Acupuncture for Migraine : French Guidelines on Non-Pharmacologicals Treatments
Gabrielle LISEMBARD, Pierre CALVEZ and Fanny SERMAN
The French Headache Society (Société Française d’Etudes des Migraines et Céphalées: SFEMC) published in 2021 the Revised Guidelines for the Diagnosis and Management of Migraine in Adults on Diagnosis and Assessment, then Pharmacological Treatment and wished to take into account and evaluate some Non-Pharmacological Treatments including Non-PharmacologicalInterventions (NPI), MedicalDevices and Surgery. Acupuncture method is one of non-pharmacological treatment.The development process consisted in five stages: 1) literature review within each writing sub-groups (writing group members and invited experts); 2) draft update within each sub-groups; 3) review of the whole draft by the writing group; 4) review by the reading group; 5) final editing by the writing group in the light of all comments.The questions asked regarding NPI were: – Is physical exercise effective for migraine prophylaxis? – What is the evidence concerning,dietary supplements and plants? – What is the evidence concerning diets? – What neuromodulation therapies are effective in migraine? – What is the efficacy of acupuncture for migraine prophylaxis? -What is the efficacy of behavioral interventions and mindfulnesstherapy for migraine prophylaxis?Acupuncture for migraine management is recommended in several Clinical Practice Guidelines (CPG) : • Duodecim EBM Guidelines (Finland) 2022 • Istituto Superiore di Sanità (ISS, Italy) 2022 • Taiwan Headache Society (THS, Taiwan) 2022 • Committee for Clinical Practice Guideline for the Management of Chronic Pain (Japan) 2021 • Japanese Society of Neurology, Japanese Headache Society, Japanese Society of Neurological Therapeutics (Japan) 2021 • Australian and New Zealand College of Anaesthetists (ANZA) 2020 • Ministry of Public Health of Qatar (MOPH, Qatar) 2020Acupuncture for migraine management is recommended in several Clinical Practice Guidelines (CPG) : Since 2021, publication of a French CPG : Strength of Recommendation= Strong : "In patients with episodic migraine asking for non-pharmacological treatments or achieving insufficient efficacy with pharmacological treatments, propose acupuncture as an alternative or a supplement to pharmacological prophylaxis." But who knows this recommendation ? GP, neurologists ?Acupuncture can be integrated into a multidisciplinary approach • Strong recommendation for migraine prevention • Interest for comorbidities management • Reduce drugs use • Safety • Respect of patient (and practitioner) values
