Developments in targeting calcitonin gene-related peptide.

IF 3.4 2区 医学 Q2 CLINICAL NEUROLOGY Expert Review of Neurotherapeutics Pub Date : 2024-05-01 Epub Date: 2024-04-01 DOI:10.1080/14737175.2024.2332754
Sawsan Alabbad, Nathalia Figueredo, Hsiangkuo Yuan, Stephen Silberstein
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Abstract

Introduction: Calcitonin Gene-Related Peptide (CGRP)-targeted therapy has revolutionized migraine treatment since its first approval in 2018. CGRP-targeted therapy includes monoclonal antibodies (mAbs) and gepants, which modulate trigeminal nociceptive and inflammatory responses, alleviating pain sensitization involved in migraine pathogenesis. CGRP-targeted therapy is effective not only for migraine but also for other chronic headache disorders that share the CGRP pathway.

Areas covered: The authors review the latest developments and evidence for CGRP-targeted therapy for episodic migraine and chronic migraine. In addition, the authors discuss the emerging evidence on response prediction, menstrual migraine, vestibular migraine, idiopathic intracranial hypertension, post-traumatic headache, and the relationship between selected migraine comorbidities and CGRP.

Expert opinion: Since the launch of CGRP-targeted therapy, many practical issues have been raised. Generally, it's safe to combine CGRP-targeted mAbs and gepants; this is an excellent option for patients with partial response. When considering stopping CGRP-targeted therapy, although a disease-modifying effect is likely, the optimal time for discontinuation remains unknown. Finally, beyond migraine, CGRP-targeted therapy may be used for other chronic pain disorders and psychological comorbidities.

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针对降钙素基因相关肽的研究进展。
导言:降钙素基因相关肽(CGRP)靶向疗法自2018年首次获批以来,已彻底改变了偏头痛的治疗。CGRP靶向疗法包括单克隆抗体(mAbs)和凝胶剂,可调节三叉神经痛觉和炎症反应,缓解偏头痛发病机制中的痛觉敏感化。CGRP靶向疗法不仅对偏头痛有效,对其他共享CGRP通路的慢性头痛疾病也同样有效:作者回顾了 CGRP 靶向疗法治疗发作性偏头痛和慢性偏头痛的最新进展和证据。此外,作者还讨论了有关反应预测、月经性偏头痛、前庭性偏头痛、特发性颅内高压、创伤后头痛以及某些偏头痛合并症与 CGRP 之间关系的新证据:自CGRP靶向疗法推出以来,人们提出了许多实际问题。一般来说,联合使用CGRP靶向mAbs和胃药是安全的;对于部分反应的患者来说,这是一个很好的选择。在考虑停止 CGRP 靶向治疗时,虽然可能会产生疾病改变效应,但最佳停药时间仍是未知数。最后,除偏头痛外,CGRP 靶向疗法还可用于其他慢性疼痛疾病和心理合并症。
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来源期刊
Expert Review of Neurotherapeutics
Expert Review of Neurotherapeutics Medicine-Neurology (clinical)
CiteScore
7.00
自引率
2.30%
发文量
61
审稿时长
4-8 weeks
期刊介绍: Expert Review of Neurotherapeutics (ISSN 1473-7175) provides expert reviews on the use of drugs and medicines in clinical neurology and neuropsychiatry. Coverage includes disease management, new medicines and drugs in neurology, therapeutic indications, diagnostics, medical treatment guidelines and neurological diseases such as stroke, epilepsy, Alzheimer''s and Parkinson''s. Comprehensive coverage in each review is complemented by the unique Expert Review format and includes the following sections: Expert Opinion - a personal view of the data presented in the article, a discussion on the developments that are likely to be important in the future, and the avenues of research likely to become exciting as further studies yield more detailed results Article Highlights – an executive summary of the author’s most critical points
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