CGRP: A Breakthrough in Migraine Relief

The introduction of Calcitonin Gene-Related Peptide (CGRP) antagonists has made managing migraines a breakthrough. These medications target CGRP, a neuropeptide implicated in the pathophysiology of migraines, to provide both preventive and acute relief.

Preventive CGRP Antagonists

Monoclonal antibodies that inhibit CGRP or its receptor have shown promise in reducing the frequency of migraine episodes. These include:

- Erenumab (Aimovig): [1].

- Fremanezumab (Ajovy): [2].

- Galcanezumab (Emgality): [3]

- Eptinezumab (Vyepti): [4].

These treatments are typically administered via injection, and studies have demonstrated their effectiveness in reducing monthly migraine days. However, they may cause side effects such as injection site reactions and, in rare cases, hypersensitivity reactions.

• Acute CGRP Antagonists (Gepants)

For acute migraine relief, orally administered medications known as gepants are available. These include:

-Rimegepant (Nurtec ODT): Approved for both acute treatment and preventive therapy [5].

-Ubrogepant (Ubrelvy): Used for acute migraine treatment [6].

- Atogepant (Qulipta): Recently approved for preventive migraine therapy [7].

These gepants serve as alternatives for patients who may not tolerate traditional treatments like triptans. Common side effects include nausea, constipation, and fatigue.

• Newest Developments

In March 2023, the FDA approved Zavegepant, a CGRP antagonist, as a nasal spray for acute migraine relief. This nasal formulation offers a non-oral option and provides rapid symptom relief [8].

• Key Considerations

While CGRP antagonists have been revolutionary in migraine treatment, they may not be suitable for everyone. It is essential to consult with a healthcare provider to determine the most appropriate treatment based on your specific medical history and migraine patterns.

For a deeper dive into CGRP therapies, refer to the [NICE guidelines]on CGRP antagonists for migraine management.

1. https://www.webmd.com/migraines-headaches/cgrp-inhibitors-for-migraine

2. https://www.webmd.com/migraines-headaches/cgrp-inhibitors-for-migraine

3. https://www.healthline.com/health/migraine/cgrp-migraine

4. https://www.health.harvard.edu/blog/cgrp-new-era-migraine-treatment-2018030513315

5. https://www.webmd.com/migraines-headaches/cgrp-inhibitors-for-migraine

6. https://www.healthline.com/health/migraine/cgrp-migraine

7. https://www.healthline.com/health/migraine/cgrp-migraine

8. https://www.health.harvard.edu/blog/cgrp-new-era-migraine-treatment-2018030513315