Update on Calcitonin Gene-Related Peptide Antagonism in the Treatment of Migraine

Caronna, Edoardo; Starling, Amaal J.

doi:10.1016/j.ncl.2020.09.001

Cited by 14 publications

(14 citation statements)

References 57 publications

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“…Anti-CGRP and anti-CGRP receptor antibodies are the first tailored treatment for migraine and have been approved for the preventive treatment of high-frequency episodic migraine and chronic migraine [ 100 ]. Furthermore, CGRP antagonists are under evaluation for their symptomatic and prophylactic use in migraine [ 101 ].…”

Section: Headache and Multiple Sclerosismentioning

confidence: 99%

Headache and immunological/autoimmune disorders: a comprehensive review of available epidemiological evidence with insights on potential underlying mechanisms

Biscetti

Vanna

Cresta

et al. 2021

J Neuroinflammation

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Several lines of evidence support a role of the immune system in headache pathogenesis, with particular regard to migraine. Firstly, alterations in cytokine profile and in lymphocyte subsets have been reported in headache patients. Secondly, several genetic and environmental pathogenic factors seem to be frequently shared by headache and immunological/autoimmune diseases. Accordingly, immunological alterations in primary headaches, in particular in migraine, have been suggested to predispose some patients to the development of immunological and autoimmune diseases. On the other hand, pathogenic mechanisms underlying autoimmune disorders, in some cases, seem to favour the onset of headache. Therefore, an association between headache and immunological/autoimmune disorders has been thoroughly investigated in the last years. The knowledge of this possible association may have relevant implications in the clinical practice when deciding diagnostic and therapeutic approaches. The present review summarizes findings to date regarding the plausible relationship between headache and immunological/autoimmune disorders, starting from a description of immunological alteration of primary headaches, and moving onward to the evidence supporting a potential link between headache and each specific autoimmune/immunological disease.

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Section: Headache and Multiple Sclerosismentioning

confidence: 99%

Headache and immunological/autoimmune disorders: a comprehensive review of available epidemiological evidence with insights on potential underlying mechanisms

Biscetti

Vanna

Cresta

et al. 2021

J Neuroinflammation

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“…All these drugs were used for other conditions (e.g., depression, epilepsy, hypertension, spasticity) and found to be effective for migraine treatment [ 3 ]. In the last few years, the approval of targeted drugs represented a paradigm shift for migraine, as these molecules designed to block the signaling of the calcitonin gene-related peptide (CGRP), which is thought to be the main culprit for migraine pathogenesis [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

CGRP Inhibitors and Oxidative Stress Biomarkers in Resistant Migraine: A Real-Life Study with Erenumab, Fremanezumab, and Galcanezumab

Luca

Baldacci

Mazzucchi

et al. 2021

JCM

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Patients with high-frequency resistant migraine and medication-overuse headache are still the main clinical challenge in tertiary headache centers. The approval of targeted antibodies against the calcitonin gene-related peptide (CGRP) and its receptor represents a powerful instrument. In this study, we observed how biological and clinical features of resistant migraineurs responded to erenumab, fremanezumab, or galcanezumab. We found a reduction in advanced oxidation protein products (AOPP) as a biomarker of improved redox state after six months of treatment. We also found that treatment efficacy was precocious and maintained with high individual responder rates. In particular, seven out of ten patients achieved a reduction of 50% from the baseline at three months, which was maintained at six months, while about one out of our patients experienced a 75% reduction in headache frequency from the first month of treatment. The migraine disability assessment (MIDAS) and the associated fatigue, anxiety, and sleep quality also significantly improved. The allodynia symptom dropped from moderate/severe to mild/absent as a sign of central sensitization reduction. Our study confirmed the safety and efficacy of CGRP inhibition in real-life, high-challenging patients. Additional evidence is needed to understand the role of oxidative stress as a migraine biomarker.

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“…Unfortunately, treatments reported for post‐traumatic headache in youth have not been very successful 27 . Since a substantial portion of these post‐concussion headaches have migrainous characteristics, 28 newer treatments for migraine might be trialed to see if they are more efficacious in these youth 29 . Tension headaches are also very common following concussion, 27 potentially secondary to the prevalence of cervical spine impairment in this population 30 .…”

Section: Discussionmentioning

confidence: 99%

Effect of Collaborative Care for Persistent Postconcussive Symptoms on Academic Function: A Randomized Clinical Trial

Rivara

Marcynyszyn²,

Wang

et al. 2021

Journal of School Health

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BACKGROUND There is limited long‐term data on the course of school‐related problems and academic needs for youth with persistent post‐concussive symptoms (PPCS). METHODS This was a randomized trial comparing collaborative care to usual care for 200 youth 11–18 years of age with PPCS. In this report, the main outcomes were academic functioning, GPA, school absences, date of return to school, and school days missed. RESULTS Youth were mean age of 14.7 (SD = 1.7), 62.0% female. New or worsening academic problems occurred in half of participants in both groups at 12 months after injury. Students were most concerned about grades and falling behind. There were no significant differences by study group on school problems or GPA, but number of days missed was lower in the collaborative care group compared at 3 months (12.5 [SD = 14.5] vs 16.1 days [20.4] adjusted relative risk [aRR] 0.67 [95% CI: 0.61, 0.74; p < .001]), 6 months (14.5 [22.1] vs 19.3 [26.6] aRR 0.77 [95% CI: 0.71, 0.84; p < .001]), and 12 months (16.9 [25.4] vs 19.6 [27.7], aRR 0.68 [95% CI: 0.62, 0.74; p < .001]). CONCLUSIONS Youth with PPCS are at high risk of school problems in the year after injury.

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Update on Calcitonin Gene-Related Peptide Antagonism in the Treatment of Migraine

Cited by 14 publications

References 57 publications

Headache and immunological/autoimmune disorders: a comprehensive review of available epidemiological evidence with insights on potential underlying mechanisms

Headache and immunological/autoimmune disorders: a comprehensive review of available epidemiological evidence with insights on potential underlying mechanisms

CGRP Inhibitors and Oxidative Stress Biomarkers in Resistant Migraine: A Real-Life Study with Erenumab, Fremanezumab, and Galcanezumab

Effect of Collaborative Care for Persistent Postconcussive Symptoms on Academic Function: A Randomized Clinical Trial

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