migraine pain and 15 or more days with headache.