Migraines can be debilitating, and some children and teenagers can have several days of migraines each week. Childhood and Adolescent Migraine Prevention (CHAMP) was used to study migraine treatment in children, and a study in JAMA Pediatrics looked at whether the benefits the children found during the study continued afterwards
The CHAMP study randomly divided children and adolescents into 3 groups: amitriptyline, topiramate or placebo and ran for 24 weeks. Upon completion of the study, the drug or placebo was discontinued and the participant received clinical care of their choice for the future. Investigators sent out surveys 3, 6, 12, 18, 24 and 36 months after the study ended. The surveys asked about headache days, disability and continued use of prescription preventive medication.
The sample consisted of 205 participants with an average migraine history of 5.7 years. The sample retention over the 36-month follow-up period was 189 participants (92%) in the 6th month, 182 participants (88%) in the 12th month, 163 participants (80%) in the 18th month, 165 participants (80%) in the 24th month and 155 participants (76%) in the 36th month [SD] Headache days per 28 days: CHAMP baseline, 11.1 [6.0] Days; CHAMP graduation, 5.0 [5.7] Days; 3-year follow-up, 6.1 [6.1] Days) and disability (mean [SD] Score: CHAMP baseline, 40.9 [26.4]; CHAMP graduation, 17.9 [22.1]; 3-year follow-up, 12.3 [20.0]). 3 years after the CHAMP study, the mean number of headache days per week was 1.5 compared to 3 per week at baseline. In addition, the disability score had moved from the medium range to the low to mild range. There were 153 participants who reported their use of prescription drugs after 3 years, and only 1 participant reported that he or she was taking preventive drugs for migraines. In addition, most of the participants stated that they had not taken any medication at most of the time points examined.
The researchers concluded that the children with a long history of migraines in the CHAMP study maintained the positive results seen in the study even after they stopped receiving the preventive drugs. However, more research is needed to understand the mechanisms behind improving treatment as well as maintaining preventive therapies.
1. Powers S, Coffey C, Chamberlin L, et al. Prevalence of headache days and disability 3 years after participating in the study on migraine prevention in children and adolescents. JAMA network open. 2021; 4 (7): e2114712. doi: 10.1001 / jamanetworkopen.2021.14712