EAN 2026 | One big question with Piero Barbanti: what migraine advance could transform care within 3 years?
Piero Barbanti, MD, PhD, IRCCS San Raffaele Pisana, Rome, Italy, discusses the key advances in migraine that could transform care in the next three years. Prof. Barbanti highlights advances in the management of chronic migraine, such as treating earlier to prevent the progression of migraine. This interview took place at the 12th Congress of the European Academy of Neurology (EAN) in Geneva, Switzerland.
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Transcript
Now we have excellent tools to treat migraine. A tool can be defined excellent if the efficacy-tolerability ratio is very high, and it is indeed what we have. So in ideal worlds, we should start treating the patient earlier. We should start first to diagnose migraine earlier and then to treat migraine earlier and then to treat migraine earlier with the right drug for a proper period of time. I think we are now facing a revolution, and this is truly a point of no return...
Now we have excellent tools to treat migraine. A tool can be defined excellent if the efficacy-tolerability ratio is very high, and it is indeed what we have. So in ideal worlds, we should start treating the patient earlier. We should start first to diagnose migraine earlier and then to treat migraine earlier and then to treat migraine earlier with the right drug for a proper period of time. I think we are now facing a revolution, and this is truly a point of no return. I used to saying to our Italian patients, after the discovery of conditioning, we do not want any longer ventilator because really these kind of drugs are so effective, so rapidly effective, and well tolerated. What is my view in the next three, probably five years? We should do everything to stop chronic migraine. So we launched a campaign in Italy with a brand which is also patented, which is “Stop Chronic Migraine: act early, treat well, and treat all the patients.” I think that by intervening very early, probably also in childhood, even though we note that fremanezumab is marketed for episodic migraine only in the US, we can block the progression of migraine by acting much earlier in the migraine population. So the future is a bright future. These kind of drugs allow us to make a prolonged treatment, and we know from other paroxysmal neurological disorders, for example epilepsy, that the longer the treatment, the better the results. Because after all, migraine progression is a slowly progressive phenomenon, and so the reversal of this condition requires subtle changes of neuroplasticity, neurotransmission, and so on. And so we have to treat properly the patient. There is one problem left: the change of the mindset of the physician who treats headache and migraine, trusting that migraine is actually a preventable disorder which can be treated with appropriate preventive treatment now. And I think that in the near future, the situation will dramatically improve, at least in those using the new drugs.
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