The Next Migraine Treatment Target
There was an interesting article in The Wall Street Journal this week, "Fresh Target in Hunt for a Migraine Cure." Reporter Shirley Wang did as good a job as I've ever seen in presenting a balanced report on the topic, despite a slightly overblown title.
Wang correctly reported on the need for new abortive medications and some of the problems with current medications including their only working for about 60% of Migraineurs and the issue of their not being appropriate for patients with heart or stroke issues. She also brings preventive medications into her report and enlightens readers with accurate statistics on the prevalence and impact of Migraine.
Obviously having done her homework, Wang consulted some of the best experts in the field for this type of report, and she didn't limit herself to New York experts. She could hardly have done better than Lipton, Dodick, Goadsby and Silberstein.
As Wang explains, much of the current medication research is focusing on CGRP (calcitonin gene-related peptide), a neuropeptide thought to have a key role in the pathophysiology of Migraine.
You may remember the excitement surrounding the clinical trials of Merck's Telcagepant a while back and the disappointment when some patients experienced changes in liver enzymes, and the drug was pulled from development. Bristol-Myers Squibb is in the early stages of studying CGRP antagonists and may develop similar drugs.
Along another line, researchers are also working to develop artificial antibodies that would grab onto CGRP in the blood or brain before it reaches the receptors or block the receptors, working on CGRP, but differently than Telcagepant and similar compounds.
Dr. Goadsby told Wang:
"The CGRP story is a story of developing an acute treatment for migraine," says Dr. Goadsby... But the antibody story is testing the larger idea [that] if you blocked continuously CGRP, would you have a preventive treatment."
There's also a video that accompanied this article. Be patient with the sound. Wang's microphone wasn't right at the beginning, but it gets fixed soon...
Wang, Shirley S. "Fresh Target in Hunt for a Migraine Cure." The Wall Street Journal. August 7, 2012.
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