Abstract
The way forward towards better therapy
Dear Colleagues,
How quickly time flies! Soon I will finish my 2 years as President for the International Headache Society (IHS). It has been a privilege and honor to serve as your President and the Society for the 2017–2019 period. I have been around the globe for countless meetings and conferences to share my knowledge and to inspire colleagues and young scientists in the headache and pain fields, as well as to provide teaching of basic and clinical sciences.
What has happened during this period in general? When I joined the IHS Board as President-elect, the IHS leadership held a strategic meeting and the result has served as a guide for the work of the President and the President-elect. I especially want to congratulate Professor David Dodick for his work and visions, and the Board for their wise decisions. Much of the strategic plan has now been implemented to the benefit of our Society. This work has resulted in a balanced budget, more support for research fellowships, more educational and research grants, increased association with other organizations, inter alia.
Some further highlights to point out: We published the 3rd headache classification, ICHD-3, in January 2018, developed several guidelines for clinical trials (chaired by Professor Cristina Tassorelli), and held a Global Patient Advocacy Summit in conjunction with the International Headache Society Congress (IHC) 2017 in Vancouver, which resulted in the “Vancouver Declaration 2018”. These initiatives have increased awareness and also promoted partnership with the World Federation of Neurology (WFN) and the World Health Organization (WHO). IHS is proud to be working with WFN as co-organizer of the World Brain Day, which will occur on 22 July 2019 on the topic “Migraine – the painful truth” and will hold joint sessions with WFN and WHO during the IHC 2019 in Dublin in September, and the World Congress of Neurology in Dubai in October. Lifting the Burden will have a session during IHC 2019 describing their hard, and over the years successful work.
Personally, it has been most rewarding to see the fruition of the calcitonin gene-related peptide (CGRP) story advancing to practice during my presidency. Although the work on CGRP started early in 1983, the acceptance for use of monoclonal antibodies in prophylaxis of severe migraine by the Food and Drug Administration (FDA) and European Medicines Agency (EMA) only occurred last year. The monoclonal antibodies are now in therapy in many countries around the world and patients and clinicians are reporting excellent results. It is gratifying to have witnessed such a successful journey from bench to bedside, something we all strive for in research but few get to experience. Now in the pipeline we also have the gepants, small molecules with CGRP receptor blocking activity. I was around for the “near launch” of telcagepant in 2009 but the process was halted. Now Phase III data are at hand for the next generation of these molecules that, predictably within a year or so, will fill another gap in our therapy modes for helping the patients.
At this juncture, I think it is useful to stop and again reflect on the purpose and goals of our Society. I suggest that education and teaching of the vast amount of knowledge gathered over the last decades must be presented to the different patient groups worldwide. This will be a challenge to us all. However, numerous patients have reported that the new therapy has changed their lives for the better in a remarkable way. I am humbly touched and grateful for such reports as a scientist and a physician. However, although migraine is relatively common, it remains an underdiagnosed and undertreated disease. We need to find ways to raise awareness for patients and clinicians that new treatments are available. Perhaps we need to adjust how we educate different population groups, depending on socio-economics and development. Here, e-learning may provide opportunities to reach the many. We need to continue to pursue promising initiatives such as the IHS Global Patient Advocacy Coalition (IHS-GPAC) and the growth of the European Migraine and Headache Alliance (EMHA) to reach out globally.
Recently, I have been honored to open conferences and celebrate anniversaries of many regional headache societies (like the German Headache Society at its 40th anniversary this year, the Swedish Headache Society 50th year jubilee last year, and more). The work performed in the individual countries over numerous decades has inspired and impressed me. These regional groups represent the foundation of our Society. Inspiring colleagues have made contributions large and small, but all add to the collective advancement of knowledge in headache disorders. There has been a build-up of clinical headache centers to the benefit of the patients. It is of utmost importance that we continue our teaching and education of colleagues all over the world, at meetings large and small, in all classes of professionals involved in taking care of the patients.
I look forward to continuing to assist the Society in many ways in the years to come, disseminating results from our research, providing new scientific data and possibly new targets that can further help the patients. It is an exciting time as the amount of information coming from research is enormous and it is our task to understand and interpret its relevance and potential for therapy. How can this new knowledge be translated to practice? This and other questions will remain for a long time.
Professor Messoud Ashina will assume the post of President after the IHC 2019 congress in Dublin in early September and I have no doubt that he will add his touch to the future path of the Society. He is dynamic and has a strong position and dedication for clinical research. The foundation is solid, and the future of the Society will be in good hands.
With my warmest wishes to you all.