New Preventative Drugs for Migraine
Calcitonin gene-related receptor (CGRP) antagonists are the most important medications in advanced stage clinical development for the treatment of both the acute migraine attack and the prevention of frequent attacks.
Clinical trials on two of the antibodies have now been published in the New England Journal of Medicine.
One antibody, Erenumab made by Novartis, was trialed on 955 patients with episodic migraine.
- At the start of the trial the patients had migraines on an average of eight days a month.
- The study found 50% of those given the antibody injections halved their number of migraine days per month.
- About 27% did have a similar effect without treatment, which reflects the natural ebb and flow of the disease.
- Another antibody, fremanezumab made by Teva pharmaceuticals, was trialled on 1,130 patients with chronic migraine.
About 41% of patients halved their number of migraine days compared with 18% without treatment.
Erenumab has recently applied to the NHS and the European Medicines Agency for a license for use in the UK and Europe. There is more press coverage on this below.
CGRP is a substance which is pivotal for the triggering of migraine and there are raised levels in the blood during an attack. It is known to cause blood vessels to dilate and cause inflammation at nerve endings. The latest drugs are monoclonal antibodies which target this pathway and prevent the actions of CGRP.
Researchers are very interested in the role of these medications as a migraine preventative therapy, as this is currently regarded as one of the major unmet needs for people who get frequent migraine attacks.
These medications are still 9- 12 months away from being licensed for approval in Ireland. To date they have met all the critical end-points regarding efficacy and safety. They offer great hope for the future and these encouraging results represent a major step forward in our understanding of migraine prevention.
UK Press Coverage