Appropriate Diagnosis and Management of Migraine Lacking in East Asian Countries

Appropriate diagnosis as well as better clinical management of migraine are unmet needs across East Asia, according to a recent review in The Journal of Headache and Pain.

Researchers searched 2 databases, EMBASE and MEDLINE, from January 1, 1988, to January 14, 2019, for publications pertaining to migraine disorders or chronic daily headache in China (including Taiwan and Hong Kong), South Korea, and Japan. A total of 1337 publications were retrieved for the review, but only 41 were included. These publications focused on the prevalence of migraines, clinical management, humanistic burden, and economic burden.

Prevalence of migraine ranged from 6.0% in Japan to 14.3% in mainland China in nonelderly adults. Across all studies in nonelderly adults, peak prevalence ranged from 11% to 20% for women and from 2.8% to 8.3% for men. In children, prevalence of migraine increased with increasing age.

There was limited information on the humanistic burden of migraine. However, when reported, the humanistic burden of migraine was substantial, suggesting a need for improved detection and treatment of migraine in East Asia. In the few studies on economic burden, there was a substantial economic impact of migraines in East Asia. With respect to clinical management, there was a low level of disease awareness and physician consultation; over-the-counter medication use was high while prescription medication use was low.

The limitations of the review include lack of recent information and significant gaps in the literature. The available evidence was limited, especially in children. However, the strengths of this comprehensive review include the detailed overview of current evidence on migraine burden and clinical management in East Asia.

The researchers conclude, “despite the high prevalence and significant level of migraine-associated disability reported in population-based studies in East Asia, there is little or no information on economic burden associated with migraine or migraine disability, work-related productivity losses, or costs associated with treatment or undertreatment. Combined with the high prevalence of migraine across all countries included in this review, the significant levels of humanistic burden among the available studies suggest that there are substantial unmet needs for migraine with regard to appropriate diagnosis, and better management of and therapies for treatment of migraine across East Asia. However, more recent evidence is required to confirm current unmet needs in each country.”

Disclosure: This study was sponsored by Eli Lilly and Company. Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

Reference

Takeshima T, Wan Q, Zhang Y, et al. Prevalence, burden, and clinical management of migraine in China, Japan, and South Korea: a comprehensive review of the literature. J Headache Pain. 2019;20(1):111.