2023-11-23 18:00:00
One in two migraine sufferers say they leave for work each morning with the fear that an attack will occur. Having migraine also results in a loss of productivity of 21 days over the last three months for more than 70% of affected patients (work stoppage, limitations in social activities and daily tasks). In addition, 55.6% missed at least one day of work or school during the last quarter.
Migraine, largely undertreated
According to an OpinionWay survey from October 2023, 27% of French people surveyed (and 37% of women) say they are affected by migraine episodes. “For some severe migraine sufferers, attacks make their daily lives hell, with sometimes intense pain, disability and anxiety,” laments Sabine Debremaeker, president of the Voice of Migraineurs.
In general, less than 20% of patients among the 11 million French migraine sufferers benefit from real medical monitoring, which exposes them to chronic daily headaches (CCQ) due to the abuse of analgesics.
However, many therapeutic possibilities exist. To treat migraine and its symptoms, patients have two options: either take anti-inflammatories or triptans for each attack, or opt for a basic treatment aimed at preventing their occurrence. It all depends on the type of migraine.
Severe migraine sufferers left without treatment
Medical monitoring of migraine is all the more crucial as 30 to 40% of migraine sufferers are unresponsive to current treatments specific to the attack, or these treatments are contraindicated for them. This is decisive progress in understanding the essential role of the small CGRP protein in migraine headache which is at the origin of recent new therapeutic classes capable of relieving them.
Neurologist Anne Ducros (Montpellier University Hospital) explains: “this neurotransmitter, released by the trigeminal nerve, is responsible for triggering migraine and the pain that accompanies it. Hence the recent development of new specific treatments, both for crises and for prevention, in relation to this peptide. These anti-CGRP monoclonal antibodies relieve nearly 80% of severe migraine sufferers who are resistant to any treatment. »
In addition, 30% are even “super-responders” with a frequency of seizures reduced by 75% and sometimes even their complete disappearance.
Reimbursement by health insurance which is long overdue
But now, “although the HAS recognized that these medications were effective and very well tolerated,” regrets Dr. Jérôme Mawet (Lariboisière Hospital, Paris – Headache Emergency Center), “they are still not reimbursed (and some are not available, editor’s note). This situation continues, which is aberrant in a country like France in 2023.”
Their reimbursement has been a battle waged by associations and the French Society for the Study of Migraines and Headaches for three years.
The cause of severe migraine sufferers is not progressing
In France, it is estimated that there are between 18,000 and 38,000 severe migraine sufferers. Philippe P, 59 years old, is one of them. The testimony of this school principal, now on disability, who has suffered from migraines since childhood, reveals the way in which severe migraine, when resistant to all basic treatments, can destroy social and professional life.
“I tried every drug, every technique, even the most innovative and confidential,” he confides. He is part of this third of severe chronic migraine sufferers considered “difficult to treat”.
“It was heartbreaking to give up my job at the age of 52. Migraine attacks give me no respite, occurring almost daily, with several very debilitating episodes per month. To soothe them, I take many crisis treatments. When nothing works, I take refuge in the darkness. My migraines prevented me from leading an active lifestyle, engaging in physical activity, maintaining social relationships, and participating in parties or trips. When attacks do not cause vomiting, the illness remains invisible. »
Anti-CGRP antibodies, effective but too expensive
Philippe tried all the drugs in this therapeutic class available in France, but he had to give them up because they were too expensive. “One of them gave me quite a relief,” he admits, “but as it was not available in France, I had to bring it back from Switzerland. Its cost, 450 euros per monthly injection, was entirely my responsibility. Migraine remains a sometimes major, but invisible handicap. »
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