Emerging therapies

Calcitonin Gene Related Peptide Targeted Therapy for Migraine

 There is an emerging class of medications for migraine treatment, targeting the calcitonin gene related peptide (CGRP). These drugs are likely to become available in the next 2-3 years. They appear to be effective and specific medications, blocking the pain pathway most likely to result in migraines. They are referred to as CGRP blocking medications.

CGRP is a substance present in many organs throughout the body, including the brain. When it is released around nerves of the head, CGRP causes blood vessels to expand and also brings about inflammation. Both of these factors probably cause the pain of migraine.

CGRP medications can be divided into 2 distinct groups, the larger sized group, called monoclonal antibodies (Mabs), that cannot cross the barrier into the brain, and the small sized compounds that are able to cross through the blood into the brain and other organs. One of the small molecules, sometimes called ‘gepants,’ was unfortunately found to cause liver problems in some patients, and this has limited the further development of these agents.

The Mab medications though are promising as they have been shown to decrease the frequency of migraine in many patients by around 50%, though in some fortunate, around 1 in 6, patients, the migraines seemed to go away, at least for 3 months. Thus far, these drugs have shown no major side effects when given to patients, although potential problems of blocking CGRP on a long term basis, if any, are not yet known, and further observation will be required.

Reference:

Calcitonin Gene-Related Peptide Targeted Therapy for Migraine, Tepper, Headache. The Journal of Head and Face Pain 2016.

Note: Information on this site is not a substitute for professional medical advice.