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3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache

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Published on: June 2, 2014

Future drugs for migraine.

Ivano Farinelli¹, Sergio De Filippis, Gabriella Coloprisco

¹Department of Medical and Molecular Sciences, Regional Referral Headache Centre, II School of Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Via di Grottarossa 1039, 00189 Rome, Italy.

Internal and Emergency Medicine

|June 25, 2009

Summary

New oral calcitonin gene-related peptide (CGRP) antagonists, like telcagepant, represent a significant advancement in acute migraine treatment. These drugs offer an effective alternative for migraineurs, particularly those with cardiovascular risks.

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Area of Science:

Neuroscience
Pharmacology
Genetics

Background:

Migraine is a complex neurovascular disorder influenced by genetic and environmental factors.
Current acute treatments include NSAIDs and triptans, but CGRP's role in migraine pathophysiology is increasingly recognized.
Triptans' vasoconstrictive properties limit their use in patients with cardiovascular risk factors.

Purpose of the Study:

To review the role of calcitonin gene-related peptide (CGRP) in migraine.
To discuss the development and efficacy of CGRP antagonists as a novel migraine therapy.
To explore future directions in acute and preventative migraine treatments.

Main Methods:

Review of existing literature on CGRP, migraine pathophysiology, and pharmacological treatments.
Analysis of clinical trial data for CGRP antagonists, including olcegepant and telcagepant.
Discussion of emerging therapeutic targets for both acute and preventative migraine management.

Main Results:

Calcitonin gene-related peptide (CGRP) is a key mediator in migraine, released from trigeminal nerves.
The first oral non-peptide CGRP antagonist, telcagepant, demonstrates high efficacy in acute migraine treatment.
CGRP antagonists offer a promising alternative to triptans, especially for patients with cardiovascular concerns.

Conclusions:

CGRP antagonism represents a major breakthrough in acute migraine therapy, validating CGRP's role in migraine.
Future treatments may include TPRV1 antagonists, EP(4) receptor antagonists, 5HT1(F) agonists, and nitric oxide synthase inhibitors.
Preventative migraine strategies are evolving with options like botulinum toxin type-A and novel receptor antagonists.