In addition, long-term effects are still unknown. Therefore, blocking CGRP may pose a risk in subjects with comorbidities such as cardiovascular diseases. However, CGRP and its receptor are abundantly present in both the vasculature, and in the peripheral and central nervous system, and are involved in several physiological processes. Thus, blocking CGRP in migraine patients is seemingly both efficient and well tolerated. The drugs have also been well tolerated, except for some of the gepants, which induced a transient increase in transaminases. In addition, the efficacy is in line with other currently used prophylactic treatments. In general, a superior efficacy compared to placebo has been shown, especially with regards to the antibodies. Several trials have been conducted to test the efficacy and safety of these drugs. To date, two different classes of drugs blocking CGRP have been developed: small molecule CGRP receptor antagonists (gepants), and monoclonal antibodies, targeting either CGRP or the CGRP receptor. Here, we review the pros and cons of blocking CGRP in migraine patients. CGRP has been shown to be released during migraine attacks and it may play a causative role in induction of migraine attacks. During the last decade, however, blocking calcitonin gene-related peptide (CGRP) has emerged as a possible mechanism for prevention of migraine attacks. Currently, preventative treatment options for migraine include drugs developed for diseases other than migraine such as hypertension, depression and epilepsy. Migraine is the most prevalent neurological disorder worldwide and it has immense socioeconomic impact.
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