Today we’re going to talk about one of the most exciting advancements in Migraine research- CGRP Antagonists. This stands for Calcitonin general-related peptide receptor antagonist. In slightly simpler terms, this new category of migraine medicine works to block a certain receptor in the brain that spikes during migraine attacks. There hasn’t been a new migraine-specific drug on the market since Triptans, released in the 1990s. These are also acute medications, not preventative. Considering how many people (36 million Americans) are affected by migraine, it is crazy that it’s taken this long to develop new medications. If one of these medications passes FDA testing, it will be the first drug ever to be designed for the preventative treatment of Migraine Disorder.
The Science behind the Treatment
One advantage of this drug over others is that they are large molecules, as opposed to small molecules. From my research, this means that those who take the drugs often suffer less side effects than when the drug contains small molecules. Because they are not degraded in the liver like small molecules, researchers believe these drugs will be more effective, and will have less drug to drug interactions. These molecules also have a long half life. This means they are well-suited for preventative treatment, as they last a long time in the body.
The Race to Market
Drug companies are in a race to the finish to try and release their version of the drug first. Amgen Pharmaceuticals, Eli Lilly and Company and Teva Pharmaceuticals are producing three drugs that are currently in phase 3 trials. They are called, Eptinezumab, Fremanezumab, and Galcanezumab, respectively. These three drugs are antibodies that target the CGRP molecule. Erenumab is another drug that targets the CGRP antibody, produced by Alder Biopharmaceuticals.
I have read online that these drugs should start to become available the second half of 2018, but of course most of this is dependent on phase testing results. Hopefully, they could be available sooner!
Phase Testing Results:
In phase III testing, Teva Pharmaceuticals’s version was shown to reduce the number of of migraines per month, as well as how often acute medications are used by patients. More than half of patients experienced 50% or greater reduction in headache days after only one week!
Eli Lilly and Company’s phase II results showed a reduction in migraine days with monthly delivery at various dosages when compared to a placebo.
Amgen’s anti-CGRP offering showed a 50% reduction in migraine days in over half of patients within 12 weeks.
How will the drug be administered?
Currently, researchers are exploring different methods of administering the drug to patients. CGRP antagonist medications cannot be administered orally, so companies are debating between subcutaneous injections, intramuscular, or IV administration. IV delivery allows for the largest dosage, but cannot be self administered and require the assistance of a healthcare professional. I use intramuscular injections quite often, and I personally hope that they formulate both options- IV for ER visits, and intramuscular for self-administration at home.
I hope that you found this information helpful and hopeful, as I have. After a lot of tough years, scientists and researchers are making some important steps toward effective treatment. So on your dark days, remember that healing happens, and that people haven’t given up on us!
Here are my sources below, if you would like to do further research: