頭痛の予防―抗体医薬の登場

抄録

Migraine is a common, disabling, and recurrent neurological disorder. The guideline published by Japanese Headache Society, based on evidence–based medicine data, is a useful source of guidance, especially for acute and preventive therapies of migraine (Japanese Guideline for Chronic Headache 2013). In acute treatment, we give migraineurs NSAIDs or triptans. In preventive therapy, we usually use calcium blockers, anti–epileptic drugs, anti–depressants, and β–blockers. Among them, lomerizine, verapamil, valproic acid, amitriptyrine, and propranolol have insurance adaptations in Japan. When we prescribe those drugs, we should choose an appropriate preventive drug with an individual patient. However, we cannot get the enough effects from those preventive drugs of migraine. Because those are not specific medicine for migraine. Recently, monoclonal antibody formulations against calcitonin gene–related peptide (CGRP) or its receptor which is one of causative molecules on migraine pathophysiolohy has been developed. Those formulations are more effective in migraine prophylaxis with minimal adverse events compared to existing preventive medicine. In this article, recent advance in CGRP–based migraine therapy and its perspective are discussed.