Targeting the PACAP-38 pathway is an emerging therapeutic strategy for migraine prevention.
Expert Opin Emerg Drugs
; 29(1): 57-64, 2024 Mar.
Article
in En
| MEDLINE
| ID: mdl-38337150
ABSTRACT
INTRODUCTION:
The pituitary adenylate cyclase-activating polypeptide-38 (PACAP-38) has emerged as a key mediator of migraine pathogenesis. PACAP-38 and its receptors are predominantly distributed in arteries, sensory and parasympathetic neurons of the trigeminovascular system. Phase 2 trials have tested human monoclonal antibodies designed to bind and inhibit PACAP-38 and the pituitary adenylate cyclase-activating polypeptide type I (PAC1) receptor for migraine prevention. AREAS COVERED This review focuses on the significance of the PACAP-38 pathway as a target in migraine prevention. English peer-reviewed articles were searched in PubMed, Scopus and ClinicalTrials.gov electronic databases. EXPERT OPINION A PAC1 receptor monoclonal antibody was not effective for preventing migraine in a proof-of-concept trial, paving the way for alternative strategies to be considered. Lu AG09222 is a humanized monoclonal antibody targeting PACAP-38 that was effective in preventing physiological responses of PACAP38 and reducing monthly migraine days in individuals with migraine. Further studies are necessary to elucidate the clinical utility, long-term safety and cost-effectiveness of therapies targeting the PACAP pathway.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Pituitary Adenylate Cyclase-Activating Polypeptide
/
Migraine Disorders
Limits:
Humans
Language:
En
Year:
2024
Type:
Article