Preventing and treating migraines by blocking calcitonin gene-related peptide (CGRP) has become ever more significant, an expert said.
Kim Byung-kun, a professor of the Neurology Department at Nowon Eulji Medical Center, explained the pathophysiology of migraines and clinical implications of the emergence of preventive treatments targeting CGRP, at a symposium to launch Lilly’s migraine drug Emgality (ingredient: galcanezumab) during the Korean Headache Society’s conference on Sunday.
According to Kim, a migraine is a complex neurological disorder with headaches, flashes, light phobias, and sound phobias. Migraine patients aged under 50 suffer a severe degree of disability. Many studies have found that most migraine patients have genetic and neurological dysfunction. If their trigeminal nerve is activated, it causes migraine with vasodilation, he said.
“To date, researchers deemed neurotransmitters such as serotonin, CGRP, PACAP, and P substances as main contributors to the trigeminal neurovascular activity. Among them, CGRP is most closely related to migraine,” Kim emphasized.
CGRP, one of the most neuropeptides in the trigeminal neurovascular system, began to draw attention as researchers have discovered that the levels of CGRP rose during migraine attacks.
Although scholars have not fully identified the pathophysiology of migraine, studies have shown that blocking CGRP reduced migraine symptoms and was associated with photophobia.
Kim said migraine treatments that block CGRP could show an innovative efficacy.
Emgality is a humanized IgG4 (Immunoglobulin G-4) monoclonal antibody that binds to CGRP molecules and blocks the binding of CGRP and receptors, Kim noted.
“Emgality has recently been approved as a preventive treatment for adult migraine patients. Any adults who need migraine prevention can use it,” he said. “Prophylactic drugs for migraines used to have various side effects because the preventive mechanism was unclear. However, Emgality has relatively fewer side effects.”
Earlier this year, the American Headache Society (AHS) revised its migraine treatment guidelines to included CGRP-targeted therapeutics as recommended preventive treatments.
“With the arrival of a treatment option to reduce pain and improve the quality of life of migraine patients in Korea, I hope that physicians could become more active in providing preventive treatment for migraines,” Kim said.