By Pat Anson, PNN Editor
A neuromodulation device worn on the arm and controlled by a smartphone has been cleared by the Food and Drug Administration for the treatment of acute migraine. The Nerivo Migra device was developed by Theranica, an Israeli medical technology company, and is expected to be available in the U.S. later this year.
The FDA’s market authorization is based on the results of a double-blind, placebo-controlled study of Nerivo Migra involving 252 migraine patients at 12 headache clinics in the U.S. and Israel. The study findings were recently published in Headache: The Journal of Head and Face Pain.
Over two-thirds of patients who wore the device for 30-45 minutes during a migraine attack experienced pain relief two hours after treatment, compared to only about a third of those who wore a sham device. For many, the pain relief was sustained 48 hours after treatment.
"The results of the study demonstrate a high efficacy ratio for single as well as multiple attacks, both at two and 48 hours after treatment," said lead investigator Dr. Brian Grosberg, MD, director of the Hartford Healthcare Headache Center in Connecticut.
Placed on the upper arm, Nerivio Migra uses smartphone-controlled electrical pulses to disrupt pain signals. At this time, the device is only indicated for acute treatment of migraine with or without aura in adult patients who do not have chronic migraine. But company officials say it shows potential as a treatment for other pain conditions.
"We have identified at least 7 different painful conditions that may be relieved by this non-invasive, drug-free technology after appropriate clinical development," said Alon Ironi, CEO and co-founder of Theranica. "While the company is preparing to launch the Nerivio Migra in the United States market later this year at an affordable price, we remain committed to continuing our clinical development, expanding the use of remote electrical neuromodulation therapy for additional indications.”
Theranica has not disclosed what its “affordable price” will be. Over the next four months, the company said it would begin a series of clinical studies of Nerivo Migra at 30 headache clinics in the U.S. to assess patient selection and correct product use.
A handheld neuromodulation device – called gammaCore – is currently available for about $600 to treat migraine and cluster headache. Another device used to treat migraine – called Cefaly – is worn on the head and costs about $350. A new class of injectable migraine drugs is even more expensive, costing about $7,000 a year or $580 for each monthly dose.
"Over the last 20 years my colleagues and I have used triptans and ergots for acute migraine treatment. There is a large unmet need for new treatments in this population when these medications are not effective, are contra-indicated, or have non-tolerable side effects,” said Stephen Silberstein, MD, a member of Theranica’s medical advisory board.
“In addition, triptans and most current acute migraine medications, including over-the-counter drugs indicated for migraine, are associated with medication-overuse headache, which is associated with increased frequency of migraine attacks, and often results in chronic migraine.”
Migraine affects a billion people worldwide and about 36 million adults in the United States, according to the American Migraine Foundation. In addition to headache pain and nausea, migraine can cause vomiting, blurriness or visual disturbances, as well as sensitivity to light and sound. Women are three times more likely to suffer from migraine than men.