Barbanti Piero, Aurilia Cinzia, Fofi Luisa, Egeo Gabriella, Ferroni Patrizia
Headache and Pain Unit, Department of Neurological, Motor and Sensorial Sciences, IRCCS San Raffaele Pisana, Via della Pisana 235, 00163, Rome, Italy.
Department of Human Sciences and Quality of Life Promotion, San Raffaele Roma Open University, Rome, Italy.
Neurol Sci. 2017 May;38(Suppl 1):31-35. doi: 10.1007/s10072-017-2907-8.
Calcitonin gene-related peptide (CGRP), a potent vasodilator and pain-signaling neuropeptide, is a validated therapeutic target for migraine and cluster headache. Four anti-CGRP monoclonal antibodies (mAbs) have been developed, representing the first specific, mechanism-based, migraine prophylactic treatment. CGRP mAbs demonstrated good efficacy coupled to excellent tolerability and safety in 5 phase II clinical trials. Notably, CGRP mAbs induced complete migraine remission in a patients' subset. To date, more than 20 phase III trials using CGRP mAbs for of episodic and chronic migraine and cluster headache prevention are ongoing. Future investigations will shed light on migraine endophenotypes predictive of good CGRP mAbs responsiveness and provide answers on their long-term cardiovascular safety.
降钙素基因相关肽(CGRP)是一种强效血管舒张剂和疼痛信号神经肽,是偏头痛和丛集性头痛已得到验证的治疗靶点。已研发出四种抗CGRP单克隆抗体(mAb),代表了首个基于机制的特异性偏头痛预防性治疗方法。在5项II期临床试验中,CGRP单克隆抗体显示出良好的疗效,同时具有出色的耐受性和安全性。值得注意的是,CGRP单克隆抗体在一部分患者中诱导了偏头痛的完全缓解。迄今为止,有20多项使用CGRP单克隆抗体预防发作性和慢性偏头痛及丛集性头痛的III期试验正在进行。未来的研究将阐明可预测CGRP单克隆抗体良好反应性的偏头痛内表型,并提供有关其长期心血管安全性的答案。