Quickest Way to 50% Less Headache Days: An Operational Research Model and Its Implementation for Chronic Migraine

Pengfei Zhang, MD

AHSAM 2020 - Poster session
Published on September 17, 2020

3 minute listen

1 minute read

Key messages

  • These authors developed a mathematically optimum model to help prescribers choose migraine prevention medications
  • One optimal sequence of chronic migraine prevention medication is sequential trial of erenumab for 12 weeks, Botox for 32 weeks, and topiramate for 32 weeks.
  • An alternative, but less realistic, optimum solution is sequential trial of erenumab for 12 weeks, Botox for 12 weeks, topiramate for 12 weeks, switch back to a trial of Botox for 20 further weeks, and switch back to a trial of topiramate for 20 further weeks.
  • Operations research provides mathematical tools for intuition.
  • The solution to the model is to order the drugs by probability of efficacy per unit time.
  • More data needed to validate the result of this study.
  • Podcast by Pengfei Zhang, MD

Key messages

  • These authors developed a mathematically optimum model to help prescribers choose migraine prevention medications
  • One optimal sequence of chronic migraine prevention medication is sequential trial of erenumab for 12 weeks, Botox for 32 weeks, and topiramate for 32 weeks.
  • An alternative, but less realistic, optimum solution is sequential trial of erenumab for 12 weeks, Botox for 12 weeks, topiramate for 12 weeks, switch back to a trial of Botox for 20 further weeks, and switch back to a trial of topiramate for 20 further weeks.
  • Operations research provides mathematical tools for intuition.
  • The solution to the model is to order the drugs by probability of efficacy per unit time.
  • More data needed to validate the result of this study.

Podcast by Pengfei Zhang, MD

Pengfei Zhang, MD
Assistant Professor of Neurology
Rutgers Robert Wood Johnson Medical School
New Brunswick, New Jersey

Pengfei (Phil) Zhang M.D is an Assistant Professor of Neurology at Robert Wood Johnson Medical School. He completed his Headache fellowship at NYU Langone in 2017 and his residency at Mount Sinai Hospital in 2016. He graduated from Georgetown University School of Medicine in 2012. Prior to entering medicine he completed a Bachelor of Science degree in Mathematics at Haverford College.

Pengfei Zhang, M.D.: Alder Biopharmaceuticals (Membership on Advisory Committees or Review Panels) (Consulting Fees (e.g., advisory boards))



Headache
Epidemiology, Pharmacoeconomics, and Outcomes Research of Headache


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