Have you heard about the new Migraine and cluster headache preventives in development? These calcitonin gene-related peptide (CGRP) monoclonal antibodies have shown promising results in clinical trials. Doctors and patients impatiently wait for news amid rampant speculation about projected cost and accessibility. Concerns about insurance coverage and out-of-pocket expenses run deep.
Setting aside these practical concerns, there are still many reasons to remain hopeful. After all, these new medications will be the only treatments on the market specifically created to prevent both episodic and chronic Migraine and cluster headache. In fact, if approved, these drugs will be the first and only FDA-approved medications for the prevention of cluster headache.
Let that sink in for a moment. We are finally about to have access to medications made just for Migraine and cluster headache. These medications are not “off label.” We will have true Migraine and cluster headache treatments. For patients who’ve not had success with current treatments, this new class of preventives offers renewed hope.
Four new preventives
We have four pharmaceutical companies to thank for this. These medications are delivered by IV infusion, intramuscular injection, or subcutaneous injection; doses are given monthly or quarterly.
Familiarize yourself with their names. We’ll be seeing a lot of them in the coming years.
- Eptinezumab was developed by Alder Biopharmaceuticals and is being tested for episodic and chronic migraine.
- Erenumab was developed by Amgen, and is now partnering with Novartis for distribution and marketing. It is projected to be the first CGRP monoclonal antibody available by prescription sometime in 2018. Amgen submitted an application to the U.S. Food and Drug Administration (FDA) on May 18, 2017.
- Fremanezumab was developed by Teva Pharmaceutical Industries, Ltd., and is being tested for the prevention of episodic Migraine, chronic Migraine, and cluster headache.
- Galcanezumab was developed by Eli Lilly and is being tested for episodic and chronic Migraine and cluster headache.
So far, research findings on CGRPs include:
Reduced frequency of migraine attacks
Reduced use of Migraine abortives
Increased number of consecutive Migraine-free days
Relief of nausea, vomiting, phonophobia, and photophobia
Patient-reported improvements in quality of life
Improvements that occur within one week of the first dose
Adverse events were mild and similar to placebo; the most common side effect was injection site irritation.
See more helpful articles:
59th Annual Scientific Meeting American Headache Society June 8 - 11, 2017 Westin Boston Waterfront Boston, MA. Headache: The Journal of Head and Face Pain, 57: 113–226. doi:10.1111/head.13102.
Reviewed by David Watson, MD.
© Tammy Rome, 2017.
Headache disorders counselor and advocate Tammy Rome maintains a private practice specializing in treating clients with Migraine and other headache disorders. She also volunteers as vice chair of the American Headache and Migraine Association and as president of The Cluster Headache Support Group. You can read more of Tammy’s work on her website and follow her on Facebook, Twitter, StumbleUpon, Pinterest, LinkedIn, and Google+.