CGRP Monoclonal Antibodies for the Preventative Treatment of Migraine
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Purpose of Review
CGRP is a key neuropeptide in migraine pathophysiology. The blockade of the CGRP pathway at the side of the CGRP receptor of the CGRP peptide leads to the interruption of trigeminal nerve system-mediated headache syndromes such as migraine. Monoclonal antibodies (mAbs) targeting the CGRP pathway have been developed and are currently under investigation for episodic (EM) and chronic migraine (CM) prevention. Here, we report data from these clinical trials.
Placebo-controlled, randomized double-blind phase studies of CGRP mAbs in episodic and chronic migraine have shown that the specific blockade of the peptide or the CGRP receptor are both powerful mechanisms to reduce migraine frequency. Along with the reduction of acute migraine-specific medication intake, early onset of efficacy of mAbs has been demonstrated. Most common adverse events are injection sider reactions. Depending on the mAb, the administration mode is a monthly or even less frequently s.c. or I.V. formulation.
Phase II studies in EM and CM demonstrate that CGRP mAbs are effective anti-migraine preventatives with a beneficial adverse event profile. Further detailed results from larger phase III clinical trials are expected soon.
KeywordsChronic migraine Episodic migraine CGRP antibody Migraine prevention Antibody safety
Compliance with Ethical Standards
Conflict of Interest
UR is a consultant or scientific advisor for Allergan, Amgen, Autonomic Technologies, Eli Lilly, Electrocore, Novartis, and Teva and has received honorarium from these companies for scientific presentations. H Israel and L Neeb have received honoraria from Pharm Allergan, Eli Lilly (LN), Electrocore Novartis (LN), and Autonomic Technologies. UR, LN, and HI are involved as investigators in clinical trials with mAbs from Amgen, Eli Lilly, Novartis, and Teva without personal remuneration.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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