Many migraine sufferers might find relief from their pain after they were told that the NHS has a wonder drug for them.
Doctors in England and Wales have been given the thumbs-up to increase the use of fremanezumab – a monthly jab into the arm, tummy or leg.
This drug is part of a group of medications called CGRP inhibits. They have revolutionized migraine treatment in recent years, and some experts consider it the most significant breakthrough in treatment for the condition since 1980.
But the drugs have until now been restricted to those with chronic migraines – defined as at least 15 days of excruciating attacks every month.
Anyone with a lower number than this is known as episodic headache sufferers.
In 2020, doctors in Scotland were already given the green light while Northern Ireland is yet to make an announcement.
The National Institute for Health and Care Excellence has now ruled that patients suffering on at most four days a month can get the jab. This could potentially help many more people every year.
The approval was welcomed by leading UK experts in headaches, who predict that the treatment will allow many patients to live normal lives again.
Doctors in England and Wales have been given the thumbs-up to increase the use of fremanezumab – a monthly jab into the arm, tummy or leg
The mystery of the foreign accent syndrome
Michelle Myers (pictured), an Arizona native, woke one morning in 2018 with a British accent that sounded like Mary Poppins.
Imagine waking up with a strong German accent – despite, er, not being German at all.
The foreign accent syndrome has been a mystery to medics for many decades.
Brain damage – commonly stroke – can change the pitch, intonation and timing of a patient’s speech, causing them to unintentionally take on a foreign accent.
An example of this is an Australian woman, Michelle Myers from Arizona who, after suffering brain damage in her car accident, developed a French accent. Michelle Myers also has a Mary Poppins-like British accent.
Most cases are resolved within the time frame, but speech therapy is an option to reduce symptoms.
According to Dr Mark Weatherall (consultant neurologist, Buckinghamshire Healthcare NHS Trust), “These drugs can change your life.”
“I’ve seen migraine patients that have been out of work for several years, but they are now back at work after this treatment.
“The social benefits of this approach to society are enormous.
‘Many of those suffering from episodic migraines may be affected up to 14 days a month – just below the old threshold for the drugs.
“Yet, their lives are substantially debilitated.
“So NICE approval could be hugely beneficial for them.
There are approximately seven million UK residents who suffer from migraines. The incidence of migraines is three times higher in women than it is for men. This could be because attacks can be linked to oestrogen, a female hormone.
It is characterized by a severe headache with a single side, but it can also be accompanied by nausea and increased sensitivities to sound and light.
Many patients use painkillers and prescription drugs, such as triptans, to ease their agony. These medications can also be used to shorten the duration of the attacks.
Over the years there has been no way to prevent or decrease migraines.
The NHS then gave its approval in March 2020 to CGRP inhibitions to those most seriously affected.
The drugs work by blocking a chemical called calcitonin gene-related peptide (CGRP), responsible for the pain and nausea associated with migraines – halving the number of attacks.
There are three anti-CGRP drugs approved for use in the UK – erenumab, galcanezumab and fremanezumab.
NICE approved Fremanezumab as a treatment for episodic and chronic migraine.
However, unlike its rivals, patients can only be given fremanezumab if they have not improved on at least three medications. These include painkillers and an anti-epilepsy drug called Topiramate, which doubles as a migraine treatment.
Because of the complexity and difficulty in identifying drugs that can help, treating migraines is proving to be a difficult task for scientists.
Certain triggers (e.g. dark chocolate, caffeine) can cause migraines.
Migraine Trust claims that the condition is genetic and can be found in all families. It’s actually a mix of different genes working together.
Nia Beynon (30 years old) from Cardiff is one patient hoping to be helped. She has suffered 12 migraines per month since her 13th birthday.
It can cause severe pain. It can sometimes make me feel nauseated.
Nia, who lives in the same house as her husband, tried various beta-blockers and preventative drugs, but it proved difficult to remember when to take each pill.
Nia suffers from migraines now for around an hour, while sumatriptan takes effect. Her head is still very sensitive.
Injectable fremanezumab would give Nia one thing fewer to think about – and until now she wasn’t eligible.
“It would be a relief,” she said. My tablets are always with me.
Weatherall acknowledged that NICE was a’very important decision’, but he stressed that many patients have difficulty accessing life-changing injections. The Mail reported this Sunday.
Migraine Trust believes that 1,000 of the 200,000+ patients who have met the anti-CGRPs requirements are eligible to be enrolled on the NHS.
A recent study by the NHS Trusts of England found that only one in thirteen NHS trusts provided headache treatment and 15 offered CGRP injections.
Rob Music from The Migraine Trust stated that “There’s a Postcode Lottery of Care, in which only the fortunate few can access treatment that has been transformational.”
It should be an amazing and exciting time, but the lack of accessibility is leading to poor health and frustration.