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Anti-CGRP in cluster headache therapy.

Luca Giani1, Alberto Proietti Cecchini1, Massimo Leone2

  • 1Neuroalgology Department, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Via Celoria 11, 20133, Milan, Italy.

Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
|March 2, 2019
PubMed
Summary

New treatments targeting calcitonin gene-related peptide (CGRP) show promise for cluster headache prevention. Monoclonal antibodies against CGRP offer hope for managing this debilitating neurological condition.

Keywords:
CGRPCalcitonin gene–related peptideCluster headacheHeadacheMonoclonal antibodies

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Area of Science:

  • Neurology
  • Neuroscience

Background:

  • Cluster headache is a severe primary headache disorder with significant patient suffering.
  • Current preventive treatments are insufficient, necessitating novel therapeutic strategies.

Purpose of the Study:

  • To explore the role of calcitonin gene-related peptide (CGRP) in cluster headache pathophysiology.
  • To evaluate the potential of CGRP-targeting therapies for cluster headache prevention.

Main Methods:

  • Review of the pathophysiology of cluster headache, focusing on the trigeminovascular system and central nervous system mechanisms.
  • Analysis of the involvement of CGRP in spontaneous and provoked cluster headache attacks.
  • Examination of clinical trial data for CGRP monoclonal antibodies (galcanezumab, fremanezumab) in episodic cluster headache.

Main Results:

  • CGRP plays a significant role in the peripheral and central nervous system mechanisms of cluster headache.
  • CGRP levels are elevated during cluster headache attacks and can induce attacks.
  • Monoclonal antibodies targeting CGRP have demonstrated promising efficacy in episodic cluster headache.

Conclusions:

  • CGRP is a key player in cluster headache pathogenesis.
  • Targeting the CGRP pathway, particularly within the central nervous system, represents a promising therapeutic avenue for cluster headache.
  • Further development of CGRP-pathway inhibitors could expand treatment options for this disabling condition.