Medical Toxicology and Headache Center, Policlinic Hospital, University of Modena and Reggio Emilia, Modena, Italy.
Clin Pharmacol Drug Dev. 2017 Nov;6(6):534-547. doi: 10.1002/cpdd.345. Epub 2017 Apr 14.
Migraine, a common neurovascular brain disorder, represents a severe and widespread health problem; along with medication-induced (medication-overuse) headache, it is the third-leading cause of disability worldwide. Currently, its therapeutic management remains unsatisfactory for several reasons; up to 40% of migraineurs are eligible for prophylactic treatment, but there are issues of efficacy, safety, and adherence. In recent years the evidence on the role of calcitonin gene-related peptide (CGRP) in migraine pathophysiology has been consolidated, so new and promising treatments for migraine pain and its possible prevention have been developed. The following review reports the results of the clinical trials conducted so far with each of the new monoclonal antibodies targeting CGRP or its receptor, with particular reference to safety, tolerance, and efficacy in migraine prevention. Moreover, the pharmacological characterization and further developments of each monoclonal antibody are reported, based on current knowledge.
偏头痛是一种常见的神经血管性脑疾病，代表着一种严重且广泛存在的健康问题；偏头痛与药物诱导性（药物过度使用）头痛一起，是全球第三大致残原因。目前，由于多种原因，其治疗管理仍不尽人意；多达 40%的偏头痛患者有资格接受预防性治疗，但存在疗效、安全性和依从性等问题。近年来，降钙素基因相关肽（CGRP）在偏头痛病理生理学中的作用的证据得到了巩固，因此针对偏头痛疼痛及其可能预防的新的、有前途的治疗方法已经得到了开发。以下综述报告了迄今为止针对 CGRP 或其受体的每种新型单克隆抗体进行的临床试验的结果，特别关注偏头痛预防中的安全性、耐受性和疗效。此外，根据现有知识，报告了每种单克隆抗体的药理学特征和进一步发展。
