Synopsis of AHS criteria for initiation and trial period for acute and preventive therapy
AHS guidance for acute therapy1
Acute treatments are taken at the first sign of a migraine attack to reduce pain and attack-related disability.
Acute therapy considerations1
Acute therapy considerations1



AHS guidance for preventive therapy1
Preventive treatments should be considered for episodic migraine patients with ≥4 monthly headache days, or when attacks significantly interfere with patients' daily lives despite acute treatment.
Oral preventive therapy considerations1
Oral preventive therapy considerations1



Anti-CGRP therapies are classified by the AHS as emerging preventive options. These treatments may be appropriate for patients who fail on 2 or more prior preventive therapies.1
For these patients, the AHS indicates initiation of anti-CGRP therapy if they continue to experience either1:
- 4-7 monthly headache days with moderate disability
- 8-14 monthly headache days
Anti-CGRP therapy considerations1
Anti-CGRP therapy considerations1


AHS = American Headache Society; CGRP = calcitonin gene-related peptide; mAbs = monoclonal antibodies; NSAIDs = nonsteroidal anti-inflammatory drugs.
AHS = American Headache Society; CGRP = calcitonin gene-related peptide; mAbs = monoclonal antibodies; NSAIDs = nonsteroidal anti-inflammatory drugs.
AHS criteria for initiation and follow-up for anti-CGRP therapy in adult episodic migraine patients
Assess frequency and impact of migraine1
4-7 headache days per month with at least moderate disability (MIDAS >11; HIT-6 >50)
8-14 headache days per month
(no disability requirement)
MIDAS and HIT-6 questionnaires evaluate migraine burden
Determine medication history1
Inadequate response or intolerability over a 6-week trial on ≥2 prior oral preventive therapies
Oral preventive therapies
If patient meets criteria listed above, consider initiating anti-CGRP therapy1
The patient questionnaire available for download below can help you assess migraine impact and determine whether an anti-CGRP may be an appropriate treatment choice.2
Patient Migraine Impact QuestionnaireAssess anti-CGRP effectiveness after 3 months1
According to the AHS Consensus Statement, "It is recommended that the benefits of anti-CGRP mAbs be assessed after 3 months of treatment for those administered monthly."
AAN = American Academy of Neurology; AHS = American Headache Society; CGRP = calcitonin gene-related peptide; HIT-6 = Headache Impact Test; mAbs = monoclonal antibodies; MIDAS = Migraine Disability Assessment.