keyword
https://read.qxmd.com/read/38520255/new-migraine-drugs-a-critical-appraisal-of-the-reason-why-the-majority-of-migraine-patients-do-not-receive-an-adequate-medication
#1
JOURNAL ARTICLE
Hans Christoph Diener, Arne May
The last three decades have produced several novel and efficient medications to treat migraine attacks and reduce attack frequency. Additionally, promising approaches for the development of acute therapy and migraine prophylaxis continue to be pursued. At the same time as we witness the development of better and more efficient medications with continuously fewer side effects, we also realise that the high cost of such therapies means that only a minority of migraine patients who could benefit from these medications can afford them...
March 2024: Cephalalgia: An International Journal of Headache
https://read.qxmd.com/read/38477313/evaluation-of-outcomes-of-calcitonin-gene-related-peptide-cgrp-targeting-therapies-for-acute-and-preventive-migraine-treatment-based-on-patient-sex
#2
REVIEW
Frank Porreca, Edita Navratilova, Joe Hirman, Antoinette Maassen van den Brink, Richard B Lipton, David W Dodick
BACKGROUND: Women show increased prevalence and severity of migraine compared to men. Whether small molecule calcitonin gene-related peptide receptor (CGRP-R) antagonists (i.e., gepants) and monoclonal antibodies targeting either the CGRP-R or the CGRP peptide might show sexually dimorphic outcomes for acute and preventive therapy has not been established. METHODS: We conducted a subpopulation analysis of available published data from FDA reviews to evaluate potential sex differences in the response rates of ubrogepant, rimegepant and zavegepant for acute migraine therapy...
March 2024: Cephalalgia: An International Journal of Headache
https://read.qxmd.com/read/38466028/calcitonin-gene-related-peptide-targeting-therapies-are-a-first-line-option-for-the-prevention-of-migraine-an-american-headache-society-position-statement-update
#3
JOURNAL ARTICLE
Andrew C Charles, Kathleen B Digre, Peter J Goadsby, Matthew S Robbins, Andrew Hershey
OBJECTIVE: To provide a position statement update from The American Headache Society specifically regarding therapies targeting calcitonin gene-related peptide (CGRP) for the prevention of migraine. BACKGROUND: All migraine preventive therapies previously considered to be first-line treatments were developed for other indications and adopted later for migraine. Adherence to these therapies is often poor due to issues with efficacy and tolerability. Multiple new migraine-specific therapies have been developed based on a broad foundation of pre-clinical and clinical evidence showing that CGRP plays a key role in the pathogenesis of migraine...
March 11, 2024: Headache
https://read.qxmd.com/read/38457093/anti-calcitonin-gene-related-peptide-monoclonal-antibodies-in-migraine-focus-on-drug-interactions
#4
REVIEW
Slobodan M Janković, Snežana V Janković
Calcitonin gene-related peptide neurotransmission was the target for recent development of monoclonal antibodies that effectively prevent attacks of both episodic and chronic migraine. The aim of this narrative review was to offer deeper insight into drug-drug, drug-food and drug-disease interactions of monoclonal antibodies approved for prevention of migraine attacks. For this narrative review, relevant literature was searched for in MEDLINE and Google Scholar databases, covering the 1966-2023 and 2006-2023 periods, respectively...
March 8, 2024: European Journal of Drug Metabolism and Pharmacokinetics
https://read.qxmd.com/read/38446344/the-role-of-the-combination-paracetamol-caffeine-in-treatment-of-acute-migraine-pain-a-narrative-review
#5
REVIEW
Barbanti Piero, Allais Gianni, Cevoli Sabina, Guerzoni Simona, Valeriani Massimiliano, Vernieri Fabrizio
INTRODUCTION: Thirty years ago, the first migraine-specific drugs (triptans) appeared. Today two new categories (gepants and ditans) are marketed for acute migraine treatment. That said, is there still a role for conventional therapy? The aim of the present narrative review is to provide an expert overview examining the possible role of the combination paracetamol/caffeine in treatment of acute migraine pain. METHODS: To understand possible settings for more appropriate use of paracetamol/caffeine (1000 mg/130 mg) in treatment of acute migraine, a structured literature search was performed using the PubMed database by a panel of experts from major Italian headache centers; articles not referring to migraine pain were excluded from this review; review articles were prioritized...
