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Review
. 2021 Jul 20;14(7):700.
doi: 10.3390/ph14070700.

Monoclonal Antibodies Targeting CGRP: From Clinical Studies to Real-World Evidence-What Do We Know So Far?

Theodoros Mavridis  1 , Christina I Deligianni  2 , Georgios Karagiorgis  3 , Ariadne Daponte  1 , Marianthi Breza  1 , Dimos D Mitsikostas  1
Affiliations
Review

Monoclonal Antibodies Targeting CGRP: From Clinical Studies to Real-World Evidence-What Do We Know So Far?

Theodoros Mavridis et al. Pharmaceuticals (Basel). .

Abstract

Now more than ever is the time of monoclonal antibody use in neurology. In headaches, disease-specific and mechanism-based treatments existed only for symptomatic management of migraines (i.e., triptans), while the standard prophylactic anti-migraine treatments consist of non-specific and repurposed drugs that share limited safety profiles and high risk for interactions with other medications, resulting in rundown adherence rates. Recent advances in headache science have increased our understanding of the role of calcitonin gene relate peptide (CGRP) and pituitary adenylate cyclase-activating polypeptide (PACAP) pathways in cephalic pain neurotransmission and peripheral or central sensitization, leading to the development of monoclonal antibodies (mAbs) or small molecules targeting these neuropeptides or their receptors. Large scale randomized clinical trials confirmed that inhibition of the CGRP system attenuates migraine, while the PACAP mediated nociception is still under scientific and clinical investigation. In this review, we provide the latest clinical evidence for the use of anti-CGRP in migraine prevention with emphasis on efficacy and safety outcomes from Phase III and real-world studies.

Keywords: CGRP; calcitonin gene-related peptide; eptinezumab; erenumab; fremanezumab; galcanezumab.

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Conflict of interest statement

T.M. has received travel grants from Merck and Sanofi-Genzyme. C.I.D. declares no conflict of interest. G.K. declares no conflict of interest. A.D. declares no conflict of interest. M.B. has received travel grants from Genesis Pharma, Teva-Specifar, Pfizer, Sanofi-Genzyme, Novartis, and G.E Healthcare. D.D.M. has received consulting, research, speaking fees and/or travel grants from Allergan, Amgen, Bayer, Biogen, Cefaly, ElectroCore, Eli-Lily, Genesis Pharma, Merck-Serono, Merz, Mylan, Novartis, Roche, Sanofi-Genzyme, Specifar, and Teva.

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