Acute treatment of migraine: quo vadis?

Migraine represents the third cause of disability in the worldwide population aged under 50 years. Facing this enormous social impact, only onabotulinumtoxinA has been evaluated, on serendipity basis, as effective chronic migraine preventative treatment [1]. Pharmacological research is now moving important steps forward towards bridging the 30-year gap of new preventative class drugs for migraine, with a new molecule in its final phase of development: monoclonal antibodies for calcitonin gene-related peptide (CGRP) or its receptors (CGRPr) [2,3]. In the development pipeline of new drugs for the acute treatment, there is only one innovative compound, lasmiditan [4], while there are numerous devices and nutraceuticals in both categories [5]. This is surely not the scenario that one billion of migraine patients is hoping for from scientific research, and a new call for action is required in order to promote the study on new innovative drugs for the acute treatment of migraine. This would reduce the personal, working, and pharmaco-economic impact and the public health expenditure caused by this pathology, that could be appropriately defined as a social disease from now on.