The FDA has allowed marketing of the Cerena Transcranial Magnetic Stimulator (TMS; eNeura Therapeutics), the first device to relieve pain caused by migraine headaches that are preceded by aura in people aged 18 years and older.
“Millions of people suffer from migraines, and this new device represents a new treatment option for some patients,” said Christy Foreman, director of the Office of Device Evaluation in the FDA’s Center for Devices and Radiological Health.
The Cerena TMS is a prescription device used after the onset of migraine pain. Using both hands to hold the device against the back of the head, the user presses a button to release a pulse of magnetic energy to stimulate the occipital cortex in the brain, which may stop or lessen the pain associated with migraine headaches preceded by aura.
The FDA reviewed the data for the Cerena TMS through the de novo premarket review pathway, a regulatory pathway for some low- to moderate-risk medical devices that are not substantially equivalent to an already legally marketed device.
The FDA reviewed a randomized controlled clinical trial of 201 patients who had mostly moderate to strong migraine headaches and who had auras preceding at least 30% of their migraines. Of the study participants, 113 recorded treating a migraine at least once when pain was present. The study showed that nearly 38% of participants who used the Cerena TMS when they had migraine pain were pain-free two hours after using the device compared with about 17% of patients in the control group. After 24 hours, nearly 34% of the Cerena TMS users were pain-free compared with 10% of the control group.
The study did not show that the Cerena TMS is effective in relieving the associated symptoms of migraine, such as sensitivity to light and sound and nausea. It also did not evaluate the device’s performance when treating other types of headaches.
Adverse events reported during the study were rare for both the device and the control groups, but included reports of sinusitis, aphasia and vertigo. Dizziness may be associated with the use of the device.
Patients must not use the Cerena TMS device if they have metals in the head, neck or upper body that are attracted by a magnet, or if they have an active implanted medical device such as a pacemaker or deep brain stimulator. The Cerena TMS device should not be used in patients with suspected or diagnosed epilepsy or a personal or family history of seizures. The recommended daily usage of the device is not to exceed one treatment in 24 hours.