Senior Research Project (Restricted)
Migraine headaches, monoclonal antibodies, anti-CGRP, preventative therapy
Anti-Calcitonin Gene Related Peptide Monoclonal Antibodies as Preventative Treatment Against Migraine Headaches
By Laura Wright
Migraine headaches are defined by the Mayo Clinic as “a genetically and environmentally influenced neurological disorder which causes unilateral pain, photophobia, phonophobia, nausea, fatigue and in some cases aura” (Mayo Clinic, 2020). Migraines occur in four major stages: prodrome, aura, attack, and postdrome, each with severe physical and psychological symptoms that impair quality of life severely. These headaches are also a major cause of disability worldwide and directly cost the United States more than 10 billion dollars per year. Migraines can be caused by many factors such as genetics, environmental triggers (stress, medications, weather changes, sleep loss, food, etc.), or neurological abnormalities. Currently, there are several different therapies available to treat migraine headache symptoms including triptans, Botox, or OTC pain relievers, but none work as effective preventative therapies. Additionally, they often cause complications such as medication rebound headaches due to abuse. The purpose of my research was to determine if a new therapy, anti-calcitonin gene related peptide monoclonal antibodies, could be a better option for those who suffer from migraines.
Calcitonin Gene Related Peptide (CGRP), a major vasodilator in the trigeminal system, was first discovered in the 1980’s as one possible cause of migraine attacks. Since that discovery, scientists have formulated a therapy to help stop migraines from occurring. Anti-CGRP monoclonal antibodies (mAbs) were first developed in 2014 to block CGRP from binding to receptors in the trigeminal region. This prevents the vasodilation that is thought to trigger the pain and other symptoms of migraine headaches. This treatment has successfully ameliorated pain in phase 3 trials and is currently out on the market as a monthly subcutaneous injection. Thus far, clinical trials have found no major adverse effects with the only notable side effects being dizziness and inflammation at the site of injection. The trials for this treatment had one notable limitations: they did not examine any long-term effects of the treatment on the body. These studies should be conducted in the near future to ensure the drug’s safety and effectiveness. With the novelty of the drug, areas for future research are wide and diverse and should include effects on other populations (younger/older adults, pregnant women, those with underlying cardiovascular comorbidities/immunosuppression, etc.) and ways to make the treatment more affordable.
Wright, Laura A., "Anti-CGRP Monoclonal Antibodies for Migraine Headaches" (2020). Allied Health Senior Research Projects. 2.
© Laura A. Wright. All rights reserved
Creative Commons License
This work is licensed under a Creative Commons Attribution-No Derivative Works 4.0 License.