Abstract
Discovering that calcitonin-related peptide (CGRP) plays a key role in the complex pathophysiology of migraine has allowed us to make great strides in the development of new approaches for acute and preventive treatment. This evidence has led to the development of small molecules antagonist molecules of the CGRP receptor (“gepants”) and of a new class of medications called “Ditans”. This review presents the data from clinical trials reporting the efficacy, safety, and tolerability of the new drugs used in the treatment of migraines. Evidences show that therapeutic approaches targeted to CGRP have the potential to transform the clinical management of migraine, even though its appropriate place has yet to be determined with accuracy.
Highlights
We considered only outcomes from randomized controlled trials (RCTs) of adult subjects affected with migraine with or without aura and studies describing the pharmacological treatment of migraine using calcitonin gene-related peptide (CGRP) Receptor Antagonists and the 5-HT1F receptor agonist
The options for a specific treatment for migraine are strongly increased since the introduction of many new approaches to the peptide related to the CGRP receptors
Especially the introduction of specific monoclonal antibodies for migraine has represented a big step forward as well as the development of the new molecules acting as antagonists for the CGRP receptors
Summary
A study carried out in 2016 by the Global Burden of Disease (GBD) classifies migraine as the sixth most widespread and one of the main causes of disability worldwide, as it often manifests in the working ages, in young adults and in women of childbearing age [1]
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