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Investigating Migraine-Like Behavior Using Light Aversion in Mice
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Therapies targeting CGRP signaling for medication overuse headache
Ioannis-Alexios Koumprentziotis1, Dimos D Mitsikostas
11 Neurology Department, Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Current Opinion in Neurology
|June 8, 2022
Summary
Monoclonal antibodies targeting the calcitonin gene-related peptide (CGRP) pathway show promise for treating medication overuse headache (MOH). Further research is needed to confirm long-term effectiveness in exclusive MOH populations.
Area of Science:
- Neurology
- Pharmacology
Background:
- Medication overuse headache (MOH) impacts over 60 million globally, with limited treatment options.
- Current treatments for MOH primarily use repurposed drugs with insufficient evidence of efficacy.
Purpose of the Study:
- To review the effectiveness and safety of monoclonal antibodies targeting CGRP (anti-CGRP mAbs) for MOH.
- To evaluate the role of the CGRP pathway in headache chronification and its therapeutic implications for MOH.
Main Methods:
- Analysis of post hoc data from phase-3 trials of anti-CGRP mAbs in chronic migraine patients with MOH.
- Review of real-world studies assessing the efficacy of specific anti-CGRP mAbs (erenumab, galcanezumab) in MOH populations.
Main Results:
- Post hoc analyses suggest anti-CGRP mAbs benefit patients with MOH compared to placebo.
- Real-world evidence supports the efficacy of erenumab and galcanezumab in MOH.
- Existing trials often group MOH with chronic migraine, not evaluating MOH exclusively.
Conclusions:
- Anti-CGRP mAbs offer a targeted, mechanism-based therapeutic strategy for MOH when combined with detoxification and non-pharmacological interventions.
- Future research should prioritize long-term, controlled trials focused solely on MOH patient populations.
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