Dubai: Are you someone who suffers from throbbing headaches, with a specific smell or light triggering nausea, vomiting and a debilitating pain in the head periodically? It is likely that you are a victim of migraine, which has been recognised as the second-highest cause of disability in the UAE with one in five individuals suffering from it. Conventionally, migraines were being treated with painkillers, anti-depressants, anti-epileptic drugs and tryptamine-based drugs, with little hope of reducing the intensity or frequency. Now you need not suffer any more. A new treatment called the Anti-CGRP (calcitonin gene-related peptide) targets the pain specifically caused by the CGRP neuropeptide by inhibiting it, thereby mitigating the pain and managing it to near minimum. The therapy not only reduces the periodicity and intensity of these headaches, but also helps you manage it so effectively that migraine patients suffer no loss of productivity at work or enjoyment hours during leisure.
The MIDAS Score
Dr Raza Siddiqui, executive director of RAK Hospital, explained why migraines seriously hamper the quality of life for a patient. “The disability resulting from this chronic condition is tremendous resulting in missed days of work and loss of ability to join family activities. This loss of productivity due to migraine is measured with the Migraine Disability Assessment (Midas). The Midas score calculates the sum of missed work or school days, missed household chores days, missed non-work activity days and days at work or school plus days of household chores where productivity was reduced by half or more in the last three months. Thanks to the new CGRP self-administered injection, people can now be free of pain and resume life normally.”
What is a migraine?
Explaining the etiology of migraines, Dr Sweta Adatia, medical director and head of the Department of Neurology at RAK Hospital, told Gulf News: “Often under-diagnosed and untreated, migraine is a highly disruptive, neurological disease that affects all aspects of a sufferer’s life, although its impact on both personal and professional life is vastly undermined. The incidence of migraine is very high in the UAE. Every month, we get about 100 cases of severe headaches at our OPD [out patient department], of which nearly 50 per cent turn out to be migraines, added Dr Adatia.
How is a migraine diagnosed?
Dr Adatia further said: “Migraine has two stages. In the first stage, there is vaso-constriction, so there is a build-up of blood in the head, as a result of which, the patient may experience loss of vision, tightness and so on. This happens when the neuropeptide CGRP begins to build up in the blood, causing vasodilation. Patients usually report pain in one half of the head and the pain intensity is photosensitive. Once the vessels dilate, patients suffer a sharp throbbing pain.
How the anti-CGRP injection works
“Once we diagnose the headache as migraine, we begin the anti-CGRP treatment, which is a subcutaneous, self-administered injection. The medicine blocks the receptor and inhibits the build-up of CGRP in the blood. Increase in CGRP causes a neurogenic inflammation resulting in the throbbing pain. Once the medicine starts to work, it begins by reducing the number of days for which the pain exists. As we continue with the treatment, the frequency of the pain goes down. Therefore, if a person had pain for five days and took additional five days to recover, the pain comes down to two days and even one and recovery is quicker. In addition, the occurrence of the pain gets progressively far apart making it possible for the patient to resume normal activities.”
• The pain recurs at fixed intervals and lasts for a fixed number of days.
• The pain increases with exposure to light, sound or smell.
• The pain is accompanied by nausea, vomiting and even occasional loss of vision.
• The pain does not respond well to conventional pain-killers.
• The pain lasts from a week to 10 days.
‘Good clinical response’
Dr Adatia pointed out that the anti-CGRP treatment is covered by most health insurances in the UAE and they had in the last few months seen a good clinical response to the treatment. She cited an interesting case in point. “One of my patients, a young Pakistani expatriate who was suffering from migraine for 15 years, has responded very well to the treatment. Her pain was triggered by the onset of her menstrual cycle. The frequency and duration was such that she would have migraine every 15 days and was suffering a lot. The anti-CGRP has worked so well in her case that her pain is less intense now. In the last four months since she began her treatment, the pain has lasted only for a day and its frequency has reduced drastically. She is able to carry out all her normal activities and is very happy with the treatment,” Dr Adatia added.