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CGRP - a target for acute therapy in migraine: Clinical data
Roberta Messina1, Peter J Goadsby1,2
11 Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Cephalalgia : an International Journal of Headache
|April 5, 2018
Summary
New migraine treatments targeting the calcitonin gene-related peptide (CGRP) pathway show promise. Gepants, a type of CGRP receptor antagonist, effectively treat acute migraine attacks and associated symptoms with good tolerability.
Area of Science:
- Neuroscience
- Pharmacology
- Neurology
Background:
- Migraine is a complex brain disease with evolving treatment strategies.
- Understanding migraine mechanisms has led to targeted therapies.
- The calcitonin gene-related peptide (CGRP) pathway is a key focus for migraine treatment.
Purpose of the Study:
- To evaluate the efficacy of CGRP receptor antagonists (gepants) for acute migraine treatment.
- To assess the impact of gepants on migraine-associated symptoms.
- To review the safety and tolerability profile of gepants.
Main Methods:
- Randomized, double-blind, placebo-controlled trials were analyzed.
- Efficacy was measured by pain freedom at two hours.
- Associated symptoms like nausea, photophobia, and phonophobia were assessed.
Main Results:
- Gepants demonstrated superiority over placebo in treating acute migraine attacks.
- Significant improvement was observed in migraine-associated symptoms.
- Hepatotoxicity concerns arose due to metabolites in some gepants.
- Gepants exhibited good tolerability and safety in patients with stable cardiovascular disease.
Conclusions:
- Targeting the CGRP pathway is a relevant and effective strategy for aborting acute migraine attacks.
- Mechanism-based treatments specific for migraine are gaining traction.
- Further research into gepant safety, particularly regarding hepatotoxicity, is warranted.
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