Monoclonal antibodies for the prevention of migraine. (2nd December 2019)
- Record Type:
- Journal Article
- Title:
- Monoclonal antibodies for the prevention of migraine. (2nd December 2019)
- Main Title:
- Monoclonal antibodies for the prevention of migraine
- Authors:
- Raffaelli, Bianca
Neeb, Lars
Reuter, Uwe - Abstract:
- ABSTRACT: Introduction : Calcitonin Gene-Related Peptide (CGRP) plays a crucial role in migraine pathophysiology. A novel specific treatment strategy for the prevention of migraine incorporates monoclonal antibodies (mAbs) against CGRP and its canonical receptor. Eptinezumab, fremanezumab and galcanezumab block CGRP mediated effects by binding to the peptide, while erenumab blocks the CGRP receptor. Areas covered : Following a brief overview of pharmacological characteristics, we will review phase III trials for the use of CGRP mAbs in the prevention of episodic and chronic migraine. Expert opinion : All four CGRP mAbs demonstrated an excellent safety, tolerability and efficacy profile in migraine patients. Across all trials mAbs showed superior efficacy for the reduction of monthly migraine days compared to placebo with a net benefit of 2.8 days. Neither cardiovascular nor immunological safety concerns have emerged from clinical trials. Fremanezumab, galcanezumab, and erenumab are approved in the USA and Europe. Based on trial data there is no reason why these mAbs should not become first-line therapies in future. For now, we advocate for the use of mAbs in migraine prevention for patients who failed a minimum of two standard oral treatments based on the novelty and costs of this approach. mAbs are also effective in patients with medication overuse and with comorbid depression or anxiety disorders. Taken together, mAbs are likely to usher in a new era in migraine preventionABSTRACT: Introduction : Calcitonin Gene-Related Peptide (CGRP) plays a crucial role in migraine pathophysiology. A novel specific treatment strategy for the prevention of migraine incorporates monoclonal antibodies (mAbs) against CGRP and its canonical receptor. Eptinezumab, fremanezumab and galcanezumab block CGRP mediated effects by binding to the peptide, while erenumab blocks the CGRP receptor. Areas covered : Following a brief overview of pharmacological characteristics, we will review phase III trials for the use of CGRP mAbs in the prevention of episodic and chronic migraine. Expert opinion : All four CGRP mAbs demonstrated an excellent safety, tolerability and efficacy profile in migraine patients. Across all trials mAbs showed superior efficacy for the reduction of monthly migraine days compared to placebo with a net benefit of 2.8 days. Neither cardiovascular nor immunological safety concerns have emerged from clinical trials. Fremanezumab, galcanezumab, and erenumab are approved in the USA and Europe. Based on trial data there is no reason why these mAbs should not become first-line therapies in future. For now, we advocate for the use of mAbs in migraine prevention for patients who failed a minimum of two standard oral treatments based on the novelty and costs of this approach. mAbs are also effective in patients with medication overuse and with comorbid depression or anxiety disorders. Taken together, mAbs are likely to usher in a new era in migraine prevention and provide significant value to patients. … (more)
- Is Part Of:
- Expert opinion on biological therapy. Volume 19:Number 12(2019)
- Journal:
- Expert opinion on biological therapy
- Issue:
- Volume 19:Number 12(2019)
- Issue Display:
- Volume 19, Issue 12 (2019)
- Year:
- 2019
- Volume:
- 19
- Issue:
- 12
- Issue Sort Value:
- 2019-0019-0012-0000
- Page Start:
- 1307
- Page End:
- 1317
- Publication Date:
- 2019-12-02
- Subjects:
- CGRP -- migraine -- clinical trial -- phase III -- placebo -- chronic migraine
Gene therapy -- Periodicals
Protein drugs -- Periodicals
Peptide drugs -- Periodicals
Immunotherapy -- Periodicals
Drug delivery systems -- Periodicals
615.5 - Journal URLs:
- http://informahealthcare.com/journal/ebt ↗
http://www.ashley-pub.com/loi/ebt ↗
http://www.tandfonline.com/toc/iebt20/current ↗
http://informahealthcare.com ↗
http://miranda.ashley-pub.com/vl=2623054/cl=18/nw=1/rpsv/journal/journal1_home.htm ↗ - DOI:
- 10.1080/14712598.2019.1671350 ↗
- Languages:
- English
- ISSNs:
- 1471-2598
- Deposit Type:
- Legaldeposit
- View Content:
- Available online (eLD content is only available in our Reading Rooms) ↗
- Physical Locations:
- British Library DSC - 3842.002940
British Library DSC - BLDSS-3PM
British Library HMNTS - ELD Digital store - Ingest File:
- 12070.xml