CGRP and Migraine Attacks
CGRP and Migraine Attacks
Olcegepant as a Treatment for Migraine Attacks
CGRP and Migraine Attacks
Research is leading to a better understanding of the severe headaches which come with migraines, and the result could be further treatment options.
A natural chemical called CGRP (the long name is calcitonin gene-related peptide) has been found in parts of the brain and the cranial nerves. These are the nerves which have the job of supplying pain signals from the scalp and head. CGRP appears to be a signal transmitter in these areas and in particular, is able to cause blood vessels near it to open wider, and dramatically increase blood flow. In people who develop migraines, the throbbing headache is due to an opening of blood vessels in the head, and CGRP appears to be part of this process.
Olcegepant as a Treatment for Migraine Attacks
A medicine has been found, named olcegepant, which can block the effects of the CGRP in the migraine process. This represents an entirely new and very specific potential treatment for migraine. Initial safety and effectiveness testing has suggested no serious adverse effects. Trials of the best route of delivery of the drug, and the evaluation of olcegepant against existing medications, are underway. Until then, it is not available in Australia.
(This article was kindly written by Professor Mervyn Eadie, Virtual Neuro Centre Editorial Advisory Board member).
Reference
- Arulmani U, Ven Den Brink AM, Villalon CM, Saxena PR. Calcitonin gene related peptide and its role in migraine pathogenesis. European Journal of Pharmacology 2004;500:315-330.
- Goadsby PJ. Calcitonin gene-related peptide antagonists as treatments of migraine and other primary headaches. Drugs 2005;65:2557-2567.
- Edvinsson L. Correlation between CGRP and migraine attacks. Cephalalgia 2005;25:163-164.
- Olesen J, Diener H-C, Husstedt IW, et al. Calcitonin gene-related peptide receptor antagonist BIBN 4096 BS for the acute treatment of migraine. New England Journal of Medicine 2004;350:1104-1110.
- Edvinsson L. Blockade of CGRP receptors in the intracranial vasculature: a new target in the treatment of headache. Cephalalgia 2004;24:611-622.
- Petersen KA, Birk S, Lassen LH, et al. The CGRP-antagonist, BIBN4096BS does not affect cerebral or systemic haemodynamics in healthy volunteers. Cephalalgia 2005;25:139-147.
- Iovino M, Feifel U, Yong C-I, Wolters J-M, Wallenstrin G. Safety, tolerability and pharmacokinetics of BIBN 4096 BS, the first selective small molecule calcitonin gene-related peptide receptor antagonist, following single intravenous administration in healthy volunteers. Cephalalgia 2004;24:645-656.
- Troconiz IF, Wolters J-M, Schaefer HG, Roth W. Population pharmacokinetic modelling of BIBN 4096 BS, the first compound of a new class of calcitonin gene-related peptide receptor antagonists. European Journal of Pharmaceutical Science 2004;22:287-295.
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