Migraine care can feel confusing, with different experts using different rules. A group of 14 headache specialists from seven Asia-Pacific countries worked to find common ground. They used a structured survey process, called a Delphi method, to agree on key points.
The experts reached consensus on most statements about diagnosing and managing migraine. Nearly all use the standard ICHD-3 criteria, and most find them easy to apply. They routinely check for disability, depression, anxiety, and sleep issues. Neck pain and dizziness are recognized as common associated symptoms.
For treatment, 86% of the specialists see anti-CGRP monoclonal antibodies as effective and filling an unmet need. Efficacy, safety, and tolerability are the top factors in choosing them. Most would consider them as a first-line option and believe they can improve adherence. In contrast, only 7% favor using gepants. The group unanimously supports anti-CGRP drugs for adolescents but not for children aged 6 to 12 due to insufficient evidence.
This consensus is based on expert opinion, not a clinical trial, so it reflects current practice patterns rather than proven outcomes.