March 6, 2024: Pain and Therapy
https://read.qxmd.com/read/38411458/novel-insight-into-atogepant-mechanisms-of-action-in-migraine-prevention
#6
JOURNAL ARTICLE
Agustin Melo-Carrillo, Andrew M Strassman, Ron Broide, Aubrey Adams, Brett Dabruzzo, Mitchell Brin, Rami Burstein
Recently, we showed that while atogepant - a small-molecule calcitonin gene-related peptide (CGRP) receptor antagonist - does not fully prevent activation of nociceptors, it significantly reduces a cortical spreading depression (CSD)-induced early response probability in C-fibers and late response probability in A™-fibers. The current study investigates atogepant effect on CSD-induced activation and sensitization of high-threshold (HT) and wide dynamic range (WDR) dura-sensitive neurons. In anesthetized male rats, single-unit recordings were used to assess effects of atogepant (5mg/kg) vs vehicle on CSD-induced activation and sensitization of HT and WDR dura-sensitive neurons...
February 27, 2024: Brain
https://read.qxmd.com/read/38361080/safety-and-tolerability-of-combining-cgrp-monoclonal-antibodies-with-gepants-in-patients-with-migraine-a-retrospective-study
#7
JOURNAL ARTICLE
Taoufik Alsaadi, Reem Suliman, Vanessa Santos, Ibrahim Al Qaisi, Princess Carmina, Batool Aldaher, Shadi Haddad, Yazan Bader
INTRODUCTION: The introduction of clacitonin gene-related peptide (CGRP) monoclonal antibodies (mAbs) has revolutionized the treatment of migraines. In clinical practice gepants might be considered as a valid option to treat acute attacks in patients with migraine who are treated with mAbs. However, the safety and tolerability of such a combination is not well addressed in the real-world setting. We designed this study to evaluate the safety and tolerability of combining CGRP mAbs with gepants in the management of migraines...
February 15, 2024: Neurology and Therapy
https://read.qxmd.com/read/38349136/update-on-gepants-for-the-treatment-of-chronic-migraine
#8
JOURNAL ARTICLE
Yu Aoh, Tsung-Wei Hou, Cheng-Chia Yang, Ching-Mao Chang, Shih-Pin Chen, I-Ju Tsai, Chin-Wen Cheng, Chun-Pai Yang
Chronic migraine (CM) is a profoundly debilitating condition that has detrimental clinical and social outcomes. Over the past two decades, novel small-molecule calcitonin gene related peptide (CGRP) receptor antagonists, known as gepants, and CGRP monoclonal antibodies (mAbs) have been developed, ushering in a new era of migraine-specific treatment. In this review, we discuss the literature investigating the role of gepants for the treatment of CM. Numerous completed and ongoing clinical studies have conclusively demonstrated the safety, tolerability, and efficacy of several gepants for the acute treatment of migraine...
February 13, 2024: Journal of the Chinese Medical Association: JCMA
https://read.qxmd.com/read/38333255/novel-fda-approved-zavegepant-drug-for-treating-migraine
#9
REVIEW
Usaid Ahmed, Muhammad Meeran Saleem, Mohamed Ashraf Osman, Shamat Fathi Shamat
Migraine is a complex neurological disorder characterized by recurring episodes of severe headaches. The pathophysiology of migraine involves abnormalities in neuronal networks, cortical spreading depression, and sensitization of trigeminovascular pathways. The global prevalence of migraine has increased substantially, warranting advancements in treatment strategies. A significant trigger in migraine pathophysiology is calcitonin gene-related peptide (CGRP). Several drugs, such as gepants and monoclonal antibodies (MABs) targeting CGRP or its receptor, have been developed to antagonize CGRP signaling...
February 2024: Annals of Medicine and Surgery
https://read.qxmd.com/read/38323326/potential-benefits-and-possible-risks-of-multitherapy-cgrp-targeted-in-migraine
#10
EDITORIAL
Keiko Ihara, Tsubasa Takizawa, Narumi Watanabe, Jin Nakahara, Paolo Martelletti
No abstract text is available yet for this article.
