ArticleThe journal of headache and pain2021
Burden and attitude to resistant and refractory migraine: a survey from the European Headache Federation with the endorsement of the European Migraine & Headache Alliance.
Article in The journal of headache and pain, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 of them syntheses that pooled it.
What it found
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Who cites it
31 citing papers in PubMed, 2 syntheses or guidelines pooled it, 70 citations in OpenAlex.
- Pooled it
- European Headache Federation guideline on the use of monoclonal antibodies targeting the calcitonin gene related peptide pathway for migraine prevention - 2022 update.The journal of headache and pain · 2022Guideline
- Long-term effectiveness of eptinezumab in patients with migraine and prior preventive treatment failures: extension of a randomized controlled trial.The journal of headache and pain · 2023Trial
- Migraine in children and adolescents.Developmental medicine and child neurology · 2026Review
- Observational
- Integrating Nutrition and Physical Activity into the EXEMIG/01 Interdisciplinary Model for Chronic and High-Frequency Migraine.Nutrients · 2026Article
- Fatigue in migraine patients and its clinical correlates: a large-scale hospital-based study.The journal of headache and pain · 2026Article
- Migraine management in Chinese headache centers: a national survey and the role of quality control inspections.The journal of headache and pain · 2025Article
- Impact of visceral pain on migraine symptoms in comorbid patients: a retrospective observational study.The journal of headache and pain · 2025Observational
- Migraine Genetic Susceptibility Does Not Strongly Influence Migraine Characteristics and Outcomes in a Treated, Real-World, Community Cohort.Journal of clinical medicine · 2025Article
- Resistant and refractory migraine - two different entities with different comorbidities? Results from the REFINE study.The journal of headache and pain · 2024Observational
- An Integrative Migraine Polygenic Risk Score Is Associated with Age at Onset But Not Chronification.Journal of clinical medicine · 2024Article
- Beyond Pain Relief: Unveiling the Multifaceted Impact of Anti-CGRP/R mAbs on Comorbid Symptoms in Resistant Migraine Patients.Biomedicines · 2024Article
- CGRP-monoclonal antibodies in Japan: insights from an online survey of physician members of the Japanese headache society.The journal of headache and pain · 2024Article
- Arterial hypertension in the chronic evolution of migraine: bystander or risk factor? An overview.The journal of headache and pain · 2024Review
- Peripheral Endocannabinoid Components and Lipid Plasma Levels in Patients with Resistant Migraine and Co-Morbid Personality and Psychological Disorders: A Cross-Sectional Study.International journal of molecular sciences · 2024Article
- Rare variants with large effects provide functional insights into the pathology of migraine subtypes, with and without aura.Nature genetics · 2023Article
- Review
- Who cares about migraine? Pathways and hurdles in the European region - access to care III.The journal of headache and pain · 2023Article
- The Migraine Stigma Kaleidoscope View.Neurology and therapy · 2023Article
Corrections and comments
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Authors and funding
15 authors at 8 institutions in 8 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNew treatments are currently offering new opportunities and challenges in clinical management and research in the migraine field. There is the need of homogenous criteria to identify candidates for treatment escalation as well as of reliable criteria to identify refractoriness to treatment. To overcome those issues, the European Headache Federation (EHF) issued a Consensus document to propose criteria to approach difficult-to-treat migraine patients in a standardized way. The Consensus proposed well-defined criteria for resistant migraine (i.e., patients who do not respond to some treatment but who have residual therapeutic opportunities) and refractory migraine (i.e., patients who still have debilitating migraine despite maximal treatment efforts). The aim of this study was to better understand the perceived impact of resistant and refractory migraine and the attitude of physicians involved in migraine care toward those conditions.
methodsWe conducted a web-questionnaire-based cross-sectional international study involving physicians with interest in headache care.
resultsThere were 277 questionnaires available for analysis. A relevant proportion of participants reported that patients with resistant and refractory migraine were frequently seen in their clinical practice (49.5% for resistant and 28.9% for refractory migraine); percentages were higher when considering only those working in specialized headache centers (75% and 46% respectively). However, many physicians reported low or moderate confidence in managing resistant (8.1% and 43.3%, respectively) and refractory (20.7% and 48.4%, respectively) migraine patients; confidence in treating resistant and refractory migraine patients was different according to the level of care and to the number of patients visited per week. Patients with resistant and refractory migraine were infrequently referred to more specialized centers (12% and 19%, respectively); also in this case, figures were different according to the level of care.
conclusionsThis report highlights the clinical relevance of difficult-to-treat migraine and the presence of unmet needs in this field. There is the need of more evidence regarding the management of those patients and clear guidance referring to the organization of care and available opportunities.
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