Deborah I. Friedman, MD, MPH, prepared useful Practice Aids pertaining to migraine management for this CME activity titled "Improving the Recognition and Management of Migraine in an Era of Expanding Options for Acute Treatment and Prevention: How Is the Role of the Primary Care Clinician Evolving?" For the full presentation, monograph, complete CME information, and to apply for credit, please visit us at http://bit.ly/2qQuwAt. CME credit will be available until November 22, 2019.

1. This Practice Aid has been provided as a quick reference to help learners apply the information to their daily practice and care of patients.
ID-Migraine Questionnaire1
1. Lipton RB et al. Neurology. 2003;61:375-382.
PRACTICE AID
Access the activity, “Improving the Recognition and Management of Migraine in an Era of Expanding
Options for Acute Treatment and Prevention: How Is the Role of the Primary Care Clinician Evolving?”
at www.peerview.com/HCU40.
With 2 of 3 positive:
Sensitivity = 0.81; Specificity = 0.75; Positive-predictive value = 93%
During the last 3 months, did you have the following with your headaches:
Did the light trouble you (much more than when there is no headache)?Did the light trouble you (much more than when there is no headache)? Yes No
P: Photophobia
Did your headache ever limit your ability to work, study, or do something you
needed to for ≥1 day? Yes No
I: Impairment
Did you ever feel nauseous when you had headache pain? Yes No
N: Nausea

2. Access the activity, “Improving the Recognition and Management of Migraine in
an Era of Expanding Options for Acute Treatment and Prevention: How Is the Role
of the Primary Care Clinician Evolving?” at www.peerview.com/HCU40.
Selected Emerging Therapies for
the Acute Treatment of Migraine
This Practice Aid has been provided as a quick reference to help learners apply the information to their daily practice and care of patients.
CGRP: calcitonin gene-related peptide receptor antagonist.
1. Wietecha LA et al. American Academy of Neurology 2018 Annual Meeting (AAN 2018). Abstract S50.008. 2. Lipton RB et al. American Headache Society 60th Annual Scientific Meeting (AHS
2018). Poster PS123LB. 3. Lipton RB et al. AHS 2018. Poster IOR-02LB. 4. Trugman J et al. AAN 2018. Emerging Science Abstract 008. 5. Silberstein S et al. AHS 2018. Poster PS111B.
PRACTICE AID
Therapy MOA Current Status
Lasmiditan1
Centrally acting serotonin
(5-HT1F
) agonist
• Two positive phase 3, randomized,
placebo-controlled trials
• Most frequently reported AEs after
first dose: dizziness, paresthesia,
somnolence, fatigue, nausea, and
lethargy
Rimegepant2,3
CGRP receptor antagonist
• Two positive phase 3, randomized,
placebo-controlled trials
• Most frequently reported AEs
included nausea and UTI
Ubrogepant4,5
CGRP receptor antagonist
• Two positive phase 3, randomized,
placebo-controlled trials
• Most frequently reported AEs within
48 h of dosing: nausea, somnolence,
and dry mouth

3. This Practice Aid has been provided as a quick reference to help learners apply the information to their daily practice and care of patients.
Approved and Emerging Anti-CGRP
Monoclonal Antibodies for Migraine
Prevention
CGRP: calcitonin gene-related peptide receptor antagonist.
1. Aimovig (erenumab-aooe) Prescribing Information. https://pi.amgen.com/~/media/amgen/repositorysites/pi-amgen-com/Aimovig/Aimovig_pi_hcp_english.pdf. Accessed October 24, 2018. 2. Ajovy (fremanezumab-vfrm) Prescribing Information. https://www.ajovyhcp.com/
globalassets/ajovy/ajovy-pi.pdf. Accessed October 24, 2018. 3. Emgality (galcanezumab-gnlm) Prescribing Information. http://pi.lilly.com/us/emgality-uspi.pdf. Accessed October 24, 2018. 4. Saper R et al. American Academy of Neurology 2018 Annual Meeting (AAN 2018). Abstract
S20.001. 5. Kudrow DB et al. AAN 2018. Abstract P4.470.
PRACTICE AID
Access the activity, “Improving the Recognition and Management of Migraine in an Era of Expanding
Options for Acute Treatment and Prevention: How Is the Role of the Primary Care Clinician Evolving?”
at www.peerview.com/HCU40.
Monoclonal Antibody Antibody Type Directed Against Indication Recommended Dosage
Approved
Erenumab-aooe1
Fully human
CGRP receptor
Preventive treatment of
migraine in adults
• 70 mg subQ, once monthly
• Some patients may benefit from 140 mg
subQ, once monthly (administered as two
consecutive injections of 70 mg)
Fremanezumab-fvrm2
Humanized
CGRP ligand
Preventive treatment of
migraine in adults
• 225 mg subQ, once monthly
or
• 675 mg subQ, every 3 months (administered
as three consecutive injections of 225 mg)
Galcanezumab-gnlm3
Humanized
CGRP ligand
Preventive treatment of
migraine in adults
• 240 mg subQ loading dose (administered
as two consecutive injections of 120 mg),
followed by monthly doses of 120 mg
Emerging
Eptinezumab4,5
Humanized
CGRP ligand Positive data from phase 3 migraine prevention trials have been reported