Cardiovascular Risk Assessment and Triptans

Papademetriou, Vasilios

doi:10.1111/j.1526-4610.2004.04106.x

Cited by 26 publications

(15 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The use of triptans in appropriate patient populations has not been associated with an increased risk of stroke, MI, or CVD-related mortality [ 7•• , 19•• , 34• , [35][36][37]. Despite the relative safety of these medications and the fact that they are generally well tolerated [ 34• , 37 ], they should be avoided in individuals with a history of known CVD or at signifi cant risk for CVD, MI, stroke, TIA, uncontrolled hypertension, or hemiplegic or basilar-type migraine.…”

Section: Implications For Clinical Managementmentioning

confidence: 99%

Migraine with and without aura and risk for cardiovascular disease

Vargas

Dodick²,

Wingerchuk³

et al. 2008

Curr Atheroscler Rep

View full text Add to dashboard Cite

Migraine, cardiovascular disease, and stroke are three highly prevalent and disabling conditions that exert a significant socioeconomic impact. The association between migraine and a twofold risk of stroke and myocardial infarction has been the topic of much debate. The mechanism underlying this link is largely unknown but may be the result of an increased prevalence of other conditions such as vasculopathies, hypercoagulable states, and patent foramen ovale seen in migraine with aura. Although many prior studies have demonstrated increased risks in women with migraine with aura, an emerging body of evidence is showing similar risks in men. These risks are further compounded with increased migraine frequency, smoking, and the use of oral contraceptive pills. Because the overall risk for stroke and myocardial infarction in migraineurs remains relatively low, recommendations at this time are limited to the modification of cardiovascular risk factors, such as smoking cessation and the avoidance of oral contraceptive pills, especially in women suffering from migraine with aura.

show abstract

Section: Implications For Clinical Managementmentioning

confidence: 99%

Migraine with and without aura and risk for cardiovascular disease

Vargas

Dodick²,

Wingerchuk³

et al. 2008

Curr Atheroscler Rep

View full text Add to dashboard Cite

show abstract

“…However, a significant number of migraine cases do not respond to these therapies. In addition, adverse effects such as cardiovascular concerns limit their use [14]. Calcitonin gene-related peptide (CGRP), is recognized as a crucial peptide in the pathophysiology of migraine, and has been increasingly investigated.…”

Section: Introductionmentioning

confidence: 99%

The effect and safety of monoclonal antibodies to calcitonin gene-related peptide and its receptor on migraine: a systematic review and meta-analysis

et al. 2017

View full text Add to dashboard Cite

BackgroundMigraine has been recognized as one of the leading causes of disability in the 2013 Global Burden of Disease Study and seriously affects the quality of patients’ life, current treatment options are not ideal. Monoclonal antibodies to calcitonin gene-related peptide and its receptor (CGRP-mAbs) appear more promising for migraine because of considerably better effect and safety profiles. The objective of this study is to systematically assess the clinical efficacy and safety of CGRP-mAbs for migraine therapy.MethodsA systematic literature search in PubMed, Cochrane Library and Baidu Scholar was performed to identify randomized controlled trials (RCTs), which compared the effect and safety of CGRP-mAbs with placebo on migraine. Regarding the efficacy, the reduction of monthly migraine days from baseline to weeks 1–4, 5–8, and 9–12; responder rates were extracted as the outcome measures of the effects of CGRP-mAbs. Regarding the safety, total adverse events, the main adverse events, and other adverse events were evaluated.ResultsWe found significant reduction of monthly migraine days in CGRP-mAbs vs. placebo (weeks 1–4: SMD −0.49, 95% CI −0.61 to −0.36; weeks 5–8: SMD −0.43, 95% CI −0.56 to −0.30; weeks 9–12: SMD −0.37, 95% CI −0.49 to −0.24). 50% and 75% responder rates (OR 2.59, 95% CI 1.99 to 3.37; and OR 2.91, 95% CI 2.06 to 4.10) were significantly increased compared with placebo. There was no significant difference in total adverse events (OR 1.17, 95% CI 0.91 to 1.51), and the main adverse events including upper respiratory tract infection (OR 1.44, 95% CI 0.82 to 2.55), nasopharyngitis (OR 0.59, 95% CI 0.30 to 1.16), nausea (OR 0.61, 95% CI 0.29 to 1.32), injection-site pain (OR 1.73, 95% CI 0.95 to 3.16) and back pain (OR 0.97, 95% CI 0.49 to 1.90) were not obviously changed compared with placebo control, but the results showed significant increase of dizziness in CGRP-mAbs vs. placebo (OR 3.22, 95% CI 1.09 to 9.45).ConclusionsThis meta-analysis suggests that CGRP-mAbs are effective in anti-migraine therapy with few adverse reactions, but more and larger sample-size RCTs are required to verify the current findings.

show abstract

“…Despite the significant contribution in the past quarter of a century, the overall associated cardiovascular risks continue to limit their use, and a significant amount of patients still may not respond to this approach [6]. Most especially, only about a third of patients treated with oral triptans will obtain sustained pain freedom (freedom from pain at 2 h with no rescue medication and with no recurrence of headache within 24 h), which supports the urgent need for novel therapy options [7].…”

Section: Introductionmentioning

confidence: 99%

Targeting CGRP: A New Era for Migraine Treatment

Goldberg

Silberstein

2015

CNS Drugs

View full text Add to dashboard Cite

Migraine is a highly prevalent headache disease that typically affects patients during their most productive years. Despite significant progress in understanding the underlying pathophysiology of this disorder, its treatment so far continues to depend on drugs that, in their majority, were not specifically designed for this purpose. The neuropeptide calcitonin gene-related peptide (CGRP) has been indicated as playing a critical role in the central and peripheral pathways leading to a migraine attack. It is not surprising that drugs designed to specifically block its action are gaining remarkable attention from researchers in the field with, at least so far, a safe risk profile. In this article, we highlight the evolution from older traditional treatments to the innovative CGRP target drugs that are revolutionizing the way to approach this debilitating neurological disease. We provide a brief introduction on pathophysiology of migraine and details on the characteristic, function, and localization of CGRP to then focus on CGRP receptor antagonists (CGRP-RAs) and CGRP monoclonal antibodies (CGRP mAbs). Key PointsThe neuropeptide calcitonin gene-related peptide (CGRP) has been indicated as playing a critical role in the central and peripheral pathways leading to a migraine attack.Targeting CGRP as a specific therapeutic tool for migraine may offer similar or even better efficacy than currently available treatments without the vasoconstrictive risk factors.Further studies are necessary to determine the exact role of CGRP receptor antagonists and CGRP monoclonal antibodies in migraine with aura, allodynia, and photophobia.

show abstract

Cardiovascular Risk Assessment and Triptans

Cited by 26 publications

References 35 publications

Migraine with and without aura and risk for cardiovascular disease

Migraine with and without aura and risk for cardiovascular disease

The effect and safety of monoclonal antibodies to calcitonin gene-related peptide and its receptor on migraine: a systematic review and meta-analysis

Targeting CGRP: A New Era for Migraine Treatment

Contact Info

Product

Resources

About