Calcitonin Gene-Related Peptide Antagonists in the Treatment of Episodic Migraine

Clin Pharmacol Ther. 2019 May;105(5):1121-1129. doi: 10.1002/cpt.1356. Epub 2019 Mar 18.

Abstract

Migraine is a prevalent, disabling neurological disorder involving the trigeminovascular system. Previous treatments were either originally intended for other conditions and/or associated with intolerable adverse effects (AEs). Calcitonin gene-related peptide (CGRP) is the most prevalent neuropeptide in the trigeminal afferent neurons and plays a significant role in pain sensitization central to migraine. The CGRP antagonists (gepants and monoclonal antibodies) are the first treatments created specifically for migraine, modulating pain signaling pathways and alleviating migraine attacks and recurrences. With their efficacy in several clinical trials and relatively fewer AEs, the CGRP antagonists show great promise for use in episodic migraine.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal / therapeutic use
  • Calcitonin Gene-Related Peptide / antagonists & inhibitors*
  • Calcitonin Gene-Related Peptide / metabolism
  • Calcitonin Gene-Related Peptide Receptor Antagonists / therapeutic use*
  • Dipeptides / therapeutic use
  • Humans
  • Migraine Disorders / drug therapy*
  • Migraine Disorders / physiopathology
  • Piperazines
  • Quinazolines / therapeutic use

Substances

  • Antibodies, Monoclonal
  • Calcitonin Gene-Related Peptide Receptor Antagonists
  • Dipeptides
  • Piperazines
  • Quinazolines
  • Calcitonin Gene-Related Peptide
  • olcegepant