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CGRP Antagonists for the Treatment of Chronic Migraines: a Comprehensive Review

Current Pain and Headache Reports volume 23, Article number: 29 (2019) Cite this article

Abstract

Purpose of Review

The purpose of the following review is to summarize the most recent understanding of migraine pathophysiology, as well as of basic and clinical science pharmacologic literature regarding the development of calcitonin gene receptor peptide (CGRP) antagonists as a novel therapeutic modality for the treatment of migraine headaches. A review is provided of erenumab, the first of its class FDA approved CGRP antagonist.

Recent Findings

Despite its high prevalence, the occurrence and treatment of migraine headaches is poorly understood. Erenumab and CGRP antagonists as a whole significantly reduce the average number of migraine days experienced in migraine sufferers.

Summary

CGRP antagonists appear to significantly improve treatment outcomes in patients who suffer from episodic and chronic migraines. Erenumab is the first CGRP antagonist to be FDA approved for public use; however, further development of biologics in this class is underway.

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Authors and Affiliations

  1. Beth Israel Deaconess Medical Center, Department of Anesthesia, Critical Care, and Pain Medicine, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215, USA

    Ivan Urits & Mark R. Jones

  2. Georgetown University School of Medicine, Washington, DC, USA

    Kyle Gress & Karina Charipova

  3. Creighton University School of Medicine-Phoenix Regional Campus, Phoenix, AZ, USA

    Jacob Fiocchi

  4. Department of Anesthesiology, Louisiana State University Health Sciences Center, New Orleans, LA, USA

    Alan D. Kaye

  5. Valley Anesthesiology and Pain Consultants, Phoenix, AZ, USA

    Omar Viswanath

  6. University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA

    Omar Viswanath

  7. Creighton University School of Medicine, Omaha, NE, USA

    Omar Viswanath

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  1. Ivan Urits
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Correspondence to Ivan Urits.

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Ivan Urits, Mark R. Jones, Kyle Gress, Karina Charipova, Jacob Fiocchi, and Omar Viswanath declare no conflict of interest. Dr. Kaye is a speaker for Depomed, Inc. and Merck, Inc.

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Urits, I., Jones, M.R., Gress, K. et al. CGRP Antagonists for the Treatment of Chronic Migraines: a Comprehensive Review. Curr Pain Headache Rep 23, 29 (2019). https://doi.org/10.1007/s11916-019-0768-y

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  • DOI: https://doi.org/10.1007/s11916-019-0768-y

Keywords

  • Chronic migraines
  • Episodic migraines
  • Calcitonin gene receptor peptide (CGRP) antagonist
  • Erenumab