HeadWise HeadWise: Volume 7, Issue 1 | Page 23

producing a well-fitted pair of pants . One would first have to measure and decipher the relevant biochemistry underlying the disease variation of that individual and then ( if a well-fitted treatment is by coincidence not available ) discover , develop , and monitor a custom drug in years of clinical trials ( oh , and then be able to charge a few hundred million dollars per individual to recoup at least some of the clinical development costs ).
Since we have not and are not able to develop individualized medicines , how bad is it really if we develop them instead for Mr . or Ms . Average - as in fact medical companies currently do ? How many people are
average ? And for those who are not average , will those medicines work ?
Fortunately , data on this exact question already exist and the results are astounding - not in a good way . Let ’ s look at the population performance of the top drugs in migraine , a classic example of a chronic disease with unpredictable but often devastating episodic attacks . What percentage of the population is effectively treated if you give them the drug in question ?
What is astounding is that the best of the acute treatments is ibuprofen , but effective in only 1 in 3 patients . The best preventive treatment in chronic
Examples of top drugs marketed or in development in migraine and the portion of the population in which they are effective
Footnotes ( a ) 50 % responder rate ; Vo P . et al . Cephalalgia 2017 , Vol .
37 ( 1S ) 319 – 374 ( b ) Diener HC et al . Cephalalgia . 2007 Jul ; 27 ( 7 ): 814-23 ( c ) Dodick DW et al . Headache . 2010 Jun ; 50 ( 6 ): 921-36 ( d ) Tepper S . et al . Lancet Neurol . 2017 Jun ; 16 ( 6 ): 425-434 ( e ) Diener HC et al . J Neurol . 2004 Aug ; 251 ( 8 ): 943-50 . ( f ) Bussone G . et al . Int J Clin Pract . 2005 Aug ; 59 ( 8 ): 961-8 .
( g ) Goadsby PJ , et al . N Engl J Med . 2017 Nov
30 ; 377 ( 22 ): 2123-2132 ( h ) Headache relief at 2 hrs ( i ) Derry CJ et al . Cochrane Database Syst Rev . 2012 Feb
15 ; 2 : CD008615 . ( j ) Rabbie R et al . Cochrane Database Syst Rev . 2010 Oct
6 ;( 10 ): CD008039 .
( k ) Kirthi V et al . Cochrane Database Syst Rev . 2013 Apr 30 ; 4 : CD008041 .
www . headaches . org | National Headache Foundation 23