CGRP mechanism antagonists and migraine management

Curr Neurol Neurosci Rep. 2015 May;15(5):25. doi: 10.1007/s11910-015-0547-z.

Abstract

Migraine is a complex disorder of the brain that is common and highly disabling. As understanding of the neural pathways has advanced, and it has become clear that the vascular hypothesis does not explain the disorder, new therapeutic avenues have arisen. One such target is calcitonin gene-related peptide (CGRP)-based mechanisms. CGRP is found within the trigeminovascular nociceptive system widely from the trigeminal ganglion to second-order and third-order neurons and in regulatory areas in the brainstem. Studies have shown CGRP is released during severe migraine attacks and the reversal of the attack with effective triptan treatment normalizes those levels. CGRP administration triggers migraine in patients, and CGRP receptor antagonists have been shown to abort migraine. Here, we review the current state of CGRP mechanism antagonist therapy as its research and development is increasing in migraine therapeutics. We discuss several recent trials, highlighting the evidence base behind these novel drugs, and their potential future contribution to migraine management.

Publication types

  • Review

MeSH terms

  • Animals
  • Calcitonin Gene-Related Peptide / antagonists & inhibitors*
  • Calcitonin Gene-Related Peptide / metabolism*
  • Disease Management*
  • Humans
  • Migraine Disorders / drug therapy*
  • Migraine Disorders / pathology
  • Nervous System / drug effects
  • Nervous System / metabolism
  • Receptors, Calcitonin Gene-Related Peptide / metabolism

Substances

  • Receptors, Calcitonin Gene-Related Peptide
  • Calcitonin Gene-Related Peptide