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The Application of CGRP(r) Monoclonal Antibodies in Migraine Spectrum: Needs and Priorities

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Migraine is among the highest impact illnesses in the global population. Its negative ramifications are personal, social, economic and work related. Research on the development of new preventative migraine therapies has been idle for decades. The introduction, shortly, of an innovative pharmacological class useful for migraine prevention, namely monoclonal antibodies towards calcitonin gene-related peptide or its receptor, opens a new, immense therapeutic scenario. The necessity to manage the chronic and refractory forms of migraine must not take our attention away from the target of the pre-chronic forms. This is the most important target in every study. Indeed, by reducing the evolution towards chronic and consequently refractory chronic migraine, we will reduce complications caused by pharmacological abuse, the serious disability of these devastating chronic states, and the healthcare expenses needed to manage chronicity, abuse and consequent pathologies. We will, lastly, be able to rehabilitate these patients to achieve a quality working and social life, and facilitate their reintegration into daily normality.

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  1. Edvinsson L. The journey to establish CGRP as a migraine target: a retrospective view. Headache. 2015;55:1249–55.

    Article  PubMed  Google Scholar 

  2. Erdling A, Sheykhzade M, Edvinsson L. Differential inhibitory response to telcagepant on αCGRP induced vasorelaxation and intracellular Ca2+ levels in the perfused and non-perfused isolated rat middle cerebral artery. J Headache Pain. 2017;18:61.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  3. Steinberg A, Frederiksen SD, Blixt FW, Warfvinge K, Edvinsson L. Expression of messenger molecules and receptors in rat and human sphenopalatine ganglion indicating therapeutic targets. J Headache Pain. 2016;17:78.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  4. Giamberardino MA, Affaitati G, Curto M, Negro A, Costantini R, Martelletti P. Anti-CGRP monoclonal antibodies in migraine: current perspectives. Intern Emerg Med. 2016;11:1045–57.

    Article  PubMed  Google Scholar 

  5. Hou M, Xing H, Cai Y, Li B, Wang X, Li P, Hu X, Chen J. The effect and safety of monoclonal antibodies to calcitonin gene-related peptide and its receptor on migraine: a systematic review and meta-analysis. J Headache Pain. 2017;18:42.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  6. Yuan H et al. CGRP monoclonal antibodies for migraine: rationale and progress. BioDrugs 2017, in press, doi:10.1007/s40259-017-0250-5.

  7. Stovner LJ, Haimanot RT. Epidemiology of common headache disorders. In: Martelletti P, Steiner TJ, (eds) Handbook of headache. Milan Heidelberg Dordrecht London New York: Springer; 2011. pp. 17–25. SBN 978-88-470-2009-2. doi 10.1007/978-88-470-1700-9.

  8. Negro A, Curto M, Lionetto L, Giamberardino MA, Martelletti P. Chronic migraine treatment: from OnabotulinumtoxinA onwards. Expert Rev Neurother. 2016;16:1217–27.

    Article  PubMed  CAS  Google Scholar 

  9. Giamberardino MA, Mitsikostas DD, Martelletti P. Update on medication-overuse headache and its treatment. Curr Treat Options Neurol. 2015;17:368.

    Article  PubMed  Google Scholar 

  10. Negro A, Curto M, Lionetto L, Guerzoni S, Pini LA, Martelletti P. A critical evaluation on MOH current treatments. Curr Treat Options Neurol. 2017;15(19):32.

    Article  Google Scholar 

  11. Steiner TJ, Birbeck GL, Jensen RH, Katsarava Z, Stovner LJ, Martelletti P. Headache disorders are third cause of disability worldwide. J Headache Pain. 2015;16:58.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Steiner TJ, Stovner LJ, Vos T. GBD 2015: migraine is the third cause of disability in under 50s. J Headache Pain. 2016;17:104.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Martelletti P, Katsarava Z, Lampl C, Magis D, Bendtsen L, Negro A, Russell MB, Mitsikostas DD, Jensen RH. Refractory chronic migraine: a consensus statement on clinical definition from the European Headache Federation. J Headache Pain. 2014;28(15):47.

    Article  Google Scholar 

  14. Martelletti P, Giamberardino MA, Mitsikostas DD. Greater occipital nerve as target for refractory chronic headaches: from corticosteroid block to invasive neurostimulation and back. Expert Rev Neurother. 2016;16:865–6.

    Article  PubMed  CAS  Google Scholar 

  15. MaassenVanDenBrink A, Meijer J, Villalón CM, Ferrari MD. Wiping out CGRP: potential cardiovascular risks. Trends Pharmacol Sci. 2016;37:779–88.

    Article  PubMed  CAS  Google Scholar 

  16. Schou WS, Ashina S, Amin FM, Goadsby PJ, Ashina M. Calcitonin gene-related peptide and pain: a systematic review. J Headache Pain. 2017;18:34.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  17. Martelletti P, Curto M. Headache: cluster headache treatment - RCTs versus real-world evidence. Nat Rev Neurol. 2016;12:557–8.

    Article  PubMed  Google Scholar 

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Correspondence to Paolo Martelletti.

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No funding was received for the preparation of this manuscript.

Conflicts of interest

Paolo Martelletti has received fees for participation on advisory boards from Teva, Allergan, Amgen, Novartis, and Electrocore; educational grants from Allergan, ACRAF, and Pfizer; royalties from Springer; research grants from Elytra Pharma, and Sanofi; travel reimbursement from EFIC, EHF and Springer Nature; and an editorial grant from Springer Nature.

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Martelletti, P. The Application of CGRP(r) Monoclonal Antibodies in Migraine Spectrum: Needs and Priorities. BioDrugs 31, 483–485 (2017).

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