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新一代头痛裤:偏头痛急性和预防性药物。

New Generation Gepants: Migraine Acute and Preventive Medications.

作者信息

Moreno-Ajona David, Villar-Martínez María Dolores, Goadsby Peter J

机构信息

Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 9PJ, UK.

NIHR-Wellcome Trust King's Clinical Research Facility/SLaM Biomedical Research Centre, King's College Hospital, London SE5 9RS, UK.

出版信息

J Clin Med. 2022 Mar 16;11(6):1656. doi: 10.3390/jcm11061656.


DOI:10.3390/jcm11061656
PMID:35329982
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8953732/
Abstract

Migraine is a debilitating disease whose clinical and social impact is out of debate. Tolerability issues, interactions, contraindications, and inefficacy of the available medications make new options necessary. The calcitonin-gene-related peptide (CGRP) pathway has shown its importance in migraine pathophysiology and specific medications targeting this have become available. The first-generation CGRP receptor antagonists or gepants, have undergone clinical trials but their development was stopped because of hepatotoxicity. The new generation of gepants, however, are efficacious, safe, and well tolerated as per recent clinical trials. This led to the FDA-approval of rimegepant, ubrogepant, and atogepant. The clinical trials of the available gepants and some of the newer CGRP-antagonists are reviewed in this article.

摘要

偏头痛是一种使人衰弱的疾病,其临床和社会影响无可争议。现有药物的耐受性问题、相互作用、禁忌症和无效性使得有必要开发新的选择。降钙素基因相关肽(CGRP)通路在偏头痛病理生理学中已显示出其重要性,针对该通路的特定药物已经问世。第一代CGRP受体拮抗剂或gepants已经过临床试验,但由于肝毒性,其开发已停止。然而,根据最近的临床试验,新一代的gepants有效、安全且耐受性良好。这导致rimegepant、ubrogepant和atogepant获得了美国食品药品监督管理局(FDA)的批准。本文对现有gepants和一些新型CGRP拮抗剂的临床试验进行了综述。

相似文献

[1]
New Generation Gepants: Migraine Acute and Preventive Medications.

J Clin Med. 2022-3-16

[2]
Gepants for Acute and Preventive Migraine Treatment: A Narrative Review.

Brain Sci. 2022-11-24

[3]
Calcitonin gene-related peptide (CGRP)-targeted therapies as preventive and acute treatments for migraine-The monoclonal antibodies and gepants.

Prog Brain Res. 2020

[4]
Gepants, calcitonin-gene-related peptide receptor antagonists: what could be their role in migraine treatment?

Curr Opin Neurol. 2020-6

[5]
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Expert Opin Pharmacother. 2023-6

[6]
Raynaud's phenomenon associated with calcitonin gene-related peptide receptor antagonists case report.

Headache. 2022-11

[7]
CGRP receptor antagonists (gepants).

Handb Clin Neurol. 2024

[8]
History and Review of anti-Calcitonin Gene-Related Peptide (CGRP) Therapies: From Translational Research to Treatment.

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[9]
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[10]
Real-world study of adverse events associated with gepant use in migraine treatment based on the VigiAccess and U.S. Food and Drug Administration's adverse event reporting system databases.

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引用本文的文献

[1]
"The efficacy and safety of Atogepant for migraine prophylaxis: a systematic review and meta-analysis of randomized controlled trials".

BMC Neurol. 2025-8-9

[2]
Population Pharmacokinetic Modeling of the Oral Calcitonin Gene-Related Peptide Receptor Antagonist Rimegepant in Adults.

CPT Pharmacometrics Syst Pharmacol. 2025-8

[3]
Gepants in Primary Care: A Targeted Approach to Acute and Preventive Treatment of Migraine.

Pain Ther. 2025-6-27

[4]
Adverse events associated with gepants: a pharmacovigilance analysis based on the FDA adverse event reporting system.

J Headache Pain. 2025-6-23

[5]
Safety evaluation and optimization of high-efficiency expression of 5hsCT in Saccharomyces cerevisiae.

Biotechnol Lett. 2025-6-14

[6]
US Real-World Effectiveness, Tolerability, and Healthcare Resource Utilization After Addition of Fremanezumab for Preventive Treatment in Patients Using Gepants for Acute Treatment of Migraine: Results From a Retrospective Chart Review.

Adv Ther. 2025-2

[7]
Effectiveness and tolerability of rimegepant in the acute treatment of migraine: a real-world, prospective, multicentric study (GAINER study).

J Headache Pain. 2025-1-6

[8]
Population pharmacokinetic modeling of zavegepant, a calcitonin gene-related peptide receptor antagonist, in healthy adults and patients with migraine.

CPT Pharmacometrics Syst Pharmacol. 2025-1

[9]
CGRP therapy in primary care for migraine: prevention and acute medication.

Br J Gen Pract. 2024-10-31

[10]
MetaCGRP is a high-precision meta-model for large-scale identification of CGRP inhibitors using multi-view information.

Sci Rep. 2024-10-21

本文引用的文献

[1]
Effect of Atogepant for Preventive Migraine Treatment on Patient-Reported Outcomes in the Randomized, Double-blind, Phase 3 ADVANCE Trial.

Neurology. 2023-2-21

[2]
Atogepant for the Preventive Treatment of Migraine.

N Engl J Med. 2021-8-19

[3]
Targets for migraine treatment: beyond calcitonin gene-related peptide.

Curr Opin Neurol. 2021-6-1

[4]
Pharmacokinetics and safety of ubrogepant when coadministered with calcitonin gene-related peptide-targeted monoclonal antibody migraine preventives in participants with migraine: A randomized phase 1b drug-drug interaction study.

Headache. 2021-4

[5]
Efficacy of ubrogepant based on prior exposure and response to triptans: A post hoc analysis.

Headache. 2021-3

[6]
Non-interacting, Non-opioid, and Non-barbiturate Containing Acute Medication Combinations in Headache: A Pilot Combinatorics Approach Based on DrugBank Database.

Front Neurol. 2021-2-17

[7]
Oral Rimegepant Safe, Effective for Migraine Prevention.

JAMA. 2021-2-23

[8]
Real-world efficacy, tolerability, and safety of ubrogepant.

Headache. 2021-4

[9]
Single-Dose Pharmacokinetics and Safety of Atogepant in Adults With Hepatic Impairment: Results From an Open-Label, Phase 1 Trial.

Clin Pharmacol Drug Dev. 2021-7

[10]
NICE guideline on long COVID.

Lancet Respir Med. 2021-2

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