Tailoring Treatment in Polymorbid Migraine Patients through Personalized Medicine

Excerpt

Headache disorders represent the most frequent clinical problem among neurological diseases [1]. Migraine alone affects nearly 14% of the global population, and is the first cause of disability in people under 50 years of age, representing a real challenge for healthcare systems [2]. Evidence of multiple comorbidities in the migraine population, especially at cardio-cerebrovascular, psychiatric, metabolic, and musculoskeletal levels, has led to an observed increase in clinical practice of patients undergoing multiple pharmacological therapies [3‐6]. The use of different drugs in the same migraine patient significantly increases the risk of potentially serious adverse events (AEs) [7]. As a consequence, the development and implementation of precision medicine in clinical practice addresses this increased clinical risk, allowing advanced and early evaluation of possible drug–drug interactions (DDIs), and guiding clinical prescription and monitoring [7]. We also have to consider that in a real-world scenario, each migraine patient might also have other (acute or chronic) non-comorbid pathologies that require additional therapies. These adjunctive treatments may result in additional DDIs and AEs, potentially adding the risk of decreased clinical efficacy of the prescribed drug(s) [8]. …