https://repositorio.fleni.org.ar/xmlui/handle/123456789/39 2026-04-05T22:49:04Z https://repositorio.fleni.org.ar/xmlui/handle/123456789/1398 Reevaluating triptan contraindications: A follow-up survey among Latin American neurologists Bancalari, Ernesto; Robblee, Jennifer; Goicochea, María Teresa; Muñoz, Joe; Peres, Mario F.P.; Velez, Karina ObjectiveSurvey Latin American (LATAM) neurologists on their comfort with prescribing triptans in the setting of common contraindications. BackgroundTriptans are associated with multiple contraindications due to 5-HT1B-mediated vasoconstriction. A previous survey study examined the comfort level of headache specialists from the American Headache Society (AHS) in prescribing triptans in the setting of various contraindications, but this has not been studied in LATAM countries. MethodsWe sent a modified and translated survey to LATAM neurologists with headache management expertise grouped in the Latin American Headache Association (ASOLAC). The survey was extended to local Neurology Associations to increase the sample. An eleventh question on selective serotonin reuptake inhibitors (SSRI) use was added to the original 10 questions. Responses were assessed with descriptive statistics. ResultsThere were 225 surveys analyzed from 10 LATAM countries. Notable results include that 54.2% (122/225) never use triptans in the setting of stroke, 60.9% (137/225) said never for dissection, and 70.2% (158/225) said never for reversible cerebral vasoconstriction syndrome (RCVS), but for venous thromboembolism responses were sometimes in 26.7% (60/225), rarely in 20.9% (47/225), and never in 31.6% (71/225). 57.8% (130/225) responded never for hemiplegic migraine but prolonged aura responses were 25.3% (57/225) sometimes, 25.3% (58/225) rarely, and 40.4% (91/225) never. Responses for use with aneurysms included 23.6% (53/225) sometimes, 15.6% (25/225) rarely, and 44.0% (99/225) never. For poorly controlled hypertension, 58.2% (131/225) said never. For pregnancy, 57.3% (129/225) reported never. Responses for age over 65 years included 35.6% (80/225) sometimes, 32.0% (72/225) rarely, and 22.2% (50/225) never. For SSRI use, responses were 22.7% (51/225) frequently, 38.7% (87/225) sometimes, and 24.0% (54/225) rarely. ConclusionTriptan contraindications were often considered absolute for RCVS, stroke, dissection, hemiplegic migraine, hypertension, and pregnancy. More studies are needed to clarify the true danger of triptan contraindications. 2025-06-04T00:00:00Z https://repositorio.fleni.org.ar/xmlui/handle/123456789/1356 Evidence-based guidelines for the pharmacological treatment of migraine Ornello, Raffaele; Caponnetto, Valeria; Ahmed, Fayyaz; Al-Khazali, Haidar M.; Ambrosini, Anna; Ashina, Sait; Baraldi, Carlo; Bellotti, Alessia; Brighina, Filippo; Calabresi, Paolo; Casillo, Francesco; Cevoli, Sabina; Cheng, Shuli; Chiang, Chia-Chun; Chiarugi, Alberto; Häckert Christensen, Rune; Kyung Chu, Min; Crema, Santiago; Goicochea, María Teresa We here present evidence-based guidelines for the pharmacological treatment of migraine. These guidelines, created by the Italian Society for the Study of Headache and the International Headache Society, aim to offer clear, actionable recommendations to healthcare professionals. They incorporate evidence-based recommendations from randomized controlled trials and expert-based opinions. The guidelines follow the Grading of Recommendations, Assessment, Development and Evaluation approach for assessing the quality of evidence. The guideline development involved a systematic review of literature across multiple databases, adherence to Cochrane review methods, and a structured framework for data extraction and interpretation. Although the guidelines provide a robust foundation for migraine treatment, they also highlight gaps in current research, such as the paucity of head-to-head drug comparisons and the need for long-term outcome studies. These guidelines serve as a resource to standardize migraine treatment and promote high-quality care across different healthcare settings. 2025-04-25T00:00:00Z https://repositorio.fleni.org.ar/xmlui/handle/123456789/1355 International Headache Society Global Practice Recommendations for Preventive Pharmacological Treatment of Migraine Puledda, Francesca; Sacco, Simona; Diener, Hans-Christoph; Ashina, Messoud; Al-Khazali, Haidar M.; Ashina, Sait; Burstein, Rami; Liebler, Eric; Cipriani, Andrea; Chu, Min Kyung; Cocores, Alexandra; Dodd-Glover, Freda; Ekizoğlu, Esme; Garcìa Azorìn, David; Göbel, Carl; Goicochea, María Teres; Hassan, Amr; Hirata, Koichi; Hoffmann, Jan; Jenkins, Bronwyn 2024-09-01T00:00:00Z https://repositorio.fleni.org.ar/xmlui/handle/123456789/1194 International Headache Society global practice recommendations for the acute pharmacological treatment of migraine Puledda, Francesca; Sacco, Simona; Diener, Hans-Christoph; Ashina, Messoud; Al-Khazali, Haidar M.; Ashina, Sait; Burstein, Rami; Liebler, Eric; Cipriani, Andrea; Chu, Min Kyung; Cocores, Alexandra; Dodd-Glover, Freda; Ekizoğlu, Esme; Garcìa Azorìn, David; Göbel, Carl; Goicochea, María Teresa; Hassan, Amr; Hirata, Koichi; Hoffmann, Jan; Jenkins, Bronwyn; Kamm, Katharina; Lee, Mi Ji; Ling, Yu-Hsiang; Lisicki, Marco; Martinelli, Daniele; Monteith, Teshamae S.; Ornello, Raffaele; Ozge, Aynur; Peres, Mario; Pozo Rosich, Patricia; Romanenko, Volodymyr; Schwedt, Todd J.; Souza, Marcio Nattan P.; Takizawa, Tsubasa; Terwindt, Gisela M.; Thuraiaiyah, Janu; Togha, Mansoureh; Vandenbussche, Nicolas; Wang, Shuu-Jiun; Yu, Shengyuan; Tassorelli, Cristina Background: In an effort to improve migraine management around the world, the International Headache Society (IHS) has here developed a list of practical recommendations for the acute pharmacological treatment of migraine. The recommendations are categorized into optimal and essential, in order to provide treatment options for all possible settings, including those with limited access to migraine medications. Methods: An IHS steering committee developed a list of clinical questions based on practical issues in the management of migraine. A selected group of international senior and junior headache experts developed the recommendations, following expert consensus and the review of available national and international headache guidelines and guidance documents. Following the initial search, a bibliography of twenty-one national and international guidelines was created and reviewed by the working group. Results: A total of seventeen questions addressing different aspects of acute migraine treatment have been outlined. For each of them we provide an optimal recommendation, to be used whenever possible, and an essential recommendation to be used when the optimal level cannot be attained. Conclusion: Adoption of these international recommendations will improve the quality of acute migraine treatment around the world, even where pharmacological options remain limited. 2024-08-01T00:00:00Z