00:00What do you think about the approach to hemicrania?
00:04As far as the approach to hemicrania is concerned, there are many novelties.
00:09These novelties have been included in a series of guidelines.
00:14There are European guidelines.
00:16International guidelines are now being published,
00:20which are actually Italian and international.
00:23We will have a list of drugs with comments from experts
00:27that go alongside the other guidelines.
00:30The main intention is to unify as much as possible
00:35the approach to subjects with hemicrania around the world.
00:39Not only in Italy, not only in different countries.
00:42We have many drugs and our idea would be
00:45to make these drugs available to all people who suffer from this disease.
00:50Because it is disabling, because these drugs are effective,
00:54because especially the new ones are very well tolerated,
00:57so they don't need monitoring, they don't create toxicity.
01:01This was the first step.
01:03The second step is to decline the effectiveness of drugs
01:08into practical recommendations.
01:10We have done this on two levels.
01:12The level at which the doctor has all the drugs available for treatment
01:19and the level, let's say, in poorer countries,
01:22where only a few of these drugs are available.
01:25In any case, there is the possibility of making patients feel better.
01:28So we gave the recommendations for both levels.
01:31Then we did something else.
01:33We asked the World Health Organization
01:36to increase the number of drugs included in the list of essential drugs,
01:42those that should be available all over the world,
01:45to increase this list by adding more drugs,
01:48including some of these new drugs.
01:51Because really, in that list there were very few drugs for migraines.
01:55We did something else recently.
01:57That was also an Italian idea.
01:59We proposed to change what we want to obtain for our patients with migraines.
02:04While until yesterday we said,
02:06effective drugs, what reduces the 50% of migraine days per month,
02:11which is a good value,
02:13but if we think that a patient with chronic migraine has 30 days per month,
02:17if we remove 15 days, there are 15 days left.
02:20So we asked ourselves, is this enough? No.
02:22So we made some other goals that we want to target.
02:27It is not said that we will reach them.
02:30Certainly we will not reach them for all people.
02:33But the first goal, the optimum, is migraine freedom.
02:38Freedom from migraines for a month, two months, three months, as long as possible.
02:42So no migraines.
02:43As soon as we reach the bottom, the optimum.
02:46Control of the disease.
02:48So the optimal control of the disease,
02:50which means no more than four days per month of migraines
02:53or severe moderate-intensity cephalitis.
02:55And in these four days that there are,
02:58have a good symptomatic drug that controls the attacks that escape.
03:02So it's a bit of a change of perspective.
03:05In our opinion, with the drugs we have available,
03:07with the ongoing research,
03:09there will be other drugs available,
03:12for those who treat patients with migraines,
03:14but especially for patients.
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