"Monoclonal antibodies in the treatment of migraine"

Abstract

Migraine is a severe primary neurological disease, that according to the World Health Organization is listed as the sixth most disabling disorder globally and the most disabling of neurological disorders. This neurological disease has many negative affects to the quality of patien’s life. Calcitonin GeneRelated Peptide (CGRP) has an important role in the pathogenesis of migraine’s attacks.

CGRP is a neuropeptide that is produced in peripheral sensory neurons and numerous sites throughout the CNS. Ιt was found that is released from the trigeminal ganglion during migraine headaches. Many therapies have been developed targeting CGRP signaling for the treatment of acute migraine pain or the prevention of migraine attacks.

Monoclonal antibodies Erenumab, Galcanezumab, Fremanezumab and Eptinezumab were developed to prevent migraine by blocking CGRP signaling within the trigeminal ganglion. Erenumab binds the CGRP-receptor while Galcanezumab, Fremanezumab and Eptinezumab block CGRP signaling by binding the peptide. They represent an extension of the therapies which already exist in migraine prevention. In placebo-controlled studies have been demonstrated the efficacy and good tolerability of these new treatments in patients with episodic and chronic migraine.

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