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Recent Advances in Pharmacotherapy for Migraine Prevention: From Pathophysiology to New Drugs

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Abstract

Migraine is a common and disabling neurological disorder, with a significant socioeconomic burden. Its pathophysiology involves abnormalities in complex neuronal networks, interacting at different levels of the central and peripheral nervous system, resulting in the constellation of symptoms characteristic of a migraine attack. Management of migraine is individualised and often necessitates the commencement of preventive medication. Recent advancements in the understanding of the neurobiology of migraine have begun to account for some parts of the symptomatology, which has led to the development of novel target-based therapies that may revolutionise how migraine is treated in the future. This review will explore recent advances in the understanding of migraine pathophysiology, and pharmacotherapeutic developments for migraine prevention, with particular emphasis on novel treatments targeted at the calcitonin gene-related peptide (CGRP) pathway.

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Authors and Affiliations

  1. Headache Group, Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK

    Jonathan Jia Yuan Ong, Diana Yi-Ting Wei & Peter J. Goadsby

  2. NIHR-Wellcome Trust King’s Clinical Research Facility, King’s College Hospital, Wellcome Foundation Building, London, SE5 9PJ, UK

    Jonathan Jia Yuan Ong, Diana Yi-Ting Wei & Peter J. Goadsby

  3. Division of Neurology, Department of Medicine, National University Health System, University Medicine Cluster, Singapore, Singapore

    Jonathan Jia Yuan Ong

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  1. Jonathan Jia Yuan Ong
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Correspondence to Peter J. Goadsby.

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The authors certify that no funding has been received for the conduct of this study and/or preparation of this manuscript.

Conflict of interest

Dr D Jonathan Jia Yuan Ong has no conflict of interest to declare. Dr Diana Yi-Ting Wei has no conflict of interest to declare. Professor Peter Goadsby has the following disclosures: grants and personal fees from Allergan, Amgen, and Eli-Lilly and Company; and personal fees from Akita Biomedical, Alder Biopharmaceuticals, Cipla Ltd, Dr Reddy’s Laboratories, eNeura, Electrocore LLC, Novartis, Pfizer Inc, Quest Diagnostics, Scion, Teva Pharmaceuticals, Trigemina Inc., Scion; and personal fees from MedicoLegal work, Journal Watch, Up-to-Date, Massachusetts Medical Society, Oxford University Press; and in addition, Dr. Goadsby has a patent Magnetic stimulation for headache assigned to eNeura.

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Ong, J.J.Y., Wei, D.YT. & Goadsby, P.J. Recent Advances in Pharmacotherapy for Migraine Prevention: From Pathophysiology to New Drugs. Drugs 78, 411–437 (2018). https://doi.org/10.1007/s40265-018-0865-y

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