Moreno-Ajona David, Villar-Martínez María Dolores, Goadsby Peter J
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.
J Clin Med. 2022 Mar 16;11(6):1656. doi: 10.3390/jcm11061656.
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.
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。
