Ground­break­ing mi­graine pre­ven­tion drugs just smashed clin­i­cal tri­als

Tehran Times - - SCI / MED - (Source: sci­enceal­ert.com)

A se­ries of late-stage drug tri­als are show­ing great prom­ise for a com­pletely new gen­er­a­tion of mi­graine pre­ven­tion drugs, which could hit the mar­ket as early as next year.

For the mil­lions of mi­graine suf­fer­ers around the world, this is the most wel­come news in decades, as cur­rent treat­ment op­tions are lim­ited and no mi­graine-spe­cific pre­ven­tion drugs even ex­isted - un­til now.

Th­ese new drugs are mon­o­clonal an­ti­bod­ies - lab-made pro­teins of the kind that our im­mune sys­tem de­ploys to tar­get var­i­ous sub­stances in the body. In the case of mi­graine, th­ese an­ti­bod­ies tar­get CGRP (cal­ci­tonin gene-re­lated pep­tide), a mol­e­cule known to play a role in mi­graines.

Al­though peo­ple some­times think of mi­graines as a type of bad headache, the de­bil­i­tat­ing con­di­tion ac­tu­ally comes with a host of symp­toms in­clud­ing nausea, vom­it­ing, light and noise sen­si­tiv­ity, and fa­tigue.

Mi­graine at­tack

A mi­graine at­tack can last from a few hours to sev­eral days, and the vast ma­jor­ity of suf­fer­ers - over 90 per­cent - have episodic mi­graine, which means fewer than 15 days per month. Chronic mi­graine can be more than 15 days per month, and can have se­vere ef­fects on one’s well­be­ing.

Any­one who’s strug­gled with mi­graines will know there’s a bunch of med­i­ca­tions out there to try. For ex­am­ple, there are a few mi­graine-spe­cific drugs peo­ple can take as ‘res­cue’ medicine when a mi­graine at­tack hap­pens. Ad­di­tion­ally, for more fre­quent mi­graines a pa­tient can try to take one or more med­i­ca­tions to pre­vent the at­tacks. But none of those drugs were ac­tu­ally de­vel­oped specif­i­cally for mi­graines - in­stead, they are things like anti-de­pres­sants, blood pres­sure med­i­ca­tion or anti-epilepsy drugs, of­ten with se­ri­ous side-ef­fects.

Which is why this new class of CGRP-tar­get­ing drugs is such a big deal. And two high-qual­ity stud­ies pub­lished last week in the New Eng­land Jour­nal of Medicine show that phar­ma­ceu­ti­cal com­pa­nies are on the right path.

One of th­ese tri­als called STRIVE tested in­jec­tions of the drug erenumab as a pre­ven­ta­tive for episodic mi­graine in 955 pa­tients across 121 study sites over the span of six months.

Episodic mi­graine

The team found that in their study pop­u­la­tion of episodic mi­graines with a base­line of 8.3 at­tack days per month, erenumab could re­duce that num­ber by 3.2 days at a 70-mg dose and by 3.7 days at a higher, 140-mg dose.

In the higher-dose group, half of the pa­tients ex­pe­ri­enced a 50 per­cent or greater re­duc­tion of the mean num­ber of mi­graine days, which means that from all the days they’d lose to a mi­graine ev­ery month, they got at least half of that pre­cious time back.

The “re­sults of STRIVE rep­re­sent a real tran­si­tion for mi­graine pa­tients from poorly un­der­stood, re­pur­posed treat­ments, to a spe­cific mi­graine-de­signed ther­apy,” says lead re­searcher Peter Goadsby from King’s Col­lege Hos­pi­tal in Lon­don and NIHR-Well­come Trust King’s Clin­i­cal Re­search Fa­cil­ity.

A mi­graine at­tack can last from a few hours to sev­eral days, and the vast ma­jor­ity of suf­fer­ers - over 90 per­cent - have episodic mi­graine, which means fewer than 15 days per month.

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