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CGRP, a target for preventive therapy in migraine and cluster headache: Systematic review of clinical data.
Cephalalgia. 2019 03; 39(3):374-389.C

Abstract

INTRODUCTION

Migraine and cluster headache are challenging to manage, with no tailored preventive medications available. Targeting the calcitonin gene-related peptide (CGRP) pathway to treat these headaches may be the first focused therapeutic option to date, with the potential for promising efficacy.

METHODS

We systematically searched PubMed and clinicaltrials.gov for randomized controlled trials investigating the preventive potential of monoclonal antibodies against the CGRP pathway in the treatment of migraine and cluster headache.

RESULTS

The literature search returned a total of 136 records, of which 32 were eligible for review.

DISCUSSION

Clinical data from phase II and III trials of the four monoclonal antibodies targeting the CGRP pathway: Eptinezumab, erenumab, fremanezumab, and galcanezumab, collectively show a positive effect in the preventive treatment of episodic and chronic migraine. Multiple phase II and III trials are under way to further determine the efficacy and safety of this new drug class. It may be particularly important to assess the cardiovascular effects of long-term CGRP blockade. Phase III trials are also currently in progress for the preventive treatment of cluster headache.

CONCLUSION

Efficacy of anti-CGRP monoclonal antibodies spells a promising future for the many patients suffering from migraine, and possibly also for the smaller but severely-affected population with cluster headache.

Authors+Show Affiliations

Danish Headache Center, Dept. of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.Danish Headache Center, Dept. of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.Danish Headache Center, Dept. of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.

Pub Type(s)

Journal Article
Systematic Review

Language

eng

PubMed ID

29110503

Citation

Khan, Sabrina, et al. "CGRP, a Target for Preventive Therapy in Migraine and Cluster Headache: Systematic Review of Clinical Data." Cephalalgia : an International Journal of Headache, vol. 39, no. 3, 2019, pp. 374-389.
Khan S, Olesen A, Ashina M. CGRP, a target for preventive therapy in migraine and cluster headache: Systematic review of clinical data. Cephalalgia. 2019;39(3):374-389.
Khan, S., Olesen, A., & Ashina, M. (2019). CGRP, a target for preventive therapy in migraine and cluster headache: Systematic review of clinical data. Cephalalgia : an International Journal of Headache, 39(3), 374-389. https://doi.org/10.1177/0333102417741297
Khan S, Olesen A, Ashina M. CGRP, a Target for Preventive Therapy in Migraine and Cluster Headache: Systematic Review of Clinical Data. Cephalalgia. 2019;39(3):374-389. PubMed PMID: 29110503.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - CGRP, a target for preventive therapy in migraine and cluster headache: Systematic review of clinical data. AU - Khan,Sabrina, AU - Olesen,Astrid, AU - Ashina,Messoud, Y1 - 2017/11/07/ PY - 2017/11/8/pubmed PY - 2020/7/10/medline PY - 2017/11/8/entrez KW - Calcitonin gene-related peptide KW - antagonist KW - antibody KW - headache KW - prevention KW - prophlyaxis KW - treatment SP - 374 EP - 389 JF - Cephalalgia : an international journal of headache JO - Cephalalgia VL - 39 IS - 3 N2 - INTRODUCTION: Migraine and cluster headache are challenging to manage, with no tailored preventive medications available. Targeting the calcitonin gene-related peptide (CGRP) pathway to treat these headaches may be the first focused therapeutic option to date, with the potential for promising efficacy. METHODS: We systematically searched PubMed and clinicaltrials.gov for randomized controlled trials investigating the preventive potential of monoclonal antibodies against the CGRP pathway in the treatment of migraine and cluster headache. RESULTS: The literature search returned a total of 136 records, of which 32 were eligible for review. DISCUSSION: Clinical data from phase II and III trials of the four monoclonal antibodies targeting the CGRP pathway: Eptinezumab, erenumab, fremanezumab, and galcanezumab, collectively show a positive effect in the preventive treatment of episodic and chronic migraine. Multiple phase II and III trials are under way to further determine the efficacy and safety of this new drug class. It may be particularly important to assess the cardiovascular effects of long-term CGRP blockade. Phase III trials are also currently in progress for the preventive treatment of cluster headache. CONCLUSION: Efficacy of anti-CGRP monoclonal antibodies spells a promising future for the many patients suffering from migraine, and possibly also for the smaller but severely-affected population with cluster headache. SN - 1468-2982 UR - https://www.unboundmedicine.com/medline/citation/29110503/CGRP_a_target_for_preventive_therapy_in_migraine_and_cluster_headache:_Systematic_review_of_clinical_data_ L2 - https://journals.sagepub.com/doi/10.1177/0333102417741297?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -