The latest on the revolutionary drug created specifically for migraine prevention
A new type of migraine treatment has shown promising results and is on its way to FDA approval. The treatment—known as anti CGRPs, because they target the calcitonin gene-related peptide—works by blocking this neurotransmitter’s communication with the brain. The level of CGRP proteins in the brain rises significantly during migraine attacks, leading researchers to suspect they may be the underlying cause of the disease. According to Dr. Amaal Starling, Assistant Professor of Neurology at the Mayo Clinic in Phoenix, Ariz, clinical trials for this treatment have shown exceptional results.
In a recent Facebook live chat hosted by the American Migraine Foundation, Starling discussed the benefits and drawbacks of anti CGRP treatment, and answered questions from people with migraine looking to get involved in its development now.
Hi! My name is Dr. Amaal Starling from Mayo Clinic in Scottsdale, AZ. Tonight, I will be answering questions regarding anti-CGRP treatment and migraine prevention.Feel free to ask questions!Follow me @AmaalStarling
Posted by American Migraine Foundation on Thursday, January 11, 2018
Benefits and drawbacks
Before anti CGRP treatments were developed, many of the drugs prescribed for migraine were first designed to treat other diseases, but later proved to incidentally reduce migraine symptoms. Conversely, anti CGRP treatments were designed specifically to target the suspected root cause of migraine, and Starling says research suggests they are extremely effective.
“On average, the studies found that there was a reduction of 4 to 6 headache days per month,” Starling said. “In addition, there’s another outcome measure that’s called the ‘50% responder rate’ — That is the proportion of patients that had 50% or less headache days that month.”
Another benefit of these treatments is how quickly they work. In one study, patients saw results in less than one week—a dramatic reduction from the two to three months it can take for other oral migraine medications to deliver results. Because they work so quickly, the majority of the studies performed so far have been short-term studies, ranging anywhere from 6 to 12 weeks, and patients have had minimal side effects.
“CGRP treatments do seem to work quite well for some patients, and with very minimal side effects, but the majority of these studies are short term studies, ranging anywhere from 6-12 weeks,” Starling said. “They are now doing some longer studies where they’re monitoring these patients over the course of a year, so we don’t know what the long-term side effects are yet.”
The one drawback to anti CGRP treatments is that the molecule involved in treatment is so large that it can’t be delivered in pill form. Instead, it has to be administered with an injection or an infusion using an IV. However, given that the treatment schedule ranges from every two weeks to once every three months, those who have a hard time remembering to take a daily pill might consider this a benefit.
The biggest concern for migraine patients is the affordability and accessibility of these treatments when they do become available. “I don’t know the answer as to how much these treatment options are going to be,” Starling said. “This is what I will tell you: It’s important for you to become a part of the process to ensure that migraine patients that need this treatment, get this treatment in an accessible and affordable way.”
Starling urged migraine advocates to get involved with the Institute for Clinical and Economic Review, also known as ICER, an independent nonprofit organization that weighs the clinical benefit and economic impact of new treatments options in order to set a market fair price.
“It’s up to us to convince insurance companies that the indirect and direct cost of migraine is higher than the cost of medicine, because if we treat people with severe migraine, we can lower both these costs.”
Knowledge is a powerful tool for migraine management, which is why it’s important to stay up to date on news and the latest research. The American Migraine Foundation maintains a comprehensive resource library full of fact sheets, toolkits and advice sourced directly from the nation’s leading migraine specialists, and distributes a monthly newsletter with the latest migraine news you need to know. Visit AMF’s website to learn more and to find a headache doctor near you.
Reviewed for accuracy by the American Migraine Foundation’s subject matter experts, headache specialists and medical advisers with deep knowledge and training in headache medicine. Click here to read about our editorial board members.