Battle of pharma advocates – in search of the ideal migraine therapy

An exciting discussion on the treatment of migraine and headaches in the format of a competition between advocates took place at the 14^th Manage Pain Congress as part of the panel discussion “The ideal choice of treatment for a migraine attack. Triptans or NSAIDs*. Pro & Contra”, which was held with the support of NovaMedica. The most renowned experts in this medical field took to the stage to debate on strategies for combating migraines and on which medications should be the drugs of choice. It is indicative that supporters of both sides of the expert battle named the new products of NovaMedica Relonova^® and Difendum indicated for the treatment of migraine-related headaches, as preferable.

The advocate for triptans in this scientific dispute was Gyuzal TABEEVA, Doctor of Medical Sciences, Professor of the Department of Nervous System Diseases of the Sechenov First Moscow State Medical University, President of the Russian Headache Society, member of the Council of Experts of the Association of Interdisciplinary Medicine. She tried to convince the panelists, or “ladies and gentlemen of the jury” as she joked, of the effectiveness of triptans by citing new research in the field. In her opinion, triptans were a breakthrough that changed the treatment options for migraine. According to Gyuzal Tabeeva, studies have shown that patient satisfaction when taking rizatriptan is higher than when taking other triptans. She also mentioned that there is now a rizatriptan available in Russia, Relonova^® offered by NovaMedica, which has demonstrated good results in studies.

Marina KORESHKINA, Doctor of Medical Sciences, member of the Russian Headache Society, the International Headache Society and the Council of Experts of the Association of Interdisciplinary Medicine, became a “denouncer” of triptans and an advocate for NSAIDs. In her opinion, first-line products are NSAIDs, and out of them, diclofenac potassium, as the gold standard, is included in all migraine treatment strategies. Marina Koreshkina noted that diclofenac potassium in soft capsules is now available to Russian doctors and patients in NovaMedica’s new drug Difendum. She said that it acts quickly, which is important for patients, and that it is sold in different strengths, including a small one, which is convenient when selecting treatment for patients of different ages. However, the expert was not actually trying to “expose” triptans, but rather spoke in favor of an alliance, a combination of different methods at different stages of treatment, taking into account the individual characteristics of each patient.  

The role of a distinguished independent expert, a conciliator of interests, in this battle of advocates fell to Alexander AMELIN, Doctor of Medical Sciences, Professor of the Department of Neurology of the Pavlov First St. Petersburg State Medical University, Head of the Department of General Neurology of the Research Institute of Neurology of the Pavlov First St. Petersburg State Medical University. Joining the advocates, he urged everyone not to look for one standard ideal, but to choose a method of treating migraine-related headaches for each patient personally, depending on the severity of the attacks and the individual characteristics of the patient. Professor Amelin believes that combination therapies should be sought based on the stratified approach balancing triptans and NSAIDs. 

Discussion moderator Alexey DANILOV, Doctor of Medical Sciences, Professor of the Department of Nervous System Diseases of the Institute of Professional Education of the Sechenov First Moscow State Medical University, Executive Director of the Association of Interdisciplinary Medicine, summed up the competition of experts, which was replete with both tricky questions for each of the advocates and good-natured jokes and support for each other. Concluding the discussion, he noted that in the treatment of migraine it was time to “move from cohort to personalized medicine”, as Pirogov taught, to know each patient well and select individual treatment, in which both triptans and NSAIDs can be useful. He thanked the expert advocates “for the brilliant discussion and its conciliatory conclusion.” 

The 14^th Manage Pain Congress was held in Moscow on November 6-8, 2023. Its goal was to disseminate advanced knowledge on the problem of pain among Russian doctors, to improve communication between doctors of various specialties, and to ensure international exchange of experience in organizing care and treating patients suffering from various pain syndromes, including headaches and migraines.

*NSAIDs are non-steroidal anti-inflammatory drugs

For information:

Relonova^® is an innovative drug based on the rizatriptan molecule for the relief of migraine attacks (headache and accompanying symptoms). Relonova^® is NovaMedica’s own-development product, the full-cycle manufacture of which is located in Russia.

Difendum is the first drug in Russia based on diclofenac potassium for the treatment of pain in the form of soft gelatin capsules that ensure its speed of action and convenient administration, even if not taken with water.