February 7, 2024: Expert Opinion on Drug Metabolism & Toxicology
https://read.qxmd.com/read/38320397/pharmacology-of-erenumab-in-human-isolated-coronary-and-meningeal-arteries-additional-effect-of-gepants-on-top-of-a-maximum-effect-of-erenumab
#11
JOURNAL ARTICLE
Tessa de Vries, Eloísa Rubio-Beltrán, Antoon van den Bogaerdt, Ruben Dammers, A H Jan Danser, Josefin Snellman, Jeanine Bussiere, Antoinette MaassenVanDenBrink
BACKGROUND AND PURPOSE: Multiple drugs targeting the calcitonin gene-related peptide (CGRP) receptor have been developed for migraine treatment. Here, the effect of the monoclonal antibody erenumab on CGRP-induced vasorelaxation was investigated in human isolated blood vessels, as well as the effect of combining erenumab with the small molecule drugs, namely rimegepant, olcegepant, or sumatriptan. EXPERIMENTAL APPROACH: Concentration-response curves to CGRP, adrenomedullin or pramlintide were constructed in human coronary artery (HCA) and human middle meningeal artery (HMMA) segments, incubated with or without erenumab and/or olcegepant...
February 6, 2024: British Journal of Pharmacology
https://read.qxmd.com/read/38307667/cgrp-receptor-antagonists-gepants
#12
REVIEW
Samaira Younis, Nina V Latysheva, Alexey B Danilov, Messoud Ashina
Small molecule calcitonin gene-related peptide (CGRP) receptor antagonists are commonly referred to as gepants. The first generation of gepants provided the first line of evidence of CGRP-mediated antimigraine medication in 2004-2011. However, further development was halted due to either lack of oral availability or concerns of hepatotoxicity. More than 15 years later, the first second generation of gepants, ubrogepant and rimegepant, are now approved for the acute treatment of migraine with or without aura...
2024: Handbook of Clinical Neurology
https://read.qxmd.com/read/38307655/menstrually-associated-migraine
#13
REVIEW
Eleonora De Matteis, Raffaele Ornello, Simona Sacco
Menstrually related migraine is a disabling condition affecting 35% to 54% females with migraine during their fertile years. The International Headache Classification distinguishes menstrually related migraine from pure menstrual migraine based on the occurrence of the attacks even outside the perimenstrual periods. Hormonal fluctuations are the main driver for the disease in subjects with genetic susceptibility and alterations of brain structures and connectivity. Menstrually related attacks are often particularly severe and disabling requiring proper management...
2024: Handbook of Clinical Neurology
https://read.qxmd.com/read/38307647/evidence-based-symptomatic-treatment-of-migraine
#14
REVIEW
Dimos D Mitsikostas, Thomas N Ward
Symptomatic treatment of migraine includes patient education, mainly to avoid medication overuse and known trigger factors, as well as pharmaceutical and nonpharmaceutical interventions. Disease-specific and mechanism-based agents include ergotamine and dihydroergotamine targeting the adrenergic, dopaminergic, and serotoninergic systems followed by triptans, specific agonists for 5-HT1B/1D/1F receptors, the latest being more favorable in terms of safety and documentation of efficacy. Recently, antagonists of calcitonin gene-related peptide (gepants) and selective agonists of the 5-HT1F receptor (ditans) have been added, with promising efficacy and safety...
2024: Handbook of Clinical Neurology
https://read.qxmd.com/read/38307640/cgrp-monoclonal-antibodies-and-cgrp-receptor-antagonists-gepants-in-migraine-prevention
#15
REVIEW
Edoardo Caronna, Alicia Alpuente, Marta Torres-Ferrus, Patricia Pozo-Rosich
Migraine is a prevalent and disabling neurological disease. Its preventive treatment for decades has been rather limited due to the absence of disease-specific therapies with limited efficacy and tolerability. The advances made in migraine research have led to the discovery of the calcitonin gene-related peptide (CGRP) and its role in migraine pathophysiology. CGRP is a neuropeptide that acts as potent vasodilator and is involved in pain processing. Increased levels of plasma CGRP have been observed during migraine attacks as well as interictally when comparing patients with migraine and healthy controls...
