CGRP antagonists and antibodies for the treatment of migraine

Abstract

Introduction: Migraine is a highly devastating neurovascular disorder that affects up to 16% of the population worldwide. In spite of intensive research, its origin remains enigmatic with no therapeutic option appropriate for all migraine patients. One of the leading hypotheses is related to the function of the calcitonin gene-related peptide (CGRP). Regardless, the pharmaceutical options currently applied for the acute and prophylactic treatment of migraine are not appropriate for all migraine patients.

Areas covered: This article is based on a literature review using the PubMed database and highlights the CGRP theory of the pathomechanism of migraine.

Expert opinion: Since migraine is a CGRP-related disorder, it appeared obvious to develop CGRP receptor antagonists that exert high efficacy, both intravenously and orally. Unfortunately, the frequent use of these antagonists results in an elevated liver transaminase level. In an attempt to bypass these harmful side effects, efforts should be made to modify these pharmacons. The use of fully humanized monoclonal antibodies (mAbs) that target CGRP and its receptors may also be possible. However, while Phase I and II clinical trials are promising, a long-term follow-up of these therapies is still needed.

Keywords:

• anti-calcitonin gene-related peptide mAbs
• anti-calcitonin gene-related peptide receptor mAbs
• calcitonin gene-related peptide
• calcitonin gene-related peptide receptor antagonists
• calcitonin gene-related peptide receptors
• migraine treatment

Declaration of interest

This work was supported by the project TÁMOP-4.2.2.A-11/1/KONV-2012-0052, by the Hungarian Brain Research Programme (NAP, Grant No. KTIA_13_NAP-A-III/9.), by EUROHEADPAIN (FP7-Health 2013-Innovation; Grant No. 602633) and by the MTA-SZTE Neuroscience Research Group of the Hungarian Academy of Sciences and University of Szeged. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Notes

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