Migraine Biochemistry: CGRP & Beyond
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Key Questions
• What is calcitonin gene-related peptide (CGRP) and what role does it play in migraine disease?
• Which medications disrupt the CGRP pathway to assist in managing migraine attacks?
• How have CGRP inhibitor medications benefitted those with migraine?
• What do we know so far about the potential side effects of CGRP-targeted medications?
• Why do some people not respond as well as others to CGRP inhibitors?
• What is pituitary adenylate cyclase-activating polypeptide (PACAP) and what role does it play in migraine treatment?
• Could an individual’s migraine symptoms potentially stem from both the CGRP and PACAP pathways?
• What other substances are researchers currently looking at for potential treatments?
• How can learning more about existing medications help us to understand migraine’s different manifestations?
• How much potential is there for migraine treatments beyond CGRP?
Interview Notes
- Study: “Ubrogepant for the treatment of migraine attacks during the prodrome: a phase 3, multicentre, randomised, double-blind, placebo-controlled, crossover trial in the USA”
- Article: “PACAP-Targeted Antibody Lu AG09222 Demonstrates Positive Results in Phase 2 Migraine Trial”
- Study: “PAR2 activation in the dura causes acute behavioral responses and priming to glyceryl trinitrate in a mouse migraine model”
Treatments Mentioned
- Almotriptan (Axert)
- Amitriptyline
- Atogepant (Qulipta)
- CGRP inhibitors
- CGRP monoclonal antibodies (mAbs)
- CGRP small-molecule receptor antagonists (gepants)
- Eletriptan (Relpax)
- Eptinezumab (Vyepti)
- Erenumab (Aimovig)
- Fremanezumab (Ajovy)
- Frovatriptan (Frova)
- Galcanezumab (Emgality)
- Naratriptan (Amerge)
- Propranolol
- Rimegepant (Nurtec)
- Rizatriptan (Maxalt)
- Sumatriptan (Imitrex)
- Topiramate (Topamax)
- Triptans
- Ubrogepant (Ubrelvy)
- Zavegepant (Zavzpret)
- Zolmitriptan (Zomig)
Please note: The Migraine World Summit’s aim is to bring you a variety of perspectives and expertise, independent of bias or judgment. Alternative theories presented in this video have not been medically reviewed. Views expressed in this interview do not necessarily represent the views of the Migraine World Summit. Please always consult your health care professional and do your own research before making changes to your treatment plan.
Peter Goadsby, MD, PhD, FRS
Professor of Neurology and Neurologist
King's College London
Dr. Peter J. Goadsby is one of the world’s leading headache neurologists and researchers. He is a professor at King’s College London and an emeritus professor at the University of California, Los Angeles (UCLA). Dr. Goadsby is on the board of directors of the American Headache Society, and is also a trustee for The Migraine Trust.
He serves on the scientific advisory board and executive committee for the American Registry for Migraine Research (ARMR). He was one of the first to explore calcitonin gene-related peptide (CGRP), the protein known for its involvement in migraine. This discovery has been instrumental in creating the new class of medications CGRP blockers, including Aimovig (erenumab), Ajovy (fremanezumab), Emgality (galcanezumab), Nurtec ODT (rimegepant), Qulipta (atogepant), and Vyepti (eptinezumab).
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The American Migraine Foundation (AMF) is a non-profit organization dedicated to the advancement of research and awareness surrounding migraine, a disabling condition that impacts more than 37 million men, women and children in the United States. The AMF was founded in 2010 to provide global access to information and resources for individuals with migraine as well as their family and friends.
At AbbVie, we are committed to empowering people living with migraine disease. We advance science that enables health care providers to care for people impacted across the spectrum of migraine. Through education and partnerships with the migraine community, we strive to help those with migraine navigate barriers to care, access effective treatments and reduce the impact of migraine on their lives. To learn more, visit AbbVie.com.
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