Basic & Clinical Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom.
NIHR-Wellcome Trust King's Clinical Research Facility/SLaM Biomedical Research Centre, King's College Hospital, SE5 9RS, London, United Kingdom.
Pain Manag. 2021 Mar;11(2):113-121. doi: 10.2217/pmt-2020-0075. Epub 2020 Dec 7.
Our knowledge of the pathophysiology of migraine and the molecules implicated in the disorder have evolved over time. Among these, calcitonin gene-related peptide has shown a crucial role that led to the development of therapies specifically targeting the molecule. Four monoclonal antibodies targeting the calcitonin gene-related peptide pathway are currently available after the US FDA approval of eptinezumab for the indication of migraine prevention. This is the only one of the class to be administered intravenously. The pharmacology of eptinezumab and the four studies that led to the approval, two Phase II and two Phase III clinical trials, are reviewed in this paper. Eptinezumab has demonstrated efficacy, tolerability and safety in patients with episodic and chronic migraine. Studies including migraineurs who have failed previous preventives, and comparison with other options administered quarterly, as well as real-world experience data will all be welcome.
我们对偏头痛病理生理学和涉及该疾病的分子的认识随着时间的推移而不断发展。在这些分子中，降钙素基因相关肽（Calcitonin Gene-Related Peptide，CGRP）显示出关键作用，这导致了专门针对该分子的治疗方法的发展。在美国食品药品监督管理局（FDA）批准依替利珠单抗（Eptinezumab）用于偏头痛预防后，目前已有四种针对降钙素基因相关肽途径的单克隆抗体可供使用。依替利珠单抗是唯一一种静脉注射给药的药物。本文综述了依替利珠单抗的药理学以及导致其获批的四项研究，其中两项为 II 期临床试验，两项为 III 期临床试验。依替利珠单抗在发作性和慢性偏头痛患者中表现出疗效、耐受性和安全性。包括对先前预防治疗失败的偏头痛患者的研究，以及与每季度给药的其他选择的比较，以及真实世界经验数据，都将受到欢迎。