2024: Handbook of Clinical Neurology
https://read.qxmd.com/read/38266063/atogepant-mechanism-of-action-clinical-and-translational-science
#16
REVIEW
Ramesh Boinpally, Mohamad Shebley, Joel M Trugman
Since the discovery of calcitonin gene-related peptide (CGRP) in 1982, its integral role in migraine pathophysiology, specifically migraine pain, has been demonstrated through cumulative scientific discoveries that have led to the development and approval of migraine-specific therapeutics. Today, eight drugs, including monoclonal antibodies and small molecule CGRP receptor antagonists, known as gepants, have received approval for acute or preventive treatment of migraine. The primary mechanism of these drugs is to block CGRP signaling, thus preventing CGRP-mediated nociception and neurogenic inflammation...
January 2024: Clinical and Translational Science
https://read.qxmd.com/read/38266060/ubrogepant-mechanism-of-action-clinical-and-translational-science
#17
JOURNAL ARTICLE
Ramesh Boinpally, Mohamad Shebley, Joel Trugman
In recent years, the treatment of migraine has experienced a breakthrough in the development of drugs that target the calcitonin gene-related peptide (CGRP) signaling pathway. Monoclonal antibodies against the receptor or ligand have been developed for the preventive treatment of migraine; whereas, orally administered small molecule CGRP receptor antagonists, called gepants, have been developed for both acute and/or preventive treatment. Both modalities have demonstrated safe and effective treatment of migraine, reducing the number of migraine days for patients as well as reducing symptoms and improving patient function and overall quality of life...
January 2024: Clinical and Translational Science
https://read.qxmd.com/read/38256423/cgrp-antagonism-and-ketogenic-diet-in-the-treatment-of-migraine
#18
REVIEW
Francesca Finelli, Alessia Catalano, Michele De Lisa, Giuseppe Andrea Ferraro, Sabino Genovese, Federica Giuzio, Rosanna Salvia, Carmen Scieuzo, Maria Stefania Sinicropi, Fabiano Svolacchia, Antonio Vassallo, Alessandro Santarsiere, Carmela Saturnino
The study of migraine is based on the complexity of the pathology, both at the pathophysiological and epidemiological levels. Although it affects more than a billion people worldwide, it is often underestimated and underreported by patients. Migraine must not be confused with a simple headache; it is a serious and disabling disease that causes considerable limitations in the daily life of afflicted people, including social, work, and emotional effects. Therefore, it causes a daily state of suffering and discomfort...
January 15, 2024: Medicina
https://read.qxmd.com/read/38240944/acute-treatment-of-migraine-expert-consensus-statements-from-the-united-arab-emirates-uae
#19
JOURNAL ARTICLE
Taoufik Alsaadi, Deeb M Kayed, Abubaker Al-Madani, Ali Mohamed Hassan, Derk Krieger, Naji Riachi, Pournamy Sarathchandran, Suhail Al-Rukn
INTRODUCTION: Migraine, characterized by recurrent headaches and often accompanied by other symptoms like nausea, vomiting, and sensitivity to light and sound, significantly impacts patients' quality of life (QoL) and daily functioning. The global burden of migraines is reflected not only in terms of reduced QoL but also in the form of increased healthcare costs and missed work or school days. While UAE (United Arab Emirates)-specific consensus-based recommendations for the effective use of preventive calcitonin gene-related peptide (CGRP)-based migraine therapies have been published previously, an absence of such regional guidance on the management of acute migraine represents a gap that needs to be urgently addressed...
January 19, 2024: Neurology and Therapy
https://read.qxmd.com/read/38223948/-new-therapeutic-era-for-migraine-attacks-with-recently-approved-monoclonal-antibodies-ditans-and-gepants
#20
REVIEW
A Mínguez-Olaondo, A López-Bravo, S Quintas, C Nieves-Castellanos, A Layos-Romero, R Belvís, P Irimia, S Díaz-Insa
Treatment of migraine attacks is advised in all patients, using non-steroidal anti-inflammatory drugs when the pain is mild and triptans when the pain intensity is moderate-severe. However, the effectiveness of these drugs is moderate, a high percentage of patients have side effects, and triptans are contraindicated in people with a history of stroke, ischaemic heart disease or poorly controlled hypertension. Hence, there is an urgent need for new therapeutic alternatives. In recent years, new drugs for migraine attacks have become available, most notably ditans (lasmiditan) and gepants (ubrogepant and rimegepant)...
January 16, 2024: Revista de Neurologia
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