Targeting CGRP for migraine treatment: mechanisms, antibodies, small molecules, perspectives.
INTRODUCTION
Calcitonin Gene-Related Peptide (CGRP) has gradually emerged as a suitable therapeutic target to treat migraine. Considering the social and economic burden of migraine, it is fundamental to optimize the disease management with efficacious and safe treatments. In this scenario, drugs targeting GCRP, monoclonal antibodies (MoAbs) and gepants, represent new therapeutic strategies.


AREAS COVERED
In the present work, the authors aim at appraising the main insights and implications of treatments targeting CGRP by reviewing pathophysiology and clinical information.


EXPERT OPINION
Anti-CGRP MoAbs are the first migraine-specific preventive treatments representing a suitable option especially for difficult-to-treat patients. They can be safely administered for long periods even in association with preventatives acting on different targets. Gepants are a safe alternative to triptans for the acute management of migraine and are currently being tested for prevention, thus representing the first transitional molecules for disease therapy. In the future, it might be possible to adapt the treatment according to patients' characteristics and disease phenotype even combining the two treatments targeting the CGRP pathway.
['De Matteis|Eleonora|E|0000-0003-3468-3412', 'Guglielmetti|Martina|M|0000-0002-5567-5297', 'Ornello|Raffaele|R|0000-0001-9501-4031', 'Spuntarelli|Valerio|V|0000-0003-1591-7703', 'Martelletti|Paolo|P|0000-0002-6556-4128', 'Sacco|Simona|S|0000-0003-0651-1939']
D000911:Antibodies, Monoclonal D000077221:Calcitonin Gene-Related Peptide Receptor Antagonists D006801:Humans D008881:Migraine Disorders
Migraine Calcitonin Gene-Related Peptide GCRP atogepant eptinezumab erenumab fremanezumab galcanezumab rimegepant ubrogepant