Nissan George R, Kim Richard, Cohen Joshua M, Seminerio Michael J, Krasenbaum Lynda J, Carr Karen, Martin Vincent
North Texas Institute of Neurology & Headache, Plano, TX 75024, USA.
Premier Health Clinical Neuroscience Institute and Department of Internal Medicine and Neurology, Wright State University Boonshoft School of Medicine, Dayton, OH 45409, USA.
J Clin Med. 2022 Jul 27;11(15):4359. doi: 10.3390/jcm11154359.
Migraine is a highly disabling and often chronic neurological disease that affects more than one billion people globally. Preventive migraine treatment is recommended for individuals who have frequent and/or disabling attacks; however, many of the medications used for migraine prevention (e.g., antiepileptics, antidepressants, antihypertensives) were not specifically developed for migraine, and often have limited efficacy or poor tolerability. Four monoclonal antibodies targeting the calcitonin gene-related peptide (CGRP) pathway, which is believed to play a crucial role in the pathophysiology of migraine, have been approved by the US Food and Drug Administration for the preventive treatment of migraine in adults. All four migraine-specific treatments have demonstrated efficacy based on reductions in monthly days with migraine for patients with both episodic and chronic migraine, including those with comorbidities. They have also demonstrated favorable safety and tolerability profiles. Based on these accounts, CGRP pathway-targeted monoclonal antibodies have the potential to revolutionize preventive treatment for patients with migraine.
偏头痛是一种极具致残性且通常为慢性的神经疾病，全球有超过10亿人受其影响。对于有频繁发作和/或致残性发作的个体，建议进行偏头痛预防性治疗；然而，许多用于预防偏头痛的药物（如抗癫痫药、抗抑郁药、抗高血压药）并非专门为偏头痛研发，且往往疗效有限或耐受性差。四种靶向降钙素基因相关肽（CGRP）途径的单克隆抗体已获美国食品药品监督管理局批准，用于成人偏头痛的预防性治疗。据信，CGRP途径在偏头痛的病理生理学中起关键作用。所有这四种针对偏头痛的特异性治疗方法，都已证明对发作性和慢性偏头痛患者（包括患有合并症的患者）有效，可减少每月偏头痛发作天数。它们还显示出良好的安全性和耐受性。基于这些情况，靶向CGRP途径的单克隆抗体有可能彻底改变偏头痛患者的预防性治疗。
