Calcitonin Gene-Related Peptide (CGRP) Antagonists and Their Use in Migraines

Abstract

Migraine is highly prevalent and associated with a large socio-economic burden in the United States. Current preventive medications have variable efficacy and their use is often limited by intolerable side effects. Calcitonin gene-related peptide (CGRP) has been identified as an integral part of migraine pathophysiology. There are currently seven CGRP antagonists under investigation, all of which are undergoing or have completed phase 3 clinical trials. Three of the investigated CGRP antagonists are approved for use within and outside of the United States. The trials have resulted in positive efficacy and safety data. The purpose of this review is to evaluate the seven CGRP antagonists and their future place in therapy.

Keywords:

• CGRP
• migraine
• calcitonin gene-related peptide
• erenumab
• galcanezumab
• fremanezumab

Disclosure statement

Dr. Henson has no interests to disclose. Dr. Hollingsworth has no interests to disclose. Dr. Nevois has no interests to disclose. Dr. Herndon declares the following interests: Research support (NIDA, SAMHSA), Honoraria (ASHP, APhA, Pharmacy Times Continuing Education), Legal Consulting (US Attorney, Southern Illinois, TJ Preuss, Feirich, Mager, Green, Ryan), Travel support (Painweek).