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Novel Pharmacological Targets of Migraine: An Overview

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Novel Synthetic Drugs in Migraine

Part of the book series: Headache ((HEAD))

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Abstract

Despite all studies during the last decades, the exact pathophysiological mechanisms underlying the onset of a migraine attack are not yet fully characterized. Notwithstanding, the important role of serotonin (5-hydroxytryptamine, 5-HT) and the discovery of calcitonin gene–related peptide (CGRP) as a key point in the pathophysiology of migraine, has allowed the development of new potential drugs for both the acute and preventive treatment of migraine. Since triptans (the gold standard for the acute treatment of migraine) induce vasoconstrictor effects and are therefore contraindicated in patients with cardio- and cerebrovascular disorders, novel synthetic acute and prophylactic antimigraine drugs have been developed. Besides the monoclonal antibodies targeted at CGRP or the CGRP receptor, these novel drugs include ditans and gepants, which target the 5-HT1F receptors at a central and peripheral level and CGRP receptors in the trigeminovascular system, respectively. Currently, these two new classes of antimigraine drugs have been evaluated in clinical trials, showing safety and efficacy in aborting and preventing migraine attacks. However, further studies are required to confirm their efficacy and long-term safety.

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Authors and Affiliations

  1. Division of Vascular Medicine and Pharmacology, Department of Internal Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands

    Eduardo Rivera-Mancilla & Antoinette MaassenVanDenBrink

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  1. Eduardo Rivera-Mancilla
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Correspondence to Antoinette MaassenVanDenBrink .

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  1. Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy

    Paolo Martelletti

  2. Department of Internal Medicine, Lund University Hospital, Lund, Sweden

    Lars Edvinsson

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The authors were financially supported by the following research grants: (1) Consejo Nacional de Ciencia y Tecnología (Postdoctoral Grant No. 740678, Mexico) for E. Rivera-Mancilla; and (2) the Dutch Research Council (NWO, Vici Grant 09150181910040) for A. MaassenVanDenBrink.

Declaration of Interests

Antoinette MaassenVanDenBrink has received personal fees or honoraria for lectures and/or advisory boards from Abbvie/Allergan, Amgen/Novartis, Eli Lilly and Teva.

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Rivera-Mancilla, E., MaassenVanDenBrink, A. (2022). Novel Pharmacological Targets of Migraine: An Overview. In: Martelletti, P., Edvinsson, L. (eds) Novel Synthetic Drugs in Migraine. Headache. Springer, Cham. https://doi.org/10.1007/978-3-030-95334-8_1

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