Calcitonin gene-related peptide-targeting drugs for migraine: how pharmacology might inform treatment decisions.
Lancet Neurol
; 21(3): 284-294, 2022 03.
Article
em En
| MEDLINE
| ID: mdl-35093196
ABSTRACT
Migraine is the second most disabling disorder across all age groups worldwide. Since 2018, two classes of drugs that inhibit the actions of calcitonin gene-related peptide (CGRP), which is implicated in migraine pathophysiology, have become available gepants (CGRP receptor antagonists) and monoclonal antibodies directed against CGRP or its receptor. Despite phase 3 clinical trials and some real world evidence, knowledge of the pharmacology and related clinical effects of these drugs is low, and trial data are not necessarily generalisable to all populations. Additionally, several pharmacodynamic processes affected by both gepants and monoclonal antibodies to CGRP and its receptor are not fully understood. Sex, body-mass index, age, ethnic background, and other characteristics, which are subject to considerable variation, might affect the pharmacokinetics of these therapies, especially gepants. If studies confirm this possibility, these characteristics could assist clinicians in choosing the optimal treatment for patients with migraine. The choice between a gepant or monoclonal antibody should be made carefully, taking into consideration a patient's comorbidities and preferences. As more becomes known about CGRP-targeted therapies, management based on the characteristics of patients could have a more prominent role in the treatment of migraine.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Peptídeo Relacionado com Gene de Calcitonina
/
Transtornos de Enxaqueca
Tipo de estudo:
Prognostic_studies
Limite:
Humans
Idioma:
En
Revista:
Lancet Neurol
Assunto da revista:
NEUROLOGIA
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Holanda