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New Migraine-Prevention Drugs Show Promise

Researchers excited about results with monoclonal antibodies

Migraine researchers and clinicians are becoming increasingly interested in a new class of drugs called calcitonin gene-related peptide (CGRP) monoclonal antibodies, which have shown promise in treating high-frequency episodic migraine and chronic migraine, according to a report from the American Headache Society (AHS).

“This development is a transformative moment in migraine treatment,” said Peter J. Goadsby, MD, PhD, chair of the scientific program of the AHS’s annual scientific meeting, to be held June 18–21 in Washington, D.C.

“There’s no question that we need something better. In fact, for prevention we really need something designed specifically for migraine,” he said, noting that there has not been a new class of antimigraine drugs since the development of triptans in 1991.

“Up till now, migraine patients have had limited choices for preventive treatment. Now four pharmaceutical companies are showing positive results in human trials targeting CGRP mechanisms,” Goadsby said. Papers on trials of CGRP monoclonal antibodies are being presented at the AHS meeting.

The new class of therapeutic agents appears to reduce elevated levels of CGRP, a key driver of migraine pain. Versions of anti-CGRP therapies are being tested by Alder Pharmaceuticals, Amgen, Eli Lilly, and Teva Pharmaceuticals.

At the AHS meeting, Teva will report phase IIb data showing that its drug, as a preventive treatment of high-frequency episodic migraine (defined as 10 to 14 headache days per month), achieved a significant reduction in the number of headache hours after 1 week, with more than half of patients in each arm experiencing a 50% or greater reduction in headache frequency. Lilly will present phase II data in episodic migraine (defined as 0 to 14 headache days per month) that established the efficacy of their medication with monthly administration across a range of doses. Amgen will present phase II data for its anti-CGRP product, showing that the drug reduced the number of migraine days by 50% in approximately half the treated patients after 12 weeks.

“The potential of these new compounds is enormous and gives us real hope that effective specific treatments for migraine may be on the near horizon,” Goadsby said. “The development of CGRP antibodies offers the simple, yet elegant, and long-awaited option for migraine patients to finally be treated with migraine preventives; it’s a truly landmark development.”

More than 36 million Americans experience migraine attacks –– more than those with asthma and diabetes combined. About 4 million people in the U.S. have chronic migraine or experience more than 15 migraine days a month. Migraine can be disabling and costly, accounting for more than $20 billion in direct (e.g., doctor visits and medications) and indirect (e.g., missed work and lost productivity) expenses each year in the U.S.

Source: EurekAlert; June 17, 2015.

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