Abstract
Trigeminal neuralgia is a severe chronic neuropathic pain condition characterised by paroxysmal pain in a region of the face corresponding to one or more divisions of the trigeminal nerve. 1 Cruccu G Di Stefano G Truini A Trigeminal neuralgia. N Engl J Med. 2020; 383: 754-762 Crossref PubMed Scopus (90) Google Scholar Available treatments are not always effective and can be associated with intolerable side-effects. 2 Bendtsen L Zakrzewska JM Abbott J et al. European Academy of Neurology guideline on trigeminal neuralgia. Eur J Neurol. 2019; 26: 831-849 Crossref PubMed Scopus (171) Google Scholar In trigeminal neuralgia, and in neuropathic pain in general, available drugs have all been identified through empirical clinical observations, whereas investigational drugs identified through bottom-up translational approaches have not been efficacious in clinical trials. 3 Finnerup NB Attal N Haroutounian S et al. Pharmacotherapy for neuropathic pain in adults: a systematic review and meta-analysis. Lancet Neurol. 2015; 14: 162-173 Summary Full Text Full Text PDF PubMed Scopus (2042) Google Scholar This situation contrasts with migraine, for which several new drugs have been identified through translational approaches and approved for clinical use, from the triptans in the 1990s to more recent approvals of selective serotonin receptor agonists and drugs targeting calcitonin gene-related peptide (CGRP). Safety and efficacy of erenumab in patients with trigeminal neuralgia in Denmark: a double-blind, randomised, placebo-controlled, proof-of-concept studyErenumab did not reduce pain intensity compared with placebo in patients with trigeminal neuralgia and CGRP probably does not have an important role in paroxysmal pain. Well tolerated, effective treatments in trigeminal neuralgia are still needed. Full-Text PDF
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