2020 Volume 37 Issue 4 Pages 675-679
Migraine is a common and debilitating neurological disorder. In the prophylactic therapy of migraine, centrally–acting calcium blockers, antiepileptic agents, and tricyclic antidepressants are currently used. Nevertheless, alternative therapy is required to treat those who are intractable to these medications. Calcitonin gene–related peptide (CGRP) is abundantly expressed in trigeminal ganglion neurons. Blood CGRP concentrations are increased in some migraine patients, and intravenous administration with CGRP has been shown to induce delayed migraine–like headache attacks almost exclusively in migraineurs. Hence, attempts have been made to develop CGRP–based migraine therapy. Initially, small–molecule CGRP receptor antagonists were developed mainly for acute therapy. In addition, there was a motion to use monoclonal antibodies targeting CGRP or its receptor for migraine prevention. Large–scale placebo–controlled double–blind randomized clinical trials have demonstrated the safety and efficacy of these monoclonal antibodies. In this article, recent advances in migraine therapy based on CGRP–related antibodies and its perspective are discussed.
