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Introduction <p>Gepants, a calcitonin gene-related peptide (CGRP) receptor antagonist, is a class of migraine therapeutic options with extensive evidence supporting a favorable efficacy and safety profile. However, as a novel class of medication in Thailand, specific guidelines or recommendations regarding rational drug use are currently unavailable. This could hinder physicians from utilizing the medications for eligible patients and prevent pharmacists from providing information to physicians and patients. </p> Main body <p>In order to develop consensus-based statement recommendations, a modified Delphi approach was employed, which included two rounds of surveys, discussions, and voting. General recommendations were made, as well as specific recommendations of gepants in both acute and preventive treatment roles. Additionally, clinical settings where gepants could be suitable options were identified, along with the recommendations for their use in special populations and relevant precautions.</p> Conclusion <p>Gepants can serve as both acute and preventive therapy for migraines. They provide an alternative to first-line therapies for patients with limitations to conventional agents, including contraindications or intolerance. Gepants can be utilized as monotherapy or in combination with other treatment approaches. Optimal prescribing practices for eligible patients could ensure that patients receive maximum benefit with minimal risk.</p>

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Expert consensus on gepants for acute and preventive treatment of migraine in Thailand

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年6月2日

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  • Prakit Anukoolwittaya,
  • Wanakorn Rattanawong,
  • Kiratikorn Vongvaivanich,
  • Thanakit Pongpitakmetha,
  • Sekh Thanprasertsuk,
  • Thaninjitra Poonpedpun,
  • Pannathat Soontrapa,
  • Kanokrat Suwanlaong,
  • Kannikar Kongbunkiat,
  • Surasak Komonchan,
  • Petcharat Dusitanond,
  • Chutithep Teekaput,
  • Nopdanai Sirimaharaj,
  • Nadolporn Yuvasilp,
  • Surat Tanprawate

摘要

Introduction

Gepants, a calcitonin gene-related peptide (CGRP) receptor antagonist, is a class of migraine therapeutic options with extensive evidence supporting a favorable efficacy and safety profile. However, as a novel class of medication in Thailand, specific guidelines or recommendations regarding rational drug use are currently unavailable. This could hinder physicians from utilizing the medications for eligible patients and prevent pharmacists from providing information to physicians and patients.

Main body

In order to develop consensus-based statement recommendations, a modified Delphi approach was employed, which included two rounds of surveys, discussions, and voting. General recommendations were made, as well as specific recommendations of gepants in both acute and preventive treatment roles. Additionally, clinical settings where gepants could be suitable options were identified, along with the recommendations for their use in special populations and relevant precautions.

Conclusion

Gepants can serve as both acute and preventive therapy for migraines. They provide an alternative to first-line therapies for patients with limitations to conventional agents, including contraindications or intolerance. Gepants can be utilized as monotherapy or in combination with other treatment approaches. Optimal prescribing practices for eligible patients could ensure that patients receive maximum benefit with minimal risk.