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CGRP-Targeted Therapy for Episodic and Chronic Cluster Headache.
Shu-Ting Chen1, Jr-Wei Wu2,3
1Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan.
Current Pain and Headache Reports
|July 26, 2022
Summary
New treatments targeting calcitonin gene-related peptide (CGRP) show limited success for chronic cluster headache (CH). While some antibodies were effective for episodic CH, none demonstrated efficacy for chronic CH prevention in controlled studies.
Area of Science:
- Neurology
- Pharmacology
- Headache Medicine
Background:
- Chronic cluster headache (CH) significantly impairs patient quality of life.
- Existing treatments for CH present challenges, necessitating novel therapeutic approaches.
Purpose of the Study:
- To review controlled studies on calcitonin gene-related peptide (CGRP)-targeted therapies for CH.
- To identify gaps and future directions in managing chronic CH.
Main Methods:
- Systematic review of randomized controlled trials (RCTs) investigating anti-CGRP monoclonal antibodies and CGRP antagonists.
- Analysis of efficacy data for episodic and chronic CH prevention.
Main Results:
- Galcanezumab and fremanezumab, anti-CGRP monoclonal antibodies, were evaluated in RCTs.
- Galcanezumab showed efficacy in episodic CH but not chronic CH prevention.
- Fremanezumab was ineffective for both episodic and chronic CH prevention.
- No CGRP-targeted therapies have demonstrated efficacy in RCTs for chronic CH prevention.
Conclusions:
- Current CGRP-targeted therapies have not yet proven effective for preventing chronic cluster headache.
- Discrepancies in efficacy between episodic and chronic CH may stem from study design differences or the distinct roles of CGRP in CH subtypes.
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