Children and adolescents with longstanding migraine experience meaningful improvements in headache status for up to three years after treatment in the Childhood and Adolescent Migraine Prevention (CHAMP) trial.
The CHAMP trial which compared amitriptyline, topiramate and placebo in 8-17 year olds with migraine was stopped early due to futility. It found neither of the two preventive medications was more effective than placebo in reducing the number of headache days over 24 weeks.
However the follow-up study, published in JAMA Network Open and comprising online surveys in 205 original participants, found evidence of an enduring treatment effect.
At the end of the 3-year follow-up, participants experienced a mean of 6.1 headache days per month, compared with 11.1 at baseline and 5.0 at the end of the CHAMP trial.
The mean overall Paediatric Migraine Disability Assessment Scale (PedMIDAS) score was 12.3, compared with 40.9 at baseline and 17.9 at the end of the original trial.
Use of prescription preventive medication during the follow-up period was reported by less than 10% of participants.
Again, there was no significant difference between the original treatment groups.
The investigators said the meaningful clinical improvement did not appear to be associated with the pharmacological action of preventive medications.