Department of Neurology, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu, Korea.
Department of Neurology, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea.
Curr Pain Headache Rep. 2023 Oct;27(10):561-569. doi: 10.1007/s11916-023-01167-6. Epub 2023 Sep 1.
Despite the unmet therapeutic needs of patients with chronic migraine (CM) and/or medication overuse, available treatment options are limited. Recently, four calcitonin gene-related peptide receptor antagonists, known as gepants, have been approved for the treatment of migraine. This review focuses on the preventive treatment of CM with gepants and highlights recent findings.
Two randomized controlled trials (RCTs) have shown promising results for rimegepant and atogepant as preventive treatments for CM. In an RCT targeting patients with CM, atogepant demonstrated a significant reduction in the mean monthly migraine days, irrespective of acute medication overuse. Moreover, the patients reported no significant safety concerns and exhibited good tolerance to treatment. These findings highlight the potential of gepants as a new and effective therapeutic option for patients with CM and/or medication overuse. Gepant use will help improve the management and quality of life of individuals with this debilitating condition.
尽管慢性偏头痛(CM)和/或药物过度使用患者存在未满足的治疗需求,但可用的治疗选择有限。最近,四种降钙素基因相关肽受体拮抗剂,即 gepants,已被批准用于偏头痛的治疗。本综述重点介绍了 gepants 治疗 CM 的预防性治疗,并强调了最近的研究结果。
两项随机对照试验(RCT)显示 rimegepant 和 atogepant 作为 CM 的预防性治疗具有有前景的结果。在一项针对 CM 患者的 RCT 中,atogepant 显示出显著减少每月偏头痛天数的作用,无论是否存在急性药物过度使用。此外,患者报告没有明显的安全问题,并且对治疗有良好的耐受性。这些发现突出了 gepants 作为 CM 和/或药物过度使用患者新的有效治疗选择的潜力。使用 gepants 将有助于改善这种使人衰弱的疾病患者的管理和生活质量。