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EAN 2025 | EHF criteria for resistant and refractory migraine: do they reflect response to acute treatment?

Simona Sacco, MD, University of L’Aquila, L’Aquila, Italy, comments on the European Headache Federation (EHF) criteria and their reflection of response to acute treatments in resistant and refractory migraine, which was explored in the REFINE study. She highlights the importance of identifying homogeneous groups of patients with distinct characteristics in order to develop targeted treatments. This interview took place at the 11th Congress of the European Academy of Neurology (EAN 2025) in Helsinki, Finland.

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Transcript

This is a very interesting question and we presented a contribution to EAN. It’s an e-poster just to address the different characteristics of patients with the resistant and refractory and non-resistant and non-refractory. And we did a cluster analysis to try to identify homogeneous groups of patients. And we have clearly identified the cluster of patients that mostly includes patients with resistance and refractoriness, but includes also an interesting proportion of patients with non-resistant non-refractory that have the worst profile in terms of comorbidities and in terms of response to treatments...

This is a very interesting question and we presented a contribution to EAN. It’s an e-poster just to address the different characteristics of patients with the resistant and refractory and non-resistant and non-refractory. And we did a cluster analysis to try to identify homogeneous groups of patients. And we have clearly identified the cluster of patients that mostly includes patients with resistance and refractoriness, but includes also an interesting proportion of patients with non-resistant non-refractory that have the worst profile in terms of comorbidities and in terms of response to treatments. On the other hand, we have identified one other homogeneous cluster of patients that is mostly composed of non-resistant non-refractory patients, but there’s also a very interesting proportion of resistant patients that is characterized by a reduced burden of comorbidities, other ongoing treatments, and a past medical history that is less complicated, and they do really well with treatments. So it’s very important to identify those clusters of homogeneous groups of patients in order to develop targeted treatments for patients that have something strong in common.